Usually, when there are so many instruments and techniques to do the same job, it tells us that no single technique or instrument has found the answer to accomplishing the task in the easiest, most favorable way when compared to the others.

We can choose from hand instrumentation, rotary or reciprocal handpiece-driven instrumentation, ultrasonic scaler and sonic instrumentation, and any combination of these. Not only are the delivery systems different, but there also are many different types of instruments themselves; for instance, files, reamers, headstroms, etc., and each can be made of either stainless steel or nickel titanium.

Each instrument and its accompanying technique have their own advantages and disadvantages. The key is to find a system to use in which all of the components are made to work together synergistically, such that they result in a procedure that is easy for the dentist to achieve the desired end results.

In this instance, the desired end result is a debrided, clean canal that has been enlarged, shaped, and finished to receive a gutta-percha and sealed obturation. This should be able to be achieved in an easy, quick, not too expensive, predictable, operator friendly manner. The dentist should not have to be Michelangelo to achieve the desired result consistently on every patient.

Let’s work backward for a moment. What size should any canal be enlarged to in order to achieve a successful result? The literature now says at least to a #30 or #35 dental endodontic instrument to the anatomic apex with a taper of .04 mm/mm. Knowing this, we now have our goal.

We can make access, open into the pulp chamber, and find the canals. Once the canals are found, I usually use a size #08 gray reamer to obtain my measurement. The measurement is achieved with the use of an apex locator. The apex locator is the only instrument we have that will give us the measurement to the constriction of the canal. Read the instructions for your apex locator, because each manufacturer marks a different point on its measurement scale indicating where the constriction or anatomic apex is located.