If you want endodontics to be more predictable and profitable, add piezoelectric ultrasonics to your toolkit. Modern endo has moved from sonics → ultrasonics → piezoelectric ultrasonics. Compared with older magnetostrictive units, piezo systems run at higher frequencies and their tips move linearly (piston-like) rather than in an elliptical pattern—ideal for post removal, separated-instrument retrieval, and precise root end preps in surgery.

Despite the perception that ultrasonics are mainly for surgery (apicoectomy), but actually about 90% of their value is nonsurgical. Five big uses: boosting irrigant effectiveness, locating calcified canal orifices, removing posts/cores, retrieving separated instruments, and taking out silver points.

Ultrasonic activation creates acoustic streaming (and minor cavitation) that moves irrigants into fins and webs you can’t clean mechanically; short bursts (replenishing solution every ~20 seconds) are especially helpful in C-shaped canals. For canal location—think calcified MB2s—troughing tips (e.g., DB (Diamond Ball) Tips) efficiently remove secondary dentin and break through calcifications and pulp stones.

For post removal, break the luting seal first (trephinate carefully along the long axis), then vibrating tip (e.g. Vibrapost) — with water spray to avoid overheating the tip, handpiece, post, or PDL. Don’t “muscle” posts with a hemostat; modern resin cements can transmit force and crack teeth.

For separated instruments, straight-line coronal fragments are feasible with thin spreader tips (counter-clockwise around the fragment); apical/curved separations are much harder—consider referral and magnification. Silver points (soft metal, round shape) are best loosened by ultrasonic troughing along their long axis, then removed with forceps.

Other handy uses: vibrating poorly fitting metal crowns to loosen them (never on porcelain), refine crown prep to get rid of undercuts/j-margins (P Tip), heating metal carriers (thermal devices like Alpha) to plasticize gutta-percha for retreatment, and periodontal scaling if you have compatible tips (with light source for better visualization).

There are many solid piezo units. Tip choice matters: use proven, durable designs (e.g., JeTip/DS Tip for microsurgery and BL Tip/DB Tip for nonsurgical), favor water-ported, diamond-coated options for efficiency (e.g., CPR with water port), and run delicate instrument-removal tips at the recommended power. Coatings vary (zirconium nitride, diamond, plain stainless); try a few and adopt what works for you. One caveat: don’t use ultrasonics to instrument canals—rotary files are safer and more controlled. Use ultrasonics as a cleaning and adjunctive tool.