Clinical Case Spotlight: Effective and Efficient Workflow in Endodontics by Dr. Steven Kalendariov

Categories: Endodontics;
Clinical Case Spotlight: Effective and Efficient Workflow in Endodontics 

Navigating challenging canal morphology with the advanced design of EdgeFile X7 with Fire-Wire


by Dr. Steven Kalendariov


Case presentation
A 28-year-old male patient presented with complaints of lingering hot/cold sensitivity and pain on biting in the left mandibular second molar (#18) (Fig. 1). A clinical examination revealed a large amalgam restoration and radiographic examination showed calcified mesial canals. Patient had pain on percussion and sharp lingering cold sensitivity on endo-ice testing that lasted more than 10 seconds. Clinical and radiographic findings confirmed a diagnosis of symptomatic irreversible pulpitis with symptomatic apical periodontitis. Nonsurgical root canal therapy was recommended.

Clinical Case Spotlight: Effective and Efficient Workflow in Endodontics
Fig. 1
Clinical Case Spotlight: Effective and Efficient Workflow in Endodontics
Fig. 2
Clinical Case Spotlight: Effective and Efficient Workflow in Endodontics
Fig. 3
Clinical Case Spotlight: Effective and Efficient Workflow in Endodontics
Fig.4
Clinical Case Spotlight: Effective and Efficient Workflow in Endodontics
Fig.5
Clinical Case Spotlight: Effective and Efficient Workflow in Endodontics
Fig.6
Clinical Case Spotlight: Effective and Efficient Workflow in Endodontics
Fig.7

Step-by-step procedure
Anesthesia and isolation
The patient was anesthetized with three carpules of 2% lidocaine with 1:100k epinephrine via an inferior alveolar nerve block, along with buccal and lingual infiltrations. A rubber dam was placed to ensure proper isolation.

Access
An endodontic access cavity was prepared with a high-speed handpiece with the EdgeEndo barrel bur diamond extra coarse (Fig. 2) to reduce occlusion and then followed by a surgical 557 bur (Fig. 3). The pulp chamber was found to have three canals (mesiobuccal, mesiolingual and distal) with help of an endodontic explorer DG-16 probe.

Shaping with EdgeFile X7
Working lengths of all three canals were obtained using an electronic apex locater. Using multiple #8 and #10 K-files helped to achieve patency and establish a safe glide path before using the 17.04 EdgeFile X7 down to working length.

  • File sequence. 17.04, 20.04 and 25.04 were used for the mesial canals. 17.04, 20.04, 25.04 and 30.04 were used for the distal canal (Fig.4).
  • Torque and speed. 350 rpm, 3.5 Ncm
  • Irrigation. EdgeEndo 5% NaOCl, followed by EdgeMix (Fig. 5) to disinfect the root canal system.
  • Recapitulation. Used with size #10 file to maintain patency.
Advantages of EdgeFile X7 NiTi Rotary Files:
  • Enhanced flexibility: The EdgeFile X7’s flexible design allows it to follow the natural contours of the canal, minimizing the risk of damaging the tooth.
  • Fire-Wire heat treatment: The proprietary heat treatment enhances the cyclic fatigue resistance and torsional resistance of the file, making it durable and able to withstand demanding conditions.
  • Safety: The flexibility reduces the chances of instrument fracture and perforation, making it a safer option for endodontic procedures.
Final irrigation
Final irrigation was performed using 5% NaOCl followed by saline flush. Sterile paper points were used to dry the canals before obturation.

Obturation
Single-cone obturation technique was used with EdgeSeal and gutta-percha was cut at orifices using the EdgePack WP4504 Tip (Fig. 6). The tooth was temporized with EdgeTemp and the final radiograph shows completed endodontic treatment (Fig. 7), with canals filled properly. Mesial canals converged together and the distal canal shows a little apical curve.


Conclusion
The enhancement of Fire-Wire with the use of the EdgeFile X7 rotary endodontic files makes endodontic therapy, efficient, seamless and predictable. This minimally invasive file technique makes the removal and disinfection of the root canal system increase stability of the tooth and improves prognosis of endodontics. Incorporating these advances in endodontic therapy will help you achieve more efficient and consistent results for your patients and your practice. With proper training and good armamentarium, general dentists can also perform great quality endodontics, starting with the EdgeFile X7 series.

This content is sponsored by EdgeEndo.
To request a product for evaluation, complete the form available at EdgeEndo’s Product Evaluation page: edgeendo.com/product-evaluation.


Author Bio
Dr. Steven Kalendariov Dr. Steven Kalendariov is a general dentist with advanced training in endodontics. A graduate of NYU College of Dentistry, he is committed to patient care, education and clinical excellence. He actively shares root canal cases and insights on social media and remains current through continuing education and active involvement with the American Association of Endodontists.


Sponsors
Townie Perks
Townie® Poll
Who or what do you turn to for most financial advice regarding your practice?
  
Sally Gross, Member Services Specialist
Phone: +1-480-445-9710
Email: sally@farranmedia.com
©2025 Dentaltown, a division of Farran Media • All Rights Reserved
9633 S. 48th Street Suite 200 • Phoenix, AZ 85044 • Phone:+1-480-598-0001 • Fax:+1-480-598-3450