System-Based Endodontics with WaveOne Gold

Three cases where efficiency meets predictability

By Reid Pullen, DDS FAGD

In the endo world, things don’t always go according to plan, so it’s a beautiful thing when they do. It was another Monday morning in my practice and I had three cases on hard to reach molars lined up back-to-back. To top it off, I also had another endodontist in my office observing so my stress level was higher than normal. But when I start getting stressed, I know I can rely on the efficiency and predictability of system-based endodontics, with all my tools working in concert. That, combined with the basic principles of open orifice, careful negotiation to patency, accurate working length, and an open glide path, helps lead the way.

Radiographs (Click to Enlarge)
Tooth #14 Pre-Op Radiograph #14 Post-Op with System-Based Endodontics
#14 Pre-Op #14 Post-Op
Tooth #15 Pre-Op Radiograph Post-Op Radiograph of Tooth #15 using System-Based Endodontics
#15 Pre-Op #15 Post-Op
Tooth #31 Pre-Op Radiograph System-Based Endodontics on Tooth #31
#31 Pre-Op #31 Post-Op

On all three of these molar cases (#3, #15 and #31) I used the same system-based endodontics approach. After scouting with a #10 K-file and establishing working lengths, I used ProGlider glide path files to obtain an open glide path efficiently and safely. I then used the primary (#25) WaveOne Gold reciprocating files to safely and efficiently shape all the canals including #31 and #15, both of which had MB2’s. With my glide path and shaping files, I like to use a series of four to five passes where I engage the canal wall and cut a few millimeters and then disengage a millimeter so as not to put too much stress on the file.

After irrigating to disinfect the canals, I used a calcium silicate root canal sealer to effectively seal the four canal molar systems and obturated using the new WaveOne Gold gutta-percha master cones. I love that the cones work hand-in-hand with the file system. They’re made with injection molding to precisely mirror the shape of your final file so they fit like a glove, giving me confidence in my fill. All in all, I walked away feeling pretty good.

The beauty of a system-based endodontics approach

I felt very little stress treating these molars. It was one of those days where I was talking, laughing and joking with the patients and my assistant. And these were challenging teeth, but with WaveOne Gold and the entire system-based endodontics approach, it makes it easy. I walked out of the room whistling, feeling joyful and energetic – like I just finished three pretty cool cases in a row with very little effort (at least it felt like that). Now that’s not always the case, but I love it when things go just like I plan. With the right tools and confidence, I can perform high quality endo and still have lots of energy left for the day. I was even able to make it to my 11 am JiuJitsu class.


Dr. Pullen has worked as an Endodontist in private practice since 2006 and has owned his own practice in Brea, CA since 2007.  He is a Diplomat of the American Board of Endodontics. Dr. Pullen received his D.D.S. from the University of Southern California in 1999. He then completed a one year Advanced Education in General Dentistry while in the U.S. Army in 2000 and served in the Army dental corps from 1999-2002 stationed in Landstuhl, Germany. After his service in the army as a dentist, Dr. Pullen worked as a General Dentist in private practice in Yorba Linda, CA from 2002-2004. He then attended the Long Beach, VA Endodontic Residency program, graduating in 2006 with a certificate in Endodontics. Read more from Dr. Pullen on his blog, RootCanalAcademy.com.

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