Hope you did well on your exam and out practicing already! :)

I'm glad iI could help. Cheers! :)

Typically people say to go up 2-3 sizes; but ideally, after crown down, you want to find a file that fits 3mm short of working length and then drive that to length. This way you've gauged the apex to be cored out with that file to get apical clearing. But either way works, as long as it's not under prepared. Of course, apical curvatures and shapes can cause modifications since larger sizes will not flexible enough to get around short radius curvatures. Cheers!

Watch the video from a couple of weeks ago from Denver on the difference between cyclic fatigue and torque (lecture excerpt). You can't have it both in the same file. Either way, a new heat treated EndoSequence File is being released at this year's AAE and will be part of a Blend Technique I have developed. I will soon share more videos on that technique.

No need for the smaller files beyond the "First File" that reaches apex. You can use one small file for occasional recapitulation but you have to decide whether you will go up in size or stop at that point. Generally, it's a good idea to go up at least one size from the first file that reaches apex. If there's remaining tissue (tissue found in the file's flutes and chip space) you may have to go up to even larger sizes. Hope this helps. : )

I should make a video about this! But the short answer is yes! :)

@@AANasseh That would be fantastic! There are lot of dentists around the world who don’t have access to machine files and handpieces :(

comes with experience. But starting lightly with a 30 or 25 is a good start. The key is to be passive and not push any file. It's about gentle movement down the canal with each file only doing part of the work. That's the basis of serial step-down. Good luck! :)

Crown Down.

I'm not sure I understand what you're trying to say. An counter clockwise motion on a file designed to cut in a clockwise direction does not cut! So, passive or active is not the point. The fact is that it won't cut and only pushes debris apically instead of pulling it coronally.

Sorry. Only 3 years late in response! LOL! Better late than never! Anyway... I take the Orifice opener to almost half way down the root or to where it goes without significant resistance (early curves, thin canals, etc.) Key is not to be too aggressive with pushing. Cheers!

It certainly helps reduce it but can't eliminate it.

It's possible but you would not be using the manufacturers' directions as they are designed for step back (if you take S1, S2, F1, etc. to apex sequentially)

Real World Endo Great, thank you for quick answer. Always looking forward to your videos, learned much from them. Keep the great work up!

Why? We SHOULD proceed increasing small amount of length.......

Sorry. Not familiar with that specific system.

Can u please share which file system u use.. (brand name)

After coronal preferring (orifice opener and a mid-root shaper)

Yes after coronal pre-flaring, to establish working length. Then confirm working length with a radiograph (if in sim lab) 😅

Never been a fan of ProTapers even though I tested their original pre-release prototypes back in the mid 90’s. We actually developed their analogues in EndoSequemce Taper CM files for Brasseler that is currently popular among ProTaper users; but I personally don’t use them as I don’t believe it’s a proper crown down method and is inefficient. But if it works in your hands then by all means keep using it with whatever technique works for you. But to answer your question, no, it’s not the best of both worlds in my opinion.

This might be a basic one on the topic: kzfaq.info/get/bejne/hJxzeMSY35ibgIU.html

Fairly similar in concept. Step Down is the passive Step Down Technique originally described by Dr. Torabinejad. It's also a good technique.

Enlighten us then.

@@AANasseh Stepping back is primarily a technique for achieving a predictable taper using 02 taper hand files. Once you have decided what apical size you want to use and the WL, U prep the canal with progressively larger sizes each being 1/2 mm shorter than the next from the WL. You can also make that 1mm if you want a more conservative taper. BTW i am a big fan

You’re just describing the taper preparation aspect of the step back technique. From an order of operations perspective regarding reaching apex, the difference between the two techniques is explained correctly in the video. In Step Back Technique you reach the Apex first and do your apical preparation first before preparing the final taper, and in Crown Down you reach the apex last after taper preparation and do your apical enlargement last. The Step-Back technique is the whole shaping technique, not just taper preparation part of the shaping. Cheers!

@@AANasseh You are right , that is what i have described and you are right again, the philosophical difference between the 2 techniques has been explained in the presentation. I am not sure if the new generation is familiar with the tapering technique i described. Thanks again for all your presentations.