Dentaltown November 2019 - 48

message board

Initially the system worked like this:
1. Necrotic teeth received two treatments. The first session involved a final "filling" by
running a reamer with sealer in reverse to coat the walls.
2. The second treatment was removing the sealer on the walls and filling a lentulo.
Vital teeth were one-visit treated and often not fully cleaned. So, leaving tissue in there was
not considered wrong.
Now, I know this because the guy I worked with a long time ago used the system, and I had
read two or three books he had on the topic. So, initially the significant difference was twofold.
1. Irrigation was not used, but coating every file or reamer with sealer was done.
2. For vital teeth, it was not considered mandatory to remove all tissue. It varied. Sometimes
cleaning only the straight part of the canal was done. Sometimes difficult canals were not
instrumented.
The philosophy did change over time, though. The end of the evolution was very much like
a conventional endo, after changing over years. ■
9/5/2019

toothdoc1978
Member Since: 07/17/17
Post: 48 of 137

My point in the highlighted line is that Sargenti allowed dentists to use cheap hand files
instead of crazy expensive rotaries and keep the preparations very conservative, which in my
opinion is a major factor in the technique's success. But it's just a theory; I'm definitely no
endodontist or RCT expert.
As far as protecting the public, I'd like to see a study of NaOCl accidents and their
sequelae vs. incidents from Sargenti paste. We might (stress: might) fi nd that we would be better protecting the public by banning the bleach and using Sargenti to replace its mechanism
of action. Also, now we've introduced rotary fi le breakage, just a new way to destroy a tooth's
long-term prognosis.
Long story short, the stuff had some great properties to it and should be studied properly,
rather than thrown out because of politics and greed. I know personally I'd save a ton of molars
I routinely extract because I lack the skills of an endodontist to do a RCT to the SOC, but I can
hand-file many of them to 20-25. ■
9/5/2019

flyfishdr
Member Since: 02/26/04
Post: 51 of 137

Well, actually the Sargenti system was really the first to use mechanized files and not hand
files. It was a reciprocating handpiece using reamers. So, reciprocation hand pieces used by some
today actually started about 40 years ago with Sargenti. I'm sure, like any endo really, hand files
can be used.
As more just a comment on your last sentence. Almunk does some just superb endo, with
minimal sizing and hand files (aided by reciprocation at times). So, a person can do endo just
fine without, as you say, expensive rotary files. ■
9/6/2019

How have you handled this?
This question led to an in-depth discussion about
current and past practices, and the conversation
is still going! If you'd like to read the entire forum,
and share your own wisdom, it's easy to find: Look
in the message boards section of this issue at
dentaltown.com/magazine.

48

NOVEMBER 2019 // dentaltown.com


http://www.dentaltown.com/magazine http://www.dentaltown.com

Dentaltown November 2019

Table of Contents for the Digital Edition of Dentaltown November 2019

Dentaltown November 2019 - Intro
Dentaltown November 2019 - Cover1
Dentaltown November 2019 - Cover2
Dentaltown November 2019 - 1
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Dentaltown November 2019 - Cover3
Dentaltown November 2019 - Cover4
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