Technical Report - Innovative „Canal Work“

· Morita: Modern solutions for endodontic practices

Coordinated practice solutions from one source offer a great deal of advantages for patients, practitioners and surgery teams. This is the reason why the endodontics specialist Morita has always focused on offering innovative concepts for the complete therapy process – from modern x-ray equipment through ergonomic treatment units to hand instruments and integrated measurement and preparation systems. After all, not only the compatibility of individual components but also the most effective possible workflow are decisive on the path to therapy success. The following article illustrates what complete solutions can offer to the endodontics practice.


As with the endodontist’s day-to-day “canal work”, the focus at Morita is also on the patient and therefore the endeavor to achieve optimum treatment results using high-quality, reliable and safe practice solutions. For this reason, the Japanese dental supplier’s portfolio is always directed towards existing and future practice requirements. The product range includes mature individual modules for patient communication, recording findings, treatment and checkups which, when combined with each other, indicate the optimum workflow – and have been scoring on all fronts for decades with innovative concepts.

The innovative route to therapy success – with modular combination systems  

A great deal of value is already placed on precision right down to the finest detail during the preparation of the access cavity: Modern straight and contra-angle handpieces with particularly small instrument heads ensure better vision and handling properties, particularly in the case of the rear molars (TorqTech straight and contra-angle handpieces), and at the same time maximum torque (TwinPower turbines). A current test phase, for example, provides evidence of the impressive performance of the TwinPower Ultra E Turbine as confirmed by a survey of users [2].  The endodontic contra-angle handpiece TorqTech CA-10RC-Endo is actually directly integrated into the Soaric premium treatment unit preferred by endodontists. Fitted with an internal file electrode for comfortable apex localization, this allows even greater working precision at low speeds.

Exact determination of the operating length is elementary for the subsequent root canal preparation: Introduced at the beginning of the 1990s, Morita’s Root ZX was the first apex locator worldwide with impedance measurement and to this day is the benchmark for determining operating length [1]. The heart of Morita’s modular combination system DentaPort ZX Set OTR is formed by the separate measurement module DentaPort Root ZX which offers the best measurement precision of its class at 97.5 % [3] and can be upgraded with further modules such as a preparation motor (DentaPort TriAuto OTR) or a polymerization lamp (LED module). The latest generation of this modular system with its innovative OTR function (Optimum Torque Reverse) once again sets the standard for automated preparation:  It reduces file breakage to a minimum and offers the practitioner the highest possible degree of safety during preparation. After all, the files used for endodontic procedures are subject to high mechanical forces which under certain circumstances could result in file breakage. Modern measurement and preparation systems are fitted with intelligent safety functions in order to minimize this risk.  In the case of the aforementioned DentaPort ZX Set OTR (Fig. 1), automatic preparation is optimized among other things by the new OTR function:  This combines the advantages of both rotating and the cyclical-reciprocating technologies to take the strain off the file if the preset torque value is exceeded permanently during a 180° forward rotation by reversing through 90° to release itself before returning back to the cutting direction.  In comparison to other safety functions, OTR requires only a small angular rotation of the file to provide an accurate feedback about the existing load. This ensures not only sound operation in the efficient cutting direction but also effectively takes the strain off the file. At the same time, the OTR function increases safety and reduces material wear-and-tear and treatment times because files do not have to be changed so often.

Ergonomic treatment units – the power is in the design  

A typical example among Morita’s endodontic practice solutions of the combination of a high level of clinical functionality with “good looks” is demonstrated by the aforementioned Soaric premium treatment unit: Its impressive features include not only its clinical functionality but also its design – as has already been confirmed by several renowned awards (Fig. 2). In addition, Soaric combines an intelligent structure with an elegant design and provides easy access to the necessary instruments whether operating alone or during four-handed or six-handed treatment procedures. The practitioner can carry out all motor, turbine and scaler settings as well as seat and height adjustments for the patient’s chair easily on the operating panel. The mucosal electrode is integrated into the backrest of the chair: As a consequence, there is no cable to get in the way and there is only a short distance to the patient’s mouth.  The possibility of integrating a variety of microscopes as well as additional monitors also ensures precision “canal work” right down to the finest detail as the practitioner and the surgery team have a direct view into the root canal. In this way, Soaric can be used as individually as necessary for the respective therapy.

Modern diagnostic radiology – a step into the third dimension

Together with the therapeutic procedure, endodontics also benefits not only from conventional x-ray technology but also and increasingly cone-beam computed tomography (CBCT) during diagnosis, planning and monitoring. This increases the 2D imaging by a third dimension and offers a high-resolution display of relevant structures, for example for examining whether specific teeth are worth saving, the exact localization of root canals, in traumatology or for verifying apical translucences. Morita was already setting a standard in this sector in the year 2001 with its 3D Accuitomo CBCT system – one of the first 3D appliances in the world for dental applications.  The 3D Accuitomo 170 offers significant advantages: It excels with high-resolution scans and covers a wide range of indications – all the way from dental diagnoses for endodontic treatment to interdisciplinary applications at the interface to oral and maxillofacial surgery, as well as otorhinolaryngology.

Morita has also played a pioneering role with its combination systems such as Veraviewepocs 3D F40 (2 FOV) or Veraviewepocs 3D R100 (8 FOV) for panoramic, cephalometric and 3D scans and developed products to optimize treatment safety: As with conventional x-ray systems, the practitioner has to weigh up the benefits of high-detail data against patient radiation exposure – for this reason, the user can select a dosage reduction program on Morita’s imaging system to achieve a lower radiation exposure or select the panorama scout with which it is possible to define exactly the required section for a CBCT scan prior to x-raying. With its fields of view (FOV: Ø 40 x 80 mm, Ø 40 x 40 mm), the Veraviewepocs 3D F40 is recommended for use with smaller scanning volumes, e.g. in order to be able to show individual teeth in detail. The F40 can achieve panorama scans at a low dosage using a small aperture.  In this way, the Veraviewepocs F40 is able to provide two and three dimensional scans in optimum quality.

Along with endodontists, colleagues from a wide variety of specialist areas can benefit from Morita’s DVT solutions as they are suitable not only for individual practices but also for group practices and apparatus companies. All Morita 3D-systems are also fitted with i-Dixel software for image processing and visualization which increases efficiency during treatment procedures and supports the endodontic practice on its road into the digital future.

Conclusion

From the ergonomic design of workplaces and instruments to complete functional solutions for diagnostics and therapy – Morita places ultramodern concepts representing the state-of-the-art at the endodontist’s disposal for each treatment stage. Nevertheless, what really counts in the end alongside the broad term of “innovation” is practicality: For this reason, the traditional company is decidedly committed to solutions that are oriented at practice workflow and offer the best conditions with regard to state-of-the-art treatment and advancing digitalization.


Literature

1.     Kobayashi C, Suda H: New electronic canal measuring device based on the ratio method. Journal of Endodontics 20, 111-4, (1994).

2.     Testphase TwinPower Ultra E Turbine, Dental Barometer 8/2014, page 46.

3.     Data available.

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