Thomas Giacobbi, DDS, FAGD
Editorial Director, Dentaltown Magazine

Guidance Endodontics, LLC is the brainchild of Charles J. Goodis, DDS, an endodontist with the heart of a philanthropist and a background in mechanical engineering. In addition to Dr. Goodis, Anthony I. Rittenberry, and Neal B. Williams are principals in this Albuquerque, New Mexico based company. The first offering from Guidance, the V-Taper three-file system, launched November 2004, promises smarter and safer endodontics. There is more to this company than endodontic products; Guidance donates a portion of its profits to charities that support disadvantaged women, children, and animals. Recently, I had an opportunity to discuss Guidance Endodontics with Dr. Goodis.

TG: How did your concept for the V-taper System originate and what steps did you take to develop the finished product?

CG: I started working on the variable taper system, or V-Taper, concept 10 years ago. I noticed that constant tapered instruments like a 04, 06, 08, or 10 taper file had too large a diameter in the middle and upper portions of the file. This was preventing the file from naturally advancing into the canal. Roots have decreasing tapers, not constant tapers. That’s why constant tapered files over-shaped the coronal part of the canal and required six to 10 instruments to complete a case.

That’s when I thought about using a variable decreasing taper along the length of the file. Three years ago I started testing prototypes. Then last year I started using the production version of the file. I love it, but most important, the dentists who use V-Taper love it.

The great advantage of using the V-Taper is that the instrument’s variable decreasing taper easily advances into the canal, while not over-preparing the coronal area—and you only need two to three files to complete most cases. That’s amazing.

TG: How did your background in mechanical engineering play a role in the development of the V-taper system?

CG: Mechanical engineering always came very easily to me, so when I noticed file design uses the same concepts, it was a natural extension of what I love.

TG: How has the response been from dentists and endodontists?

CG: Fantastic! Those who are using the system and have taken our hands-on seminar at the American Association of Endodontists Annual Session, California Dental Association Spring Scientific Session, New Mexico Dental Show, and Florida National Dental Congress have had lots of great things to say about it. But, really, the most overwhelming comments have come from that first group of endodontists who purchased the product and have been using it in their practices. They just can’t believe how well these files perform and hold up. In addition, the V-Taper System will be used in five endodontic residency programs in its inaugural year. That’s remarkable. As a designer, I am gratified that the V-Taper system is so well received by the leaders in our field.

TG: What about the three Glide-Path Hand Files?

CG: These are just as amazing as the rotary files. We all know it’s important to form an effective glide-path before using rotary files, but we rarely talk about it—and a new glide-path file has not been introduced in 50 years. The V-Taper Hand Files let us make the glide-path better and more easily because they have the variable taper design, too. All three have a #10 tip but with different tapers—10(V02), 10(V04), 10(V06)—that make a far superior glide-path with fewer files than the standard 02 tapered files. They allow the rotary files to perform better. Again, saving you time and money. That’s what makes the V-Taper Glide-Path Hand Files so special.

TG: What is Endonol® and how is it different from your competitors’ files?

CG: Nitinol (NiTi) comes in a lot of different grades for different uses, of course. Thousands of miles of “cheap” orthodontic wire are made every day. Many file manufacturers use it for their files. Now, it’s fine for ortho-wire, but it doesn’t make a good endodontic rotary file. So at Guidance, we developed our own enhanced Nitinol specifically for endodontic files. That’s Endonol—and it makes the best rotary files in the world.

TG: The file shape is unique, too. What’s the idea behind the Parabolic Cross-Section?

CG: Canal preparation is essentially a deep drilling and reaming application. Look at other fields where they do deep-hole drilling. They don’t use U-shaped or triangular instruments. They use the parabolic cross-section because it’s the best design for this kind of work. We took that into consideration when we developed the V-Taper system.

V-Taper files have a high resistance to fracturing. We designed them that way, with the Safe-Core™ feature, their symmetrical design, the absence of a land—all these help prevent breakage from strain, friction, and overheating.

Triangular files have an excessive clearance angle, which causes canal transportation, but the parabolic cross-section avoids that. And it has a neutral rake angle, so it cuts well without gouging or burnishing the canal walls, which is another way ordinary files get overheated and break.

Plus, if you’re using a torque-control motor that reverses when the torque limit is reached, other file designs will engage dentin in reverse and stress the file. The parabolic cross-section doesn’t cut in reverse, so that problem is eliminated. We also designed it with a non-cutting tip, to prevent ledging and transportation.

TG: Sounds like protection against breakage was a priority in your design.

CG: It was absolutely a priority. And it has paid off. I’ve personally done more than 2,500 root canals with the V-Taper without breaking a single file—which is truly amazing.

Of course, we’re excited about other measures of V-Taper’s performance, too. You can achieve deeper apical shapes and keep coronal preparations conservative. You can create natural-shaped canals that are more like the original anatomy. You get better access for cleaning, irrigating, and obturation. Just higher-quality cases overall.

TG: What steps are necessary to complete a case? Take me from start to finish.

CG: It really is pretty simple. Of course, we start with good straight-line access, and then establish the glide-path using the V-Taper hand files. The hand-file sequence starts with the 10(V02), followed by the 10(V04) and the 10(V06).

Once the glide-path is confirmed to working length with the hand files, we’ll proceed to crown-down shape the coronal or top half of the canal with the V-Taper rotary files: the 30(V10), next the 25(V08), then the 20(V06). Now, we reconfirm the glide-path to the working length using the 10(V02), followed by the 10(V04) and the 10(V06). Then crown-down shape the apical or bottom half of the canal with the V-Taper rotary files: the 30(V10), then the 25(V08), and then the 20(V06) if needed.

The final shape of the canal will correspond to one of the three files: the 30(V10) for larger, easier canals; the 25(V08) for medium canals; or the 20(V06) for smaller, more difficult canals. It’s also helpful to apical gauge the canals.

TG: I understand that your company has gutta percha to match each of the file sizes. What obturation technique do you advocate?

CG: The V-Taper gutta percha is color-coded to match each file size. You can use vertical, lateral, or a single-cone technique to obturate with the V-Taper gutta percha, or continue to use your current gutta percha. You can also use a thermal carrier device to fill your canal.

TG: How many canals can you treat with each file before it should be thrown away?

CG: A good rule for any NiTi rotary file is three or four individual canals—but if the file becomes deformed it should be discarded. That’s true of our files, too. One endodontist told us that at V-Taper’s price, you can use a file only once and you don’t feel guilty.

TG: Are there any other tips for someone adjusting to the three-file system?

CG: Going to the three-file system is really easy—especially for dentists who are making their first venture into rotary files.

Of course, we emphasize good rotary-file fundamentals. That begins with straight-line access. Avoid overheating the files by cutting dentin for less than two seconds, by using a lubricant, and by setting the electric motor between 200 and 400 rpm. It’s also important to identify the location of merging canals, and then shape the most patent canal to working length and the other canal to the merger point. One other tip is to test the glide-path with a straight #10(02) file before using rotary files. If it has a sharp bend, use hand files to shape the canal more before moving on to rotary.

Our Web site, GuidanceEndo.com, has plenty of pointers on using the V-Taper system, as well as other great tips, that can help provide better endodontic outcomes.

TG: With V-Taper being so well received, what’s next on the horizon for Guidance Endodontics?

CG: Wow. We have a lot of great products coming up that are going to revolutionize endodontics, and we have a lot of places to go with V-Taper before we realize its full potential. My goal is to allow all of us to practice smarter, safer endodontics. Whatever we do, now and in the future, I want that to be the principle that guides Guidance.

TG: According to your mission statement, your company is “dedicated to an interlinked concept of Product, Economic and Social prosperity.” Tell me more.

CG: Let’s start by talking about them individually. Our Product Mission is to distribute and sell the best endodontic products in the world while promoting business practices that respect people, the earth, and the environment. Our Economic Mission is to have sustainable growth to expand opportunities for our employees and the company. Our Social Mission is to recognize the role our company can play to help society by improving the quality of life around the world. That’s why we’re committed to helping disadvantaged women, children, and animals—and why a portion of our profits goes to charities for them.

All of these are interlinked to improve the company, but most important, the world. I believe it’s best summed up by paraphrasing one of my heroes, Dr. Martin Luther King, Jr., “Humans and companies strive to be first—strive to succeed—and that can be good. But strive to be first at showing love. Strive to succeed at showing compassion.” Personally, I am striving to be a fraction of Dr. King.

TG: I understand your company offers product specials to Townies. What other ways is Guidance involved with the Dentaltown community? Do you have a dedicated staff member who will respond to inquiries about the V-Taper system on Dentaltown.com?

CG: The Dentaltown community and Townies are the best in the world! That’s why I personally respond to all inquiries on Dentaltown.com. But what’s great about Dentaltown.com is that I learn far more than I could possibly teach. There are so many excellent dentists online and everyone wants to learn and improve. What a great Web site.

TG: I would like to thank Dr. Goodis for taking the time to discuss his company and products with our readers. Personally answering inquiries on Dentaltown.com demonstrates a commitment to education and a quality product. Guidance Endodontics has joined a growing list of companies that have discovered our loyal, inquisitive online community. I will look forward to the next endodontic innovation from Guidance Endodontics.