20142348
Root canal treatment
- Access
preparation
- Conservation of tooth structure
- avoid cusp tips and marginal ridges
- avoid cusp tips and marginal ridges
- Where to drill?
- Lingual surface
- anterior teeth
- anterior teeth
- Occlusal or biting surface
- posterior teeth
- posterior teeth
- What burr?
- Round or tapered in high speed handpiece
- Round or tapered in high speed handpiece
- Lingual surface
- Deroof chamber to expose pulp horns and orifices
- Straight -line acces to orifice and apex
- Properly sealed rubberdam before
- Access preparation
according the tooth
- Number of canals / Shape
- Incisors
- 1 canal (LLI tends
to have 2)
- Triangular
- 1 canal (LLI tends
to have 2)
- Canines
- Ovoid/oval
- 1 canal
- Ovoid/oval
- Premolars
- 1 or 2 (1st
MPM)
- Oval
- 1 or 2 (1st
MPM)
- Upper molars
- 3 or 4 (MB2)
- Blunted triangle
or romboidal
- 3 or 4 (MB2)
- Lower molars
- 3*
Annotations:
- - The distal root usually has 2 canals - Not so often: 4 canals is possible with 2 canals in each root
- Trapezoidal
- 3*
- Incisors
- Number of canals / Shape
- Conservation of tooth structure
- Instruments
- Stainless Steel hand files = .02 taper
Annotations:
- .02 taper means that the file gets .02 milimeters THICKER in diameter for each milimeter you go down from the tip
- K files
(Kerr)
- Twisted
square
- Watch
winding
method
- Twisted
square
- H files
(Hedstrom)
- Spiral
cone
- Cuts only in
retraction
- Spiral
cone
- Color
scheme
- File dimensions
- D16 = size file + convexity*k (k=16mm)
Annotations:
- F.ex: Size file 15, convexity 0.2 --> D16= 0.15 mm + 0.2*16mm = 0.47 mm
- D16 = size file + convexity*k (k=16mm)
- NiTi rotary instruments
= .04 or .06 taper
- Gates Glidden
drills
- open orifice for
straight-line access
- open orifice for
straight-line access
- Barbed
broaches
- entangle and remove
things that are
caught or stuck in the
root canal
- entangle and remove
things that are
caught or stuck in the
root canal
- Reamer
- Twisted
triangle
- Twisted
triangle
- Stainless Steel hand files = .02 taper
- Cleaning and shaping tecniques
- Crown.-down
- Step-back
- Crown.-down
- Irrigation and medicaments
- Sodium
hypochlorite
(NaOCl)
- irrigant
- irrigant
- Citric acid
- Chloroform
Annotations:
- dissolves GP in retreatment
- Sodium
hypochlorite
(NaOCl)
- Endodontic microbiology
- Primry endodontic infection
- Bacteroides
Annotations:
- GM obligated anaerobes
- Bacteroides
- Failed endodontic treatment
- Enterococcus faecalis
Annotations:
- GP facultative anaerobic
- Enterococcus faecalis
- Primry endodontic infection
- Obturation
- To seal canal
system
- Gutta-percha (GP)
- Match the size of
the GP to the last
file you used (color)
- Match the size of
the GP to the last
file you used (color)
- Sealer
(ZOE)
- Condensation
tecniques
- Warm
vertical
- Plugger
- Plugger
- Cold
lateral
- FInger
spreader and
tiny accessory
cones
- FInger
spreader and
tiny accessory
cones
- Warm
vertical
- Gutta-percha (GP)
- To seal canal
system
- Temporary
restoration
- Avoid ingress of the bacteria from the oral
cavity
- Avoid ingress of the bacteria from the oral
cavity
- Surgical Treatment
- Incision and drainage
- Surgical opening in SOFT tissue
- Realeases exudate and pressure
- Realeases exudate and pressure
- Surgical opening in SOFT tissue
- Trephination
- SUrgicsl opening in HARD
tissue
- SUrgicsl opening in HARD
tissue
- Periapical microsurgery
- Achieving acces through the apex to seal anterograde
- Apicoectomy: Resect 3 mm of root tip
- Use ultrasonic tip to instrument the canal 3 mm
- Mineral Trioxide Aggregate (MTA)
- Suture soft tissue and let the bone heal
- Suture soft tissue and let the bone heal
- Mineral Trioxide Aggregate (MTA)
- Use ultrasonic tip to instrument the canal 3 mm
- Apicoectomy: Resect 3 mm of root tip
- Achieving acces through the apex to seal anterograde
- Incision and drainage
- Endodontic treatment planning
- RCT > retreatment > surgical RCT
- RCT > retreatment > surgical RCT
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