Managing Curved Root Canal Anatomies
3 Ways Endodontists Should Think Like Golfers
The late, great Arnold Palmer once said, “Golf is deceptively simple and endlessly complicated.” Anyone who performs root canal treatment knows the same holds true for endodontics. The goals of successful treatment may be clear-cut — but cleaning, disinfecting and filling complex and curved root canal anatomies is anything but straightforward.
Jamie Ring, DMD, owns a busy endodontics practice, Foothills Endodontic Specialists, in Westminster, Colorado, near Denver. After performing multiple root canals daily for eight years as a specialist, he knows firsthand the challenges that curved root canal anatomies present — and the rewards of sending successful cases back to his referring providers. Like golf, he sees endodontics as a game of precision. With that insight in mind, here are three lessons from the golf course that also tee up great endodontic outcomes when handling curved root canal anatomies.
1. Drive for show, putt for dough.
This phrase famously coined by World Golf Hall of Famer Bobby Locke sums up the end game of root canal treatment. All the work getting onto the green is for naught if you can’t sink your putt. The same holds true for safely reaching the apex.
“You can have good, proper access and identification of your canals, but if you don’t fully achieve working length, it’s a domino effect. It all goes downhill from there,” said Dr. Ring.
“The final two to three millimeters is where the precision comes in. It’s what defines us as good clinicians,” he said.
2. Know the tools in your bag.
Today’s top golf clubs are engineered with advanced metallurgy and strict tolerances for consistent performance. Your endodontic instruments should deliver predictability as well.
“I’m a big believer in you get what you pay for,” said Dr. Ring. “When I open a pack of WaveOne Gold, I know exactly what I’m getting.” Manufactured in the U.S.A. by Dentsply Sirona, each file is measured for quality assurance down to fractions of a millimeter.
Just like a golfer’s grip, Dr. Ring also appreciates the tactile “feedback” he gets from his WaveOne Gold files, which use reciprocating motion instead of continual rotary motion.
“Reciprocation is not as fast as rotary, so you really have a tactile sensation. It gives me a greater sense of control,” he said.
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3. Watch out for the doglegs.
Navigating severe curves – whether on the course or in a canal – requires your “A” game. When presented with curved root canal anatomies, the hazards are clear: risk of transportation and file separation.
Dr. Ring’s advice for getting around challenging curves is twofold. First, he says that file flexibility is key to avoiding transportation.
He said when he first tried WaveOne Gold, he was immediately taken by the flexibility of the file and the ease with which it allowed him to “abide by what you’re originally given within the tooth.”
“If you alter any internal anatomy, it can lead to possible fractures and inadequate filling and sealing,” he said. “With WaveOne Gold, I don’t see any transportation or deviation from the anatomy.”
His second piece of advice for challenging cases is simply to know when to refer. Dr. Ring regularly hosts study clubs with his robust referral base. Organized by his Dentsply Sirona representative, the informative events build relationships with both current and new referring dentists in his local area.
Perhaps Jack Nicklaus explained it best when he said, “It takes hundreds of good golf shots to gain confidence, but only one bad one to lose it.” It’s always better to refer challenging cases to a specialist, which creates a win for you and your patient.