Technology and positive change

Read about how evolving endodontic technology and materials have profoundly affected Dr. Brian McGue’s practice.

The practice of endodontics has evolved dramatically over the course of the last few decades. Many practitioners consider endodontics to be at its golden age. Technology and materials have been at the forefront of these positive changes. When I reflect back on 30+ years of practice, there are a few of these technological changes that I feel have positively influenced the practice of endodontics — nickel-titanium files, torque-controlled handpieces, and cone beam computed tomography (CBCT).

NiTi files

I was first exposed to nickel-titanium files in the 1990s. At that time, most endodontic files I used were made out of stainless steel. To have a material with lower chance of separation but still remarkably flexible at larger diameters dramatically changed my endodontic preparations. I was able to reduce the types and numbers of files I was using to get the clinical result I wanted. Though I still use some stainless-steel files today, in my practice I do most of my preparations with NiTi files in a safe and efficient manner.

Torque-controlled handpieces

Nickel-titanium files were a game changer, but in the early use of these files there was a problem with separation while using a rotary instrument. This forced an evolution of handpieces specifically designed for endodontic uses. One of the vast improvements was handpieces for which a practitioner could control the torque values. This allowed a much safer way to use NiTi files in handpieces without a reduced risk of file separation. By introducing a safer rotary method for instrumentation, a practitioner could debride canals with less hand files and more efficiency.


Perhaps nothing that has been developed over the course of the last few decades has profoundly changed endodontics for me personally as has CBCT. Diagnostically, a CBCT is without question the most definitive way to image the oral cavity. We diagnose far more pathologies with the CBCT than without it. Additionally, the ability to image the internal structure of a tooth slated for endodontic therapy has changed our decisions to treat a tooth and the manner of how we are going to treat a tooth. Prior to CBCT, I was a big proponent of using an operating microscope in endodontics. After using CBCT, I have found I use my operating microscope far less because I know the internal anatomy of a tooth long before I begin treating a tooth.

These three technologies have had a profound impact on my practice. I am excited for the next generation of advances.

Among other endodontic technology, sedation can reduce trauma and benefit a dental office. Read more about it in Dr. McGue’s CE article, “Dental Sedation: An Overview,” here: Subscribers can take the quiz and receive 2 CE credits!

Brian McGue, DDS, is a fulltime practicing general dentist with a private practice in Chesterton, Indiana. Dr. McGue and his wife, Susan, lecture on the topic of sedation and run hands-on workshops for dentists interested in incorporating oral and IV sedation into their practices at The Pathway in Tempe, Arizona ( and the 3-D Dentists facility in Raleigh, North Carolina, and Nashville, Tennessee ( Together they have authored three textbook manuals on sedation. Dr. McGue is a fellow of the Academy of General Dentistry and a member of the American Dental Society of Anesthesiology, the International Anesthesia Research Society, and an educational member of the American Society of Anesthesiologists. Dr. McGue and Susan McGue can be reached at

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