The Milton Syringe is simply the most accurate method yet devised for injecting cement into a root canal.
Since the degree of accuracy in any syringe is determined by the inside diameter (bore) of the syringe, the Milton syringe was made very small, slightly larger than the outside diameter of the 30 gauge needle used to fill it.
In fact the Milton is so small it must be filled with another syringe.
To use the Milton syringe you must also have a Precision Endodontic Syringe and the 30 gauge needles used with it.
The driver on the Milton precisely fits the barrel/needle.
Each millimeter travel of the driver extrudes a very precise amount of cement.
So small in fact that you can actually decide in advance how big the puff of cement at the apex will be or how short of the apex you want cement. Instructions for Filling:
At this point continue forcing cement through the Precision Endo Syringe and put your finger over the apical end of the Milton Syringe and the cement will force the Milton Syringe off the 30 gauge needle.
The tip of the driver has been sharpened to make it easier to find the opening of the Milton Syringe.
Determining Driver Travel:
the distance from landmark to apex.
This will tell you exactly the distance you will need to move the driver on the Milton Syringe to exactly fill the truncated cone that is the canal from the wedge point to the apex.
Sealing and Filling the Apex:
If it is short reinsert the Milton Syringe to its previous place and move the driver a millimeter at a time until cement reaches the apex.
A few salient points:
The small amount of air that is trapped between the end of the Milton Syringe and the apex must be expelled through the apex.
If you do not have a patent apex, the air will be compressed and cement will be pushed back as the air expands once the Milton Syringe is removed.
Enlarge the canal to size 30 as deep as you have prepared it, insert the 30 gauge needle on the Precision Endo Syringe and fill from the end of your prep to the coronal area as you withdraw the needle.
If the apex is NOT patent, there is no danger of cement flowing through the apex.
It is a good idea to hand prepare a portion of the canal with a #40 standard tapered file.
The Milton Syringe should wedge about 5mm from the depth prepared with the #40.
Otherwise the cement will flow down one canal and up the other without sealing the apex.
Once the apex is sealed then use the Precision Endo Syringe to back fill the canal that had the file in it.
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