The efficacy of step-down procedures during endosonic instrumentation

The step-back method of root canal preparation may not be suitable for endosonic files as they may be prevented from working efficiently within the apical region. This study determined the debris present in the apical portion of the canal after using three different endosonic instruments and compared the step-back versus the step-down technique; the latter involves initial preparation of the upper regions of the root canal which may reduce file constraint. Thirty-six teeth were prepared by either the step-back or step-down method using endosonic generators (magnetostrictive, piexoelectric, and sonic). Preparation times were standardized so that files were used for the same period. From scanning electron micrographs, debris removal was scored on a four-point scale by four clinicians. A log linear analysis showed that there was significantly less debris present with the step-down method using piezoelectric and sonic devices. More debris was present when files driven by a magnetostrictive instrument were used with the step-back method. This study showed that the step-down method may be useful when using certain types of endosonic generators.