![]() Making sure each success step is correctly accomplished before proceeding can prevent the clinician from having to back up, redo steps, and correct otherwise avoidable problems. Mentally, as well as tangibly, the entire procedure should be broken down in a larger number of very small steps that are moved through in a slow and yet intentional, deliberate, and focused manner. ![]() As a starting place, having the entire procedure rehearsed with our assistants as well as having all the needed supplies on the tray table placed in the expected order of use is essential for creating efficiency. Moving through the treatment process sequentially can mitigate many of these potential risks. In moving through the tangible steps of the endodontic treatment, how many of us have, at one time or another, wished we could go back 5 minutes in time before a problem occurred or refer the case from the start? If we are wholly honest with ourselves, risk was there and predictable, we just may not have recognized it for what it is. ![]() Alternatively, adequate straightline access and coronal third management can make apical enlargement much more streamline. For example, a poor access cavity can easily lead to fractured rotary nickel titanium (RNT) instrument or apical blockage amongst many other problems. When problems occur in diving, they often multiply very quickly. In a cave diving context, each step in the dive builds positively upon the previous one to bring the dive to a safe conclusion. SLOWLY AND PROGRESSIVELY Steve Bogearts suggested to me that in cave diving “slow is smooth and smooth is fast.” It is an idea that resonated with my experience in endodontics. The comprehensive management of the situation is described along with the rationale behind the steps taken. These strategies and concepts are discussed below in the context of a clinical case that was referred to me recently. Interestingly, the conceptual strategies that make a safe and well-executed cave dive and a well-carried-out endodontic procedure are very much the same. In caving, the skill sets and responses required for various scenarios should be reflexive. Dive plans, especially in cave diving, should be carefully discussed beforehand amongst all team members. Appreciating the risk present at any given time is essential to avoiding and/or overcoming these risks. ![]() Integration of new equipment, techniques, and skills, be it in a cave under water or with a complex anatomy in a root canal can, at times, be difficult. I have been blessed to be trained by, and cave dive with, 2 of the very best technical scuba cave divers and explorers in the world, Steve Bogearts (Mexico, ) and Brian Kakuk (Bahamas, ). ![]()
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