Cleaning and Shaping Flashcards by Michael McMahan

What are the 9 step prep for shaping canal?

Scouting (#10 hand file)
Patency (#10 hand file)
Working Length (#15 hand file) TIGHT file for Radiograph
Glide Path (#15 hand file) LOOSE file ONLY HAND FILES to this point
Shaping of coronal 1/3 of canal (Wave One Gold)
Shaping of middle 1/3 of canal (Wave One Gold)
Perfecting Straight-Line-Access to mid-root (.25/.12 carefully)
Shaping of apical 1/3 of canal (Wave One Gold)
Final Shaping Objective (Apical Gauging) + Vortex Blue or
Serial Step Back (SSB) using HAND FILES if MAF >#50

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Should you use bur, file, or endo explorer to locate all canals?

Endo explorer

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What motion should be used to scout file (#10)?`

Watch winding motion

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______ = where the canal exits the tooth

Patency

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What file is used to check patency?

10 file

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On an apex locator, what line denotes that you have gotten to patency?

Single Red line

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If it is ____RESISTANCE to apical advancement, you probably have a
small canal which must be enlarged carefully to reach patency.

TIGHT resistance

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If it is ______ RESISTANCE to apical advancement, you have
encountered a canal curvature and you must bend the terminal flute of
your file and search for the path to negotiate the curve.

LOOSE resistance

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____ = 1 mm short of canal exit

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On anterior teeth, what is the reference point?

Incisal edge

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On posterior teeth, what is the reference point for WL?

• Posteriors: Cusp for which canal is named,
flatten cusp when possible

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What file is used to create a smooth glide path?

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• Purposes:
– To smooth curves & make sure there are no canal obstructions.
– To create space for rotary instruments to be used safely without
excessive torque requirements.
– To relieve stress on tip of rotary file to minimize fracture.

Glide path

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• The ____ is created using hand files (pre-curved to
match or slightly exceed the curvature of the canal) using
watch-wind entry followed by pull strokes directed in a
circumferential manner to enlarge the canal to a size #15 at
the WL. (#15 File should end up SLOPPY LOOSE)

Glide Path

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What motion should be used with wave one?

Pecking motion

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What motion should be used on vertex blue files?

smooth in smooth out (Cutting mostly on outstroke)

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What wave one file is mostly used in most cases?

Primary Wave one gold

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If a 10 K-file was very resistant to movement, use

Wave One Gold ____ file.

Small

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If a 10 K-file moves to length easily, is loose or very

loose, use Wave One Gold _____ file. (85%)

Primary

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How should the files be shaped after glide path is created?

In thirds with wave one files

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The operator action is a light “pecking” motion. It
is important to note that one must be vigilant as the Wave One action
tends to push debris ahead of the file so stop action at ____ and _____ of
the operation approaching the apex to clean the file and to irrigate
thoroughly at these stages of shaping.

1/3 and 2/3 (root length)

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What is used to perfect straight line access?

.25/.12 vortex orifice

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For perfecting straight line access on root, how deep into root should the .25/.12 file be taken?

Depth of mid root only

• If you are still patent, set the ________ file
at the confirmed WL (Working Length) and reset
the Pro-Mark motor to _____ action and
guide it to advance to the WL.

Wave One Gold; reciprocal

T/F: • If you have a considerable apical curvature, you may encounter resistance to advancement at this point. STOP! Recheck your WL & Pro-Mark settings. Confirm patency & smooth glide path with #15 hand file & then irrigate and continue to WL with Wave One.

True

What files are used for final shaping?

Vortex blue files

What size vortex blue file should be used for a small root?

#30-35

What size vortex blue file should be used for a medium root?

#40-45

What size vortex blue file should be used for a large root?

#45-50

Teeth with moderate to severe curvature require _____ MAF to avoid transportation of canal.

smaller

Younger teeth will have larger canals & | require _____ MAF to clean

larger

The following roots are considered ______ sized: Mand. Incisors, 2 canal Premolars, M. canals of Mand. molars, B. canals of Max. Molars

Small =

The following roots are considered ______ sized: | = Palatal canals of Max. Molars, Single Distal canals of Mand. Molars

Medium

The following roots are considered ______ sized: | = Max. Anteriors, M/M Cuspids, Single canal M/M Premolars

Large

◼ We will be using _______ Files for the final shaping and smoothing of the canal. Sizes .25/.06 through .50/06 available.

Vortex Blue

Each Vortex Blue file should be KEPT MOVING and go completely to WL on each of 10 strokes. They should be flexed while rotating & being drawn out to increase the flare of the canal in an appropriate direction - _______ from furca or ______ the greater dimension of the canal.

away from; toward

Each Vortex Blue file should be _______ and go completely to WL on each of 10 strokes. They should be flexed while rotating & being drawn out to increase the flare of the canal in an appropriate direction - away from furca or toward the greater dimension of the canal.

KEPT MOVING

Shaping is | complete when clean dentinal filings are on _______ 1/3 of vortex blue file

Apical 1/3

These files will automatically give you a ____ taper of the Apical Control Zone when carefully taken to the apex in the proper size. (All lab Vortex Blue files are this TAPER)

.06 taper

When a Vortex Blue is taken to WL, it should be for no longer than ____ (period of time) at WL or short of WL or it will begin to transport the canal. Rotating the file short of the WL will ALWAYS create a ledge.

1 sec

When a Vortex Blue is taken to WL, it should be for no longer than 1 sec. at WL or short of WL or it will begin to transport the canal. Rotating the file short of the WL will ALWAYS create a ______

Ledge

• Primary Etiologies of ____ and ______ disease: – Caries or other Injuries – Infected dentin & soft tissue (pulp) – Micro-organisms and their toxins invade – Substrate in canal system fuels micro-organisms – Result is peri-radicular lesion

Pulpal & P/A

Primary Objectives of ___: – Remove all caries – Remove infected dentin & pulp – Remove micro-organisms & toxins – Remove substrate from the canal system – Create a shape encouraging proper obturation – Seal the root canal system and all portals

RCT

What are the 5 shaping principles that should be attained by any method of shaping the canal?

1. A constantly tapering funnel from crown to WL 2. Curves of canal respected w/o “transportation” 3. Retention of the “apical constriction” 4. Enlargement of the canal system to create clean white filings (adequate cleaning) 5. Adequate “deep space” for proper obturation

SHould all caries be removed or can some be left in endo treatment?

All caries must be removed

SHAPING: FILES ______ - REMOVAL OF ALL CARIES AND INFECTED DENTIN - ALLOW CONVENIENCE FORM FOR EFFECTIVE IRRIGATION - CREATE RESISTANCE FORM TO FACILITATE EFFECTIVE OBTURATION - CONSERVE TOOTH & ROOT STRUCTURE TO MINIMIZE VRF

SHAPE

IRRIGATION: ______ - KILLS BUGS* - LUBRICATES - DILUTES & NEUTRALIZES TOXINS - DISSOLVES & REMOVES SUBSTRATE - FLUSHES OUT DEBRIS - EDTA REMOVES “SMEAR LAYER”

CLEANS

• ____ consists of a file positioned 1mm. short of the canal exit & measured at a REPRODUCIBLE REFERENCE POINT on the crown of the tooth.

Reproducible _______ are basic to consistent length control*

Reference Points

Strongly suggest the Reference Points coincide with the ____ for which the canal is named*

cusp (flattened ideally)

Is the standard of care less or more for a general dentist than for an endodontist?

The same

``` • A process to create an apical resistance form when rotary instruments are not available due to very large canal diameter. ```

Serial step-back

Should a canal require enlargement larger than a size | ____, it will be necessary to employ SSB.

#.50

What does ACZ stand for in SSB?

Apical control zone

In a serial step back procedure, will the canal be smooth or stepped to gain ACZ and taper?

Stepped; not smooth

In a SSB method where a 50 file is the initial apical gauge file, what file is used at ACZ?

#60

For SSB, how often (how. many mm) should the next file size increase coronal to ACZ?

Every 1 mm increase file size