Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

endo > more about access and WL > Flashcards

more about access and WL Flashcards

1
Q

how is RCT a service to pt?

A
  • To relieve acute pain
  • To retain otherwise lost natural tooth
    Excellent Practice Builder:
    • creates grateful disciples
      may send you many patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

most common failure in endo?

A

access

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Access Procedure- making the outline

A
  • Create outline form just
    through enamel with number
    2 round or 330 bur HS
  • At this point bur is
    somewhat perpendicular to
    lingual/occlusal surface of tooth
  • Stay shallow at this point.
    Just through enamel < 1mm.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Access Procedure - Penetration

A
  • Penetrate pulp chamber roof
    with bur angled approaching
    parallel to long axis of root in
    center of outline form.
  • You should reach the pulp in
    most cases by 7 mm. – if not,
    call for instructor help.
  • Confirm Pulp canal entry with
    endodontic explorer DG16:
    PUSH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Access Procedure – Un-roofing
what is used during this? why?

A
  • Un-roof Pulp Chamber with brushing out-strokes. Take care not to gouge axial walls.
  • Remove obstructions & smooth the walls
  • Irrigate well (NaOCl)
    – Vision
    – Remove Debris
    – Begin Disinfection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Access Procedure - Refining

A
  • Refine access prep with Safe
    ended diamond bur or Endo–Z
    bur to help provide straight-line
    access to mid-root. ( Mostly in
    molar access).
  • The non-cutting tip is simply a
    pilot.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
  • After ACCESS, your
    next big task is:
A

WL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

poor WL results in

A

poor outcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

proper WL

A

1mm short canal exit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you FIND the Canal exit?

in hand and mouth

A
  • In your HAND; Look at it
    – Observe the canal exit
    – Measure before you MOUNT tooth
  • In the MOUTH; Start w/ Average Length
    – Chart
    – Apex Locator (if possible)
    – Radiograph (with #15 file in canal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

is apex locator used in lab

A

not really

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

radiograph for WL procedure

A

Place a #15 hand file in the access and extend it in the
canal to the estimated canal length

Take a radiograph and adjust until you determine
the correct Working Length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

why 1mm short of canal exit?

A

this places the WL in close proximity to the natural Apical Constriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

too short of WL canal will be:

A

the canal is NOT well CLEANED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

WL too long

A

Even ¼ of a mm. long of the constriction – we have created a “BLOW-OUT” which guarantees incomplete compaction at the apex and an explosion of sealer in the PA tissues.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

must have what for WL

A

Reliable Reference Point
– Select a solid, reproducible location on the tooth
* Tip of incisal edge (anteriors)
* Tip of cusp for which the canal is named (molars)
– Don’t reduce it after WL is determined
– No need to reconfirm unless something has changed.
Write it down when determined

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

– Access to the Pulp Chamber FACILITATES:

A

– Locating the Canals
– Negotiating the Canals
– Gaining Patency
– Establishing Working Length
– Maintaining Apical Constriction
– A GOOD OUTCOME

18
Q

1st step after dx?

A

access

19
Q

Proper _______ is arguably the single most
important requisite contributing to routine
endodontic success.

A

Proper Access is arguably the single most
important requisite contributing to routine
endodontic success.

20
Q

what can occur with poor access
results? canals? clean? shape? fill?

A
  • You will NOT have predictable result
  • You will routinely miss canals
  • You will NOT be able to clean properly
  • You will NOT be able to shape completely
  • You will NOT be able to fill adequately
  • *** You will easily create problems and make your RCT far more difficult, dangerous and time-consuming than it needs to be.
21
Q

OBJECTIVE of ACCESS

A

Create effective SHAPE:
– SMOOTH
– CONSTANTLY TAPERING
– RESPECTING THE SHAPE OF THE NATURAL CANAL
– CONSTRICTING NEAR THE TERMINUS OF THE ROOT

22
Q

avoid what with access

A
  • “Coke Bottle” effect (canal is bigger than the cervical access at some more apical point in the canal)
23
Q

Requirements from Access

A
  1. Visibility of pulp chamber and all canal orifices from a single vantage point
  2. Straight-line access to mid-root for instrument placement
  3. Complete removal of pulpal roof & pulp horns
  4. Avoidance of unnecessary weakening of tooth
24
Q

“DRAW” of access

A

Visibility of pulp chamber and all canal orifices from a single
vantage point

25
Q

Straight-line Access to Mid-root

A
26
Q

3 Steps of Access

A
  1. Outline Form (2 dimensional surface shape)
  2. Coronal Access (Extending into pulp)
  3. Radicular Access (Adjustments to allow easy straight-line entry to mid-root of each canal) *
27
Q

outline form of access

A

The 2 dimensional plan for the initial opening (Could be traced onto crown)
While canal anatomy & tooth damage somewhat determine shape, size and location of initial entry into tooth – there is an “Ideal” to be mastered ***
First Shape the Outline Form in a shallow (1/2 to 1mm) fashion ( #4 round for molars, #2 for PM and Anteriors)

28
Q

coronal access

A

To allow unobstructed visualization of the pulpal floor and ALL canal orifices from a single vantage point . . .
You should reach the pulp at 7mm or less. Mark your bur at 7mm
Extend your bur within the Outline Form to remove Pulpal Roof.
Pulpal FLOOR should NOT be touched by access bur

29
Q

walls of coronal access angulation

why?

A

Walls of the coronal access should DIVERGE to the occlusal (B)
1. better light
2. better visualization
3. Your temporary restoration which is placed between visits
will not be easily dislodged to Leak & Contaminate***

30
Q

Radicular Access:

A

To allow straight-line access to midroot for all shaping instruments and obturation materials ( observe canal path- not long axis of tooth)

Flare into canals to remove obstructions and make instrument placement simple and foolproof without looking.

Facilitates “Crown-Down” procedure.

31
Q

Hand files generally require _____ strokes/file
before going to next larger size file *

A

Hand files generally require 100 strokes/file
before going to next larger size file *

32
Q

common canal configurations

A
33
Q

difficulties of max LI

A
  • Thinner root than central
    (narrower access M-D
    narrower pulp horns)
  • Root often curves to distal
  • Apex tips to palatal (most
    difficult of max. ant. teeth)
34
Q

max C apex tips towards?

A

palate

35
Q

preventing perforation

A

Line up penetration in 2 planes: M-D & F-L
Visualize cervical cross section
Perforations often spell the demise of the tooth = iatrogenic error

36
Q

if access is too small/cervical in the anterior what can happen

A

can miss the pulp horns

37
Q

inadequate access and shaping

A

Inadequate access compromises shaping:
*induces unnecessary bending of file
*creates apical transportation of canal

38
Q

max m1 access shape

A

Triangle –
apex to palatal: should
not cross oblique ridge

39
Q

perforations are what sort of error

A

mental,Get your perception RIGHT :
Line it up in 2 planes (Know
where the root angles)
STAY FOCUSED***

40
Q

worst error to make in access

A

perforation

endo (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions