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Endodontics > Root Canal Preparation 1 and 2 > Flashcards

Root Canal Preparation 1 and 2 Flashcards

1
Q

What are the aims of root canal preparation

A
  • A continuously tapered preparation is produced
  • The original anatomy is maintained
  • The foramen position is maintained
  • The apical foramen is kept as small as possible
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2
Q

What motions are used for hand files

A
  • Rotational (best)

- Push and Pull Filing

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3
Q

When do we use push pull filing

A
  • Not for the preparation and only for the final refining
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4
Q

Describe Rotational motion hand filing in detail

A
  • Clockwise until dentin is lightly engaged
  • Then anticlockwise rotational motion back and forth with light apical pressure
  • Be gentle and regularly clean the flutes of the instruments
  • Make sure you precurve the files
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5
Q

What types of file primarily uses push-pull filing

A

Hedstrom files

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6
Q

What issues can arise from using push and pull filing with K files

A

Zips and elbows can form

NOTE - need to do circumferential filing to no cause grooves

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7
Q

What do we use in the labs for irrigation

A

Sodium hypochlorite

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8
Q

How should we irrigate when doing an RCT

A
  • Use a shit load of irrigation
  • use in between each instrument
  • Deposit in canal until is runs clear
  • Ensure to do patency after irrigation
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9
Q

How can we ensure safe irrigation

A
  • never bind the irrigation needle?
  • Use a side venting needle
  • Always inject solution using index finger v slowly
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10
Q

What size needle is used for irrigation

A

27 gauge - 0.4mm diameter

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11
Q

Why do we use sodium hypochlorite for irrigation

A
  • Antimicrobial

- Dissolves organic tissue remnants

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12
Q

What should you do if you have an accident with the sodium hypochlorite and patient becomes fooked

A
  • irrigate with sterile water
  • reassure patient
  • immediate referral to max fax on call
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13
Q

What solution other than sodium hypochlorite can we use for irrigation

A
  • EDTA (17%)
  • Chlorhexidine
  • Aqueuous Iodine based compounds
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14
Q

When do we use EDTA for irrigation

A
  • EDTA is helpful in sclerosed canals and can be alternated with NaOCl to allow deeper penetration of NaOCl into infected tubules
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15
Q

AY BAWS CAN I HABE DE NOTE PLZ

A

EDTA removes the smear layer and inorganic tissue remnants

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16
Q

What are the issues with using chlorhexidine as an irrigant

A
  • Doesn’t dissolve organic tissue

- Cannot be used with NaOCl

17
Q

How would you use Aqueuous iodine based compounds as an irrigant

A
  • Used in therapy resistant cases

- After use you’d flush through with NaOCl to remove brown colouration

18
Q

What is a potential issue with using Aqueuos iodine base compounds as irrigants

A

Has allergic potential

19
Q

Describe the all the steps of a Canal Preparation

A
  • Explore coronal 1/3-2/3s with size 10 file and DG16
  • Prepare coronal 1/3-2/3s with SX protaper or GGs
  • Establish patency
  • Find the definitive working length radiograph
  • Prepare apical 1/3 and apical gauge
  • Step back filing
  • Smooth the canal circumferentially

ENSURE COPIOUS IRRIGATION AND PATENCY

20
Q

Why do we prepare the coronal portion of a canal first

A
  • removes bacteria from being introduced apically
  • Helps reduce curvature and achieve straight line access
  • Improves tactile sense
  • Greater volume of irrigant can be used
21
Q

Which direction should we use the SX protaper in

A

In the safe zone which is the outer curvature of the canal

22
Q

Where do you finish the apical preparation

A

at the apical constriction before the apical foramen

23
Q

How do we determine the working length

A

We use apex locators that tell us how long the canal is and then we go back about 1mm, which is considered the working length

24
Q

What patients can you not use an apex locator on

A

Patients with cardiac pacemakers

25
Q

When do we start patency filing

A

Only after the coronal 1/3-2/3s shaping has been done

26
Q

What are the advantages of patency filing

A
  • Prevents blockage
  • Checks whether there is exudate present
  • Helps maintain and follow anatomy
  • Helps to deliver irrigant apically
27
Q

What is the aim of the apical preparation and why

A

To get a file to the WL slightly larger than the natural size of the canal

This ensures that we have optimal cleaning and allows for resistance form with which to obturate against

28
Q

THERES A BIT ABOUT INTRACANAL MEDICAMENT BUT I DONT REALLY GET THAT YET

A

THERES A BIT ABOUT INTRACANAL MEDICAMENT BUT I DONT REALLY GET THAT YET

29
Q

What problems can occur from incorrect instrumentation

A
  • Ledges
  • Zips
  • Perforations
30
Q

How can we avoid ledges from incorrect instrumentation

A
  • Precurve a size 10 handfile at the tip that may help it to negotiate a ledge
  • Create a good coronal flare

Endodontics (9 decks)

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