Endodontic Vanguard Zoom with Dr. Sonia Chopra and ProTaper Ultimate Q&A, Part 2

This episode opens with Ruddle and Lisette giving us a glimpse into the Ruddle Family holiday traditions. Next, Ruddle zooms with guest endodontist, Dr. Sonia Chopra, about her recent TED Talk, her eLearning courses, and female entrepreneurship. Then Ruddle continues with Part 2 of the Q&A on ProTaper Ultimate, recently launched in September. And finally, since most of us enjoy a good mystery, the show closes with Ruddle and Lisette talking about one of their favorite unsolved mysteries.

Show Content & Timecodes


00:09 - INTRO: Ruddle Family Holiday Traditions
05:31 - SEGMENT 1: Zoom with Dr. Sonia Chopra
26:57 - SEGMENT 2: ProTaper Ultimate Q&A, Part 2
43:26 - CLOSE: Unsolved Mysteries – Amelia Earhart

Extra content referenced within show:

  • Special Show Guest: Dr. Sonia Chopra
  • Sonia Chopra, DDS Website: https://soniachopradds.com
  • Chopra S: The Endodontic Renaissance and Modern-Day Root Canals, Dentistry Today, 8 September 2021, https://www.dentistrytoday.com/the-endodontics-renaissance-and-modern-day-root-canals/
  • Dr. Sonia Chopra TEDx Talk: “Modern Day Root Canals: Saving Teeth Will Save Healthcare” – https://youtu.be/XXnhqe3TFFw
  • E-School by Sonia Chopra, DDS Website: https://soniachopradds.com/e-school/
  • Gladwell M: Outliers: The Story of Success. New York: Little, Brown & Co, 2008
  • The Ruddle Show, SPECIAL E03 – “SPECIAL REPORT: ProTaper Ultimate – The Launch of an Improved File System”
  • Ruddle CJ: Endodontic Controversies: Structural & Technological Insights, Dentistry Today 36:10, pp. 120-124, October 2017 (see downloadable PDF below)
  • History Channel: Television Documentary “Amelia Earhart: The Lost Evidence” – https://www.history.com/specials/amelia-earhart-the-lost-evidence/pages/exploring-the-lost-evidence


  • Select PDF content displayed below. See Ruddle's complete library of downloadable PDF content at www.endoruddle.com/pdfs

    See also Ruddle's complete Just-In-Time® Video Library at www.endoruddle.com/jit

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    Disclaimer

    This transcript is made available by The Ruddle Show in an effort to share opinions and information, and as an added service. Since all show text has been transcribed by a third party, grammatical errors and/or misspellings may occur. As such, we encourage you to listen/watch the show whenever possible and use the transcript for your own general, personal information. Any reproduction of show content (visual, audio or written) is strictly forbidden.

    INTRO: Ruddle Family Holiday Traditions

    Lisette

    Welcome to The Ruddle Show. I’m Lisette and this is my dad, Cliff Ruddle. How are you doing?

    Cliff

    Excellent.

    Lisette

    Well, we have a special guest on our show today so I’m excited about it.

    Cliff

    Yeah, I’m really excited to feature this mystery guest, and we’ll have her on shortly. Her.

    Lisette

    Oh okay. So, we’re going to start off talking about the Ruddle family holiday traditions, because the holidays are once again upon us, and everybody celebrates differently, enjoys different foods and traditions. So, we thought we’d tell you how the Ruddles like to celebrate Christmas and Thanksgiving. So, these days we keep it pretty low key. We all live very close to each other, in close proximity, and so it’s pretty easy to just pop over on Thanksgiving and Christmas day.

    Cliff

    Well for Thanksgiving and Christmas day, there’s kind of a team effort. So, the cook next-door would be Mazy Ostovany and Lori, they help out, and then Phyllis is chief of cooking, and they do a lot of collaboration on bringing the meals in, but what I can share with the group, if you’re ever around, around Thanksgiving time, drop by the Ruddles, cause she’s known for making her famous apple pie, lemon pie and pumpkin pie.

    Lisette

    Okay. Well, we usually eat the same dinner for Thanksgiving and Christmas, patties and green rice and those are both vegetarian dishes, and I always have to explain to people what they are, but they are family favorites. The patties is – consists of like walnuts, cheese, onions, bread crumbs and some other stuff. And the green rice is like a rice, spinach, cheese casserole. So, I love those. I love both those dishes so much. My mom sometimes makes a chicken or a turkey, but really what motivates us to go over and celebrate with you guys is the patties, green rice and pie.

    Cliff

    I thought it was about the football.

    Lisette

    It is about that, too.

    Cliff

    Okay, so for most Americans, we get together because it’s a family thing. Those are probably your two biggest American holidays, so for Thanksgiving, we get to watch three NFL football games. That’s that oblong ball, not the round one. And then for Christmas ,it’s fun to watch also with all the food and the family, we always used to watch parts of four basketball games.

    Lisette

    I think there’s like five now.

    Cliff

    Is there five?

    Lisette

    Yeah.

    Cliff

    Okay, might miss dinner, huh?

    Lisette

    I actually find it kind of stressful when my team plays on a holiday, cause it’s really hard to not let a loss affect the holiday mood. Another thing we do, though, that’s a little different is we exchange presents on Christmas Eve and that’s nice because it’s night time and it’s cooler because living in Santa Barbara, sometimes Christmas Day can be really warm and sunny and sometimes just outright hot.

    So, but that’s kind of how we celebrate now. We also do – a lot of years, we go to The Nutcracker. We do gingerbread houses. We do Christmas cookies. We do that stuff now, but growing up, I remember that almost every year we went to Yosemite for Thanksgiving.

    Cliff

    Oh, those are great memories. I think we went – I don’t think – we went 11 out of 13 years, so it’s a long run. And when you arrive in Yosemite Valley, as you know, it’s just this spectacular scenic valley with these sheer granite faces that come right up out of the valley vertical. So, that’s always impressive. It’s inspiring and then, of course, it’s cool and there’s coldness. It can snow, it can rain. It can do any of that at that time of year.

    But we like to take hikes. We took a lot of hikes so you can go up Yosemite Falls. Those are – that’s an all-day thing. But you can take smaller – I think the iconic hike is the Missed Trail, cause you go by Vernal and Nevada Falls, and these are fabulous falls that you walk right alongside, and the lighting and stuff is good, and if you keep hiking, that would be how you would get to the back side of Half Dome.

    Lisette

    Yeah, and then I just remember having Thanksgiving dinner at the Ahwahnee Hotel which is an architectural wonder, so that was pretty fun.

    Cliff

    That’s fun. They have a spectacular Thanksgiving dinner. I think you have to go – it used to be booked two years in advance. Now maybe it’s even a lottery.

    Lisette

    Okay. Well, I do have a lot of great memories of Yosemite. I wish I could share more of Yosemite with my kids, but maybe we’ll go there soon.

    Cliff

    Well, if there was snow in the valley, we even went to Badger and skied. So, that was just out of the valley and up and there was the mountain, there was the ski lift, there you go.

    Lisette

    Okay, well we have a great show for you today, and we hope you enjoy all of your holiday traditions, but we’re going to get going with the show now.

    SEGMENT 1: Zoom with Dr. Sonia Chopra

    Lisette

    Today we are joined by a special guest endodontist, Dr. Sonia Chopra, who is not only a very skilled clinician and the first female endodontist in Charlotte, North Carolina, but she is also an author, entrepreneur, educator, and a motivational speaker as well. Dr. Chopra provides groundbreaking digital education through her online course, E-School, and also recently completed a TED Talk which we will discuss shortly.

    For Dr. Chopra, it is about self-empowerment, intentionality, and balance, and this is very evident when you meet her. So, we are very honored to have Dr. Chopra on our show today to talk about her recent TED Talk, E-School and female entrepreneurship. So, welcome, Dr. Chopra.

    Sonia

    Thank you so much for having me. This is truly an honor. So, again, it’s awesome to be here.

    Cliff

    Sonia, I’m just delighted to have you on. It hasn’t been so easy with your schedule and my schedule, but we’re busy people, so we’re going to learn more about today what you’re up to and there’s going to be a lot of people that have maybe not known all the things you’re doing, so I’m really proud to have you here.

    And I want to mention her Dentistry Today article. Those of you – this will be in the Show Notes. You’ll be able to get it. But it’s in September of 2021 and she does a case report. But it was called “The Endodontic Renaissance, Modern Day Root Canals.” And believe me, she has some stuff to share with us. And I feel also affectionate to her because for 40-some years I’ve been talking like a voice in the wilderness, root canal systems, and Sonia is treating root canal systems. So, welcome.

    Sonia

    Thank you.

    Lisette

    Okay, well I briefly introduced you, and we’re going to get to your TED Talk and E-School in a minute, but first I wanted you to share with us the events in your life that led to you becoming an endodontist because your experience really influenced not only the clinician that you are today, but also your vision for how you see the future of dentistry and endodontics.

    Sonia

    Yeah, so my story starts with my own tooth story. I had a really bad toothache the summer after I graduated high school, and I was born without eight teeth, by the way, so I was always at the dentist, and my mom was really adamant that I had a full compliment of teeth before I went to college. So, after I graduated high school, I was at the dentist once a week just to restore those missing spaces.

    But soon after that, I developed a toothache that nobody could really figure out where it was coming from. And I don’t even want to say it was a toothache at the moment, because it was pain that was coming from somewhere in my head that I couldn’t pinpoint where it was coming from. And as an endodontist, we know that referred pain happens all the time, and it can be very frustrating to not only the patient, but also the clinician, right?

    So, my story dragged on for about nine months. I saw about seven different doctors, including like a neurologist that really couldn’t even diagnose my pain. Finally, my dentist got really kind of fed up with me always calling the practice, that he sent me to the oral surgeon to get my tooth out. I hadn’t met an endodontist just yet. I went to the oral surgeon first, and at this time I’m only 17 years old, so I don’t really know what the proper protocol is.

    And my mom, she’s an anesthesiologist, so I always had medicine in my family, so medicine was a driving force for me. But she felt helpless, because she didn’t know how to help her child who was in pain. And so she took me to the oral surgeon. The oral surgeon I could tell was hesitating to take out my tooth, cause he was reading that referral slip and I knew that like he was questioning it. But he took out my tooth, but after the anesthesia wore off, I still had my toothache. And so, they diagnosed the wrong tooth.

    So, an endodontist diagnosis has been such a huge driver for me when it comes to how I am as a clinician today. That whole experience, getting that tooth out, still having pain afterwards, and then finally getting referred to the endodontist after the fact, and him relieving my pain, was just groundbreaking for me, and it just had such a huge impact on my life. Everything that he did, from the way that he educated me and told me that it was okay to trust my body, and just listening to my body and all those little steps along the way throughout the whole root canal process, it really changed my life.

    So, I knew I wanted to go to dental school, but when I was in dental school, I was always drawn to endo, and I gave general dentistry a chance. I was a GP for a little bit, but when I was doing all my dentistry, the only thing that I really cared for like to do was root canals. So, I ended up going back to school, doing a residency, becoming an endodontist. I opened my own practice. It was a scratch, startup practice, and as I was looking, my same tooth story, showing up at my practice, you know, every single day, and I realized that there’s still something missing in the dental education, and so I wanted to change that.

    So, that’s kind of how I became an endodontist is because of my own toothache, and what’s kind of propelled that trajectory to where I am now.

    Cliff

    Well Sonia, I’ve said for a long time, many decades, if all endodontics works, it only works if we get the right tooth.

    Sonia

    That’s so true.

    Cliff

    Yeah.

    Lisette

    Okay, well you touched on patient education and the importance of it, and that brings us to your recent TED Talk which we both watched recently, me and my dad, and we were very impressed.

    Sonia

    Thank you.

    Lisette

    So, how did this opportunity come about and how did you prepare for it, and how did you even decide on the topic? Like there’s a lot of questions there, but do you want to start answering them?

    Sonia

    Yes, so at the end of 2016, I created a vision board and I really just spent some time with myself, and I was like okay, where do I see myself going? And I just kind of laid it out all on a board, and a TED Talk was on there because one of my missions in life is to bring a little bit more awareness to endodontics as a specialty because, you know, if you walk around the street and ask people what an endodontist is, people still don’t know the answer to that. And so, I realized that maybe I can help that mission.

    And I feel like a TED Talk is a really good way to just get some more eyeballs on what we do as a profession. And in the beginning of this year, I decided to invest in a speaking coach, and one that was more geared towards giving a Ted, and I worked all year and finally this past October I was able to complete that goal, that bucket list item of mine.

    Cliff

    I think that’s just awesome. You know, I’m talking now to the audience, but I want – a lot of you have a lot to give, and maybe you need to overcome your fear and kind of listen to this approach, because doing a TED Talk, which I’ve never done, it’s going to pave the way for Sonia for years and years to come, because there’s so many disciplines that she had to master to do that. So, good job, and we’ll get it in the Show Notes, cause everybody should watch it.

    Lisette

    Yes, we will definitely have your TED Talk in our Show Notes, so our viewers should check it out. And even if you’re not a dentist, you don’t need – I mean it’s actually for just everyone, because it explains, you know, how – the public perception of dentistry and how this could evolve to be better, and that kind of thing. I do, just also as a child growing up, every time someone asked what my dad was, I’d say, an endodontist, and I don’t think anyone ever said, oh, yeah, I know what an endodontist is. I always had to explain it.

    Cliff

    Plumber.

    Lisette

    Okay, well now we want to hear a little bit about this E-School, and can you tell us a little bit – it’s one of the first online endodontic course of its kind, but can you tell us a little more about how it works and what it’s designed to do?

    Sonia

    Yeah, so basically, I have a set of modules, you know, everything you learn in dental school, it’s kind of reiterated. I think there’s some beauty in, you know, getting a little clinical experience under your belt and then being able to go back and relearn things. Like when I got board certified as an endodontist, and I had to go back and relearn all that literature after I had so much experience, like clinically with my hands, that relearning process really is what catapulted me to the clinician that I am now. That’s what gave me the confidence to just, you know, serve my patients even better.

    And so, that learning experience is something that I really hung onto, and I thought, okay, well this needs to happen for general dentists and endo as well. Like how can I help them relearn, you know, endo? Because we only get two weeks of endo in school. I mean that’s what I did, and then I only had to do like three or four root canals to graduate. In my opinion, that’s not enough to master endo. It really isn’t.

    And like it’s all about diagnosing tooth pain. Like this is why our patients are coming to us, and so we need to really get good at it. And again, seeing the tooth stories that would walk into my practice every single day, being a volunteer educator at the local GPR and seeing how these dentists were graduating and going into this GPR and seeing that they still needed so much support, I wanted to create that support.

    And as a busy mom of three, I know that it’s hard for a lot of people to leave their practice, to leave their families and take CE, and sometimes certain CE will trump endo CE. I feel like people want to learn more implants or practice management, and endo kind of gets pushed to the wayside. So, how can I create something that’s easy to access, that doesn’t take too much time from people, but it gives them everything that they need to learn about this?

    It’s like a little mini endo residency. And even includes like the business of dentistry kind of part of it from an endodontic perspective. You know, how do you do good risk assessment? How do you know which teeth to keep and which ones like you shouldn’t even waste your time, cause they’re going to end up with a mid-treatment referral. So, there’s so much into it, and I really thought about it globally and how this could work and help support general dentists everywhere, not just in the states, but everywhere in the world.

    Cliff

    Well, you’re at the right time, at the right moment with the right stuff. Well, I’m saying this because, you know, unlike me, you’ll be smarter and you won’t jump on as many planes as I did. Phyllis and I had 5 million lecture related miles at the end of 2019, but then COVID came. And actually, long before COVID came, if you went to the big meetings and lectured at the Midwinter as an example, I remember sitting in the speaker’s room with the guys that wore the coats, the red coats, the blue coats are from different meetings, and they were all complaining about CE and attendance is falling.

    And it’s just a big nut to fly your staff there, hotels, feeding them, and then maybe the lecturer is really good, maybe it’s just so-so. So, what you’re offering is very specific, it’s on time, and it’s highly relevant, so that’s available for everybody in the world.

    Lisette

    No, it’s great. It’s very timely. And so, okay, I want to ask this now, because, you know, you’re clearly very busy, and you just did the Ted Talk. You have E-School and running a private practice. And I know you also have a beautiful family and three children. So, how do you balance everything? It seems like it might be a little overwhelming.

    Sonia

    It really takes a village to do all of this stuff, and so I have learned that I don’t need to be good at everything, and I need to lean on people who are really good at what they do. And so having the proper support system in every area of my life is key to still having time for my own self care at the end of all of it. And so my team and my practice runs like clockwork. They are amazing at what they do! We have our systems in place. Everyone knows what they like to do, what they need to do, but they’re doing what they like to do, right? So, that’s key. So, that team works like a well-oiled machine.

    And then I have my E-School team that also everyone is working within their zone of geniuses and if I feel like okay, there’s something that I don’t want to do or I’m just like I shouldn’t be wasting my time doing it, I will outsource. So, I’m like the queen of outsourcing. Currently, as we speak, I have a chef in my kitchen, because I don’t have time to cook a healthy meal. I could cook something, but it won’t be healthy.

    So, the chef is like that’s his forte, making sure that the healthy meals are ready. He makes a few of those a week for me, and that way, I can support my family and still have time to do stuff like this. So, it really is about having the right people in place and really not thinking that you need to do everything yourself.

    Cliff

    I always liked to say hire to your greatest weakness.

    Lisette

    I was actually thinking about that exact line you –

    Cliff

    That’s why I have all these people around me, because they’re not hats I wear.

    Sonia

    Yeah.

    Lisette

    No, I think probably any person that’s operating at a high-level today is having people around them that are helping. Like I mean it’s just hard to do everything by yourself.

    Sonia

    Yeah.

    Cliff

    And to do it at a high level.

    Lisette

    Yeah. All right, well on our last show we talked a little bit about some of the biggest challenges facing dentists today in 2021, and I was just wondering what would you say in this past year has been your biggest challenge? Like either professional or personal, and what would you recommend to individuals going through similar struggles? Or did you have no challenges?

    Sonia

    No, I had a lot. I would say my biggest challenge was probably childcare, and you know, just home-schooling, like that was – I’m not a teacher to little kids. I can be a teacher to the general dentists of about root canals, but not the little kids. But again, like I think just globally, like anybody in life, like you’ve got to be able to just adapt and not really worry about getting everything done. In that moment, I had to like stop other things that I was doing so I could focus on that home care and that childcare and home-schooling. And that’s okay.

    And I felt like that was – I think having grace with yourself in those kinds of moments is really important, and being able to do that in any situation, whether you’re at work or at home or whatever, is a really important lesson to learn. I think things that we’re learning or like challenges that we’re learning in dentistry or facing in dentistry, I think there’s a lot to learn in dentistry, and I think that’s becoming a problem, like keeping up with all this technology.

    I kind of want everyone to become like mini-specialists and create your niche and the more you kind of identify your niche – again, that could be personally or professionally, right? I think you’ll realize that, you know, you can take a lot of the burden off of yourself and just have more focus on things that you really love.

    Cliff

    That’s a good point you made about the educational side and what is required, I think today by young students to learn. When I went to dental school, you know, there was a certain requirement for crowns and bridges and dentures, and I think we had to do 25 root canals. Then when I went to postgraduate school, that was at Harvard, and at Harvard, the undergraduates did one root canal, and it was a maxillary anterior preferably. So, to your point, they don’t know very much. They don’t know what they don’t know, but then they’re twice as smart as I am in so many other areas.

    So, it’s hard to see how you get all this into a curriculum, when we didn’t even have implants, CVCT, disinfection. I mean these are all new flags that we’ve elevated, so I like your perspective on that, because they don’t know what they don’t know, and many of them are begging – they’re yearning to get better.

    Sonia

    And if I could have my way, I would make dentistry a little bit more like medicine and where you had to pick a track to go to after. Like you could be a primary care physician but, you know, if you wanted to do OB/GYN or be a neurologist or, you know, be a dermatologist, you go to more, you know, schooling after that. That, in my opinion, would be like the perfect world, but that doesn’t exist in dentistry.

    But I see people getting so like anxious because they are expected to learn so much, but if they just kind of niche it down and maybe hey, this doctor, if you’re in like a multi-group practice, so maybe this doctor is the Invisalign doctor, this one does the implants, this one does the root canals, just to get really good at one thing, and you know, be the best. I mean anybody can be a specialist, if you ask me. You just have to focus on it.

    Cliff

    Right.

    Cliff

    But if you’re focusing on everything, cosmetics, the ortho, the everything, that’s a lot, and then that’s a lot of technology investment, too, that I think that’s unrealistic.

    Lisette

    Yeah, we always refer – it seems like it comes up a lot, this book we read, Outliers. I don’t know if you’ve read it as well, but –

    Sonia

    I have.

    Lisette

    – they talk about that it takes to be really good at something, it requires 10,000 hours. So, you know, in karate, we talk about it’s better to learn, you know, to do one kick – practice doing one kick 10,000 times, rather than do 10,000 kicks one time each. So, yeah, you want to be really – like maybe narrow your focus a little bit and focus on being really good at one or two things, maybe.

    Sonia

    Yeah, I think that’s great. Again, lean on your support system, who knows how to do things better, you know. That’s – like my chef, he can cook way better than I can, so I lean on him.

    Lisette

    Well, thank you so much for coming on our show today. I really love your passion, the emphasis you put on patient education, and just how – I really, just from visiting your website, I can tell that you really intentionally focus on creating an exceptional practice culture. So, I really like everything I saw about your practice on the website, even the cooking contest with the crockpot! So, definitely our viewers should check that out. But is there anything maybe that we haven’t asked you that you would like everyone to know, something that we don’t know about you that others would want to know?

    Sonia

    Gosh, you know, I – all I’d love to do is travel and make some bread and take care of the people around me. That’s really me in a nutshell. I try to be a simple person and just try to give back to the world as much as I can.

    Cliff

    Well, I’m just delighted you’ve come on, and thanks for your time, cause I know – I think the audience is getting the sense that you’re not a normal person. You’re like a driven person, and that’s fabulous, so I think you’re a role model, and I think that the audience today can see that, and I think you’ve given them some clues about how to focus in on something they really love because if you love what you do you get really good at it.

    Sonia

    You nailed it.

    Lisette

    Yeah, I bet you have a very nice chairside demeanor. I would like to be your patient, I think.

    Sonia

    Oh thank you. That’s so nice. Thank you.

    Lisette

    All right, well thank you for coming on the show today, and we feel really lucky that you came on as a guest, so thanks.

    Sonia

    Thank you so much for having me. It’s really an honor to be here.

    Cliff

    Thanks, Sonia.

    Sonia

    Thank you.

    SEGMENT 2: ProTaper Ultimate Q&A, Part 2

    Lisette

    All right, so here we are for another Q&A on ProTaper Ultimate, and just to remind everyone, ProTaper Ultimate launched September 1, and we do have a Ruddle Show Special Report on ProTaper Ultimate, on the launch of it, so that is available to watch, but since it’s been launched there were a lot of questions that came in from key opinion leaders and we started with the questions a couple shows ago, maybe three shows ago, and we got through a few, and now we’re just – we’re continuing on part two.

    Cliff

    All right.

    Lisette

    All right. Well just this is in the Special Report, but just to remind everyone that the ProTaper Ultimate files are created with alternating offset machining, so this question is related to that. Is alternating offset machining proprietary? What are its advantages?

    Cliff

    Yes. That’s a commonly asked question, and the best way to do it is not Ruddle trying to draw offset alternating machining on the board, but if you go back to the Special Report that we were just coached to do, there’s some really fascinating pictorials that will tell you exactly what that means, if you’re interested. But it is proprietary, and in fact, Dentsply Sirona has that on their files, and maybe we should talk just a little bit about why that might be important.

    But when you go up a file and you go up the active portion of a file, you – and then think of the files being mainly a cross-section that’s round if you just look at it. First of all our cross-section is a little bit different. It’s a rhomboid, and then it varies to a parallelogram. So, it’s evolving as we go up the active portion. But the reason you want alternating offset machining is because it deactivates the file and reduces friction between the file and dentin.

    So, as we go up the file, and if we just put a little tip on this thing, and if this is D0 right here, and we go D1, D2, D3, D4, D5, and we work our way up the file, you have one point of contact at the end. You have two, one, two, one, two, one. The two points of contact hold the file centered in the root. The one point means the file has a lot of available space around it. That means it can load really well with dentinal chips and it can haul debris coronally. So, it deactivates the file and it’s great for hauling debris. And it’s proprietary.

    Lisette

    When you say “deactivate,” that means it makes it not jam in?

    Cliff

    Well, if you put a circle around this, if I can do this, I didn’t do it quite right, but you have two points of contact. You have a point right here like that, so it’s touching in two walls. The other two points are not touching. You can get to a point where if I could draw even a better circle, maybe I just should start over, but what you could do is have your parallelogram, it’s an 85-degree parallelogram, where you can have it where it’s like this, so it only has one point of contact. So, you don’t have the other side, the contralateral side of that parallelogram. You don’t have it touching or engaging.

    So, all this is available chip space. This is where all your mud can accumulate. And that means the file doesn’t have a lot of torque on it because it’s not engaging.

    Lisette

    So, it’s safer?

    Cliff

    It’s safer.

    Lisette

    Okay.

    Cliff

    Safer, cuts more effectively, files more flexible, there’s a lot of advantages. And of course, people will try to knock off this file. We have a famous company out there, and they always have the replacements files five minutes after we launch. Good luck on this one!

    Lisette

    Okay.

    Cliff

    Or should I say good luck, Chuck.

    Lisette

    Okay.

    Cliff

    Good luck, Chuck.

    Lisette

    Next question. Do the sizes of ProTaper Ultimate Finishers F1 to F3 correspond to ProTaper Gold F1 to F3?

    Cliff

    In ProTaper Gold, you have an F4 and you have an F5, and there was an F1 through an F3. The F4 was a 40/06 and the F5 was a 50/05, so these are completely new instruments. They have never been conceived before. We don’t – I’m sorry, these are useless instruments, and the ones we did over here called Ultimate, we have a different language. We have an FX and we have an FXL. This is an auxiliary finisher. This is an auxiliary finisher. This is a 35/12 and this one here is a 50/10.

    So, these two instruments replaced these two instruments, because foramina they’re typically about a 40 or a 50, really big foramina. They’re usually found in bigger dimension tapered pathway canals. So, they’re kind of okay at the tip, but the tapers were totally inappropriate for the anatomy of those sizes of foramina. So, we wanted to have bigger tapers to go with bigger tip diameters. So, that’s a difference between the F4 and the F5 and the FX, FXL.

    Now if you’re asking me what about just F1 through F3, ProTaper Gold, Ultimate, then we have an F1 and we have an F3; we have those three files. These are 20/07, 25/08, there’s another one there. And then we have a 30/09. That’s exactly the same geometries on both, but the cross-section is different, the rake angle is different, the helical angle is different, but the final silhouette of the tapered preparation you’re trying to cut would be the same.

    Lisette

    Okay. Why are the finishing files, F1 to F3, gold heat treated and the FX and FXL are blue heat treated?

    Cliff

    This is called “purpose specific heat treatment.” So, most manufacturers that make instruments, at least up to now, I’m sure they’ll be emerging copycats immediately, because that’s just how it works, but more or less, if you get a company’s files in that line of files, everything has the same heat treatment, okay? So that’s just normal. What we started to realize years ago actually, that, you know, we just talked about, you know, you might have an instrument that is a 35/12 and then you might have an instrument down here that’s a 20/07, and you might just put gold on everything. You know, I want to go with gold heat treatment.

    However, it makes sense to you in the audience, there’s a huge difference between a 20 and a 35. There’s a huge difference between 7 and 12, so why would all the files have exactly the same heat treatment? So, different heat treatments have been built for the first time that I’m aware of, on a series of the same instruments, but they are different between files and among files based on the geometries of those files.

    Lisette

    I have a question. Does the color change because of the heat treatment or is it actually a different substance that makes, that’s being used?

    Cliff

    That’s a great question. I’m often asked that. It’s an oxide. So, when you heat treat something, you put in cassettes into a furnace, you go up in temperature, and as you’re going up in temperature, there’s a byproduct called an oxide, so at certain temperatures, you might find gold, so it looks gold. If you go to a higher temperature and you get to blue wire, that’s a different heat treatment with a different range of temperatures.

    And the reason being if you put – so this is going to give us – so if we do blue wire heat treatment on the big file and we do gold on the small one, you might think well blue wire gives you so much flexibility, why not put blue wire on the F1, on the F2 and on the F3? The problem is we learned what Chuck Goodis learned at EdgeEndo. When you overcook the files for smaller instruments, they unwind, and they stretch and they don’t hold their cutting edge, so you don’t get good efficiency and you’re replacing files a lot.

    So, it isn’t really twice as good, half the cost. So, blue wire, though, as you get up to a significantly bigger D0 diameter and a significantly greater taper, then you want that flexibility and gold would be too stiff.

    Lisette

    And you don’t need to worry about unwinding because you’re not using it the amount of time that it would require for it to unwind?

    Cliff

    No, you’re taking advantage of the metallurgy and so it’s the actual blue wire metallurgy that gives you resistance to torque, so we talk about cyclic fatigue. So when an instrument is going around a curve and it’s spinning 400 rpm it’s like taking a paper clip and doing this many, many times until it fails. That’s the elastic limit of the paper clip. Well, when you have these big geometries and if you’re going around a curve there’s a lot of cyclic fatigue on that instrument because of the diameter, the dimensions. You’ve got something much bigger, now you’re trying to flex it again. So, you need more flexibility, so the heat treatment is what gives us flexibility and resistance to cyclic fatigue.

    Lisette

    Okay.

    Cliff

    Cyclic fatigue is like a man’s shirt. So, if this is a file and it’s in a canal and it’s going on a curve, you have compressive stresses on the inside of the curve. You have tensile stresses on the outside of the curve, and that’s back to that analogy compressive, tensile, compressive, tensile, and you’re going to get metallurgic failure.

    Lisette

    Okay.

    Cliff

    So, the colors on the different instruments are pretty cool, but they’re made specifically to optimize performance.

    Lisette

    I’m looking at the next question, and you might have already answered this, but I’ll still read it. The ProTaper Ultimate FX and FXL files are very different from the ProTaper Gold F4 and F5. Can you clarify how and why they are different?

    Cliff

    Oh.

    Lisette

    And I know you already did, but if there’s anything else you want to add to that.

    Cliff

    No, the – just to say it in words this time and not draw it, the F4 and the F5 of ProTaper Gold was a 40/06 and a 50/05. And what I was trying to say is that a lot of these teeth that, you know, they have like big terminuses. If you need something that you believe is a 35 or a 40 or something, you know, something in this range at D0, so these would be D0s, well normally, those canals are also much wider, and they have a bigger tapered pathway. So, to put a little 40/06 in, you’re going to have a file that’s just swimming in here.

    Now if you have fabulous, you know, methodology for your disinfection, you might say well I don’t want to take dentin off, but you might want to create a capture zone. So, a capture zone is right here. You want to have sufficient taper – oh, I think this is a chance to do something we’ve never even done before. If you want to have different tapers, then you need to have – like this was, we said, this is the F4 and then we said the 50/05, we said that was an F5. Well 5 and 6 are going to be a swimmer, so that’s why the FX became 35/12 and that’s why your FXL, your auxiliary large finisher, that’s why it’s a 50/10.

    So, you have bigger tapers so you can cut a capture zone in the apical third. We don’t care if this is pretty parallel. Nature gives us already tapered pathways everybody, so unless there’s pathology like internal resorption, things like that, they’re already pretty tapered, so we’re not – I’m not advocating trying to cut the coronal and the middle one-third; I’m advocating cutting a capture zone to make sure we have taper so when we irrigate, we don’t have irrigate going out through the foramen and get an accident going, and when we’re using hydraulics during three-dimensional obturation like a carrier-based operator or vertical condensation, that holds our gutta percha and sealer inside the root.

    Lisette

    Okay. Next question. What changes were made to the SX file? I notice that it no longer has a silicone stopper.

    Cliff

    Well, you know, the SX file, the auxiliary shaper, this is used for several reasons. There’s interferences, coronal interferences. There’s triangles of dentin and we often use this tip to brush out a triangle of dentin or to remove a coronal interference, to marry the line angle to the orifice, so with your eyes closed you can just slide down an axial wall and make a smooth transition to a pre-flared orifice. That’s what SX does. It’s only 19 mm overall, so if you imagine this file, you know, I got to do it different. I have to do it the other way.

    Drop down, and then you got your file. And so on and so forth, and you got a file. It’s 19 mm from here to here, to this point, so I should put the 19 right here. It’s a short file. What does that mean? Then you got the head of a handpiece right above it. So, the clinician is looking down on the head of the handpiece and the rubber stop that used to be on here was a visual obstruction for a lot of operators, so it’s not made to go to length, it’s not carried to length.

    So, the idea was get rid of the stop and improve vision and now they just did this. They just put it on the handle, oh, we’re doing selective erasing. Now we just have that, as you said, we have a shaft and they just did a little 18 mm stripe right here and then our flutes start, you know, like this. Now we’re getting a little better bond, getting warmed up now. And then, you know, you got your handle that is like that. So, this is –

    Lisette

    So, it wasn’t just about cutting costs.

    Cliff

    No, and this is your handpiece and this is chucked up inside your handpiece, and so all of a sudden, you’re looking at the back end of your handpiece and a stop that was sticking out to here proportional was thought get rid of it, eliminate it, and just go with the stripe, cause it’s easy to see and doesn’t block vision.

    Lisette

    Okay, well that’s all the time we have for the Q&A for today. We do still have some questions so looks like we might have to do a ProTaper Ultimate Q&A Part 3.

    Cliff

    I would like to say in closing look, go back and cherry pick, go back to that special report show and I go through this with pictures behind me that are animations that are done in tremendous clarity and it will really help you understand some of the things that maybe were a little harder conceptually to understand because of poor penmanship.

    Lisette

    Good advice. Well thank you.

    CLOSE: Unsolved Mysteries – Amelia Earhart

    Lisette

    All right, well we have a fun new closing segment to debut for you today, and it’s our Favorite Unsolved Mysteries. And since we Zoomed today with Dr. Chopra, a female clinician, on the leading edge of endodontics, we thought it appropriate that the subject for our first unsolved mystery segment to be a female pilot on the leading edge of aviation in the 1930s, so maybe you can guess who that is. It’s Amelia Earhart. When I grew up, I was absolutely fascinated by Amelia Earhart. Why don’t you set up the circumstances surrounding the mystery.

    Cliff

    Well, she was quite an aviator, especially in the decade of the 30s. After Charles Lindberg, who made the first Atlantic crossing, she was the first female and the second person, and she left from Newfoundland and landed in a field in Northern Ireland. And that was in 1932, and then in 1935, she was the first female, the first pilot ever to go from Honolulu to Oakland, California, so she went across the – most – a lot of the Pacific.

    And then the biggest stops on the world tour were at 37, and there were two attempts. The second attempt though she left Oakland, then she went to Miami, skirted across the northern part of South America, went across to Africa and India and went right along the Equator. She wanted to go around, as she called it, “the waist of the globe,” the biggest dimensions from a diameter standpoint. Finally she got to New Guinea, a little town of Lai, and she took off there and that’s where she disappeared, and so that was a little bit about – we’ll go on, but that’s a little bit of what took her down and fell off the radar and nobody ever found her.

    Lisette

    Yeah, she was supposed to be in contact with the US Coast Guard Cutter Itasca, and she was going to refuel at Howland Island, but there was – something went wrong with the navigational instruments. Earhart’s twin engine Lockheed Electra for some reason, it showed that the navigational instruments showed that they should have been right above the Itasca and Howland Island, but for some reason they couldn’t see them, so apparently is what happened is they speculate that the plane eventually just ran out of fuel and crashed.

    Cliff

    Yeah, and there’s a couple theories on that. One is she could have done an ocean crash with her co-pilot. He was a navigator; was it Noonan?

    Lisette

    Fred Noonan.

    Cliff

    And he was very, very well known. I did read, though, that he did have a little propensity for alcohol. But anyway, I’m sure he was completely sober on that day. But it could have just crashed in the sea and disappeared. It’s a vast ocean, as everybody knows. So, they would have just disappeared and I might add that that part of the Pacific Ocean is routinely 14,000, 15,000, 16,000 feet deep.

    The other theory was she might have been able to sit that thing down on a little island, cause there’s a lot of islands, and if she could sit it down, then the question was, you know, what did they drink, what did they eat? Because these islands are uninhabited, sometimes not even having fresh water. So, anyway, that’s the two theories.

    Lisette

    Yeah, I think on one island, they had found some items that are consistent with a woman from the 1930s. I think they even found a jar of freckle cream that I guess Amelia Earhart used freckle cream.

    Cliff

    Right.

    Lisette

    So, they think it might have belonged to her. There’s also theories about her being captured by the Japanese military and maybe dying in a prison camp. Or some people even think that Franklin Roosevelt enlisted her to spy on Japan, but there is actually no evidence from the flight records that she ever got close to Japan, and also her around the world attempt was very publicized and not very covert.

    Cliff

    The whole world was following this flight.

    Lisette

    But apparently in 2017, there was a photo that emerged that showed – the picture was a bit blurry, but it looked like it could have possibly been Amelia Earhart and Fred Noonan on a dock and behind them is – looks like a plane on a barge, and so they were thinking that this was definitive evidence that she actually survived the crash and the History Channel did a documentary on it.

    Cliff

    Yeah, but like a lot of these mysteries, there’s curves and twists and turns, aren’t there? Actually, a Japanese travel log, two years prior to her disappearance, had that very photograph that you’re talking about. It was published in the travel log magazine.

    Lisette

    Right, and National Geographic discovered that. So, that whole theory just seemed to be a little bit like shot down. So, but it’s a really interesting mystery and Amelia Earhart is a very inspiring person. My favorite quote by her is, “Use your fear. It can take you to the place you store your courage.”

    Cliff

    Oh, that’s pretty – that’s damn good, isn’t it?

    Lisette

    Yeah. So, do you have a favorite quote by her?

    Cliff

    Well, I don’t know if it’s about her, but because of her excellence, I would say “When your work speaks for itself, don’t interrupt.”

    Lisette

    Okay, yeah. So, that’s our first unsolved mystery segment, and we will have more in the future. We hope you enjoyed it and we hope you enjoyed the show. See you next time.

    [music playing]

    END

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    03.03.2022 Update

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    2020

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    Behind-the-Scenes Studio Construction

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    The content presented in this show is made available in an effort to share opinions and information. Note the opinions expressed by Dr. Cliff Ruddle are his opinions only and are based on over 40 years of endodontic practice and product development, direct personal observation, fellow colleague reports, and/or information gathered from online sources. Any opinions expressed by the hosts and/or guests reflect their opinions and are not necessarily the views of The Ruddle Show. While we have taken every precaution to ensure that the content of this material is both current and accurate, errors can occur. The Ruddle Show, Advanced Endodontics, and its hosts/guests assume no responsibility or liability for any errors or omissions. Any reproduction of show content is strictly forbidden.

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