Day 2

Question 1

Irrigants

Answer 1

Sodium hypochlorite (bleach) is best. Some others have also been used, but we will use water in clinic.

Question 2

We use bleach because it

Answer 2

flushes, lubricates, disinfects, dissolves tissue, however it does not remove the smear layer. We need to keep this in the tooth*

Just grab some bleach from the store for this.

Question 3

Apical section of canal prep slightly

Answer 3

larger - to size 20 hand file.

Question 4

Gates gliddens used

Answer 4

Straight line access help - if you have a canal that takes a curve pretty quickly as it goes down apically, gates gliddens can be used to plane walls of canal to straighten it up. Rotary orifice opener files also can be used.

Question 5

Once coronal third of canal is opened by gates gliddens, you can

Answer 5

get to the apex with larger files and make it all smooth and clean.

Question 6

Work a #10 file to working length, then a #15, then a #20. Recapitulate (——) with a ———

Answer 6

10 file (1 mm beyond your working length) between each file used.

gain patency

Question 7

Also continue to irrigate after

Answer 7

every couple of files.

Question 8

Debris in canal can

Answer 8

deflect file into the wall, leading to a ledge.

Question 9

Patency - *To prevent losing the

Answer 9

working length and prevent packing of debris (blocking out or ledging/zipping)

Question 10

Patency maintained by

Answer 10

*Done by using small hand files 1 mm beyond the working length

Question 11

Zipping is

Answer 11

when it goes out of the root – when the ledge has been worked out of the root itself. Patency helps this, keep clearing with small file 1mm beyond. Patent = clear canal. If you have this, you can make adjustments if needed.

Question 12

Gates gliddens -

Answer 12

Their purpose is to help create a straight line to the apex and help you to place bigger files to the working length.

Question 13

Gates gliddens -

Answer 13

Their purpose is to help create a straight line to the apex and help you to place bigger files to the working length.

Question 14

Rotary orifice openers

are used very similarly to

Answer 14

gates gliddens

Question 15

2 should go

Answer 15

passively inward. \

Question 16

The other two are based on how far 2 went. 3 should go —– as far as the 2. 5/4 just goes

Answer 16

½

into the orifice to open up the first 2-3mm of orifice.

Question 17

Gates gliddens requires

Answer 17

full reostat pressure.

Question 18

IF gates gliddens gets stuck,

Answer 18

remove from handpiece, spin/twist it out.

Question 19

FINAL APICAL SIZE.

Answer 19

This should be a minimum of #30 and is estimated by going two file sizes larger than the first file that binds after using your Gates Gliddens

Question 20

The biggest size you prepared at the apex should be recorded as your

Answer 20

FINAL APICAL SIZE.

Question 21

If a 10 is barely going in at first, going to a

Answer 21

25 is acceptable

Question 22

Step back is

Answer 22

Moving back 1mm from working length, going 1 size up in files. Repeat for next 3 file size.

Question 23

Another rule – after gates gliddens, see which size file engages root canal walls (this is tactile). Then go —– and you’re done. This engagement is called ——-.

Answer 23

two sizes up

binding

Question 24

Step back - You will usually prepare with about —— file sizes but with longer teeth you need to

Answer 24

3-4

“step back” even more to cover the long distance between your apex and where your Gates Glidden burs prepared the canal.

Question 25

Apical stop –

Answer 25

this is maintaining apical constriction, and where the prep ends. We want to make sure that obturation material stops here. Put in apical file and put some pressure to make sure that it doesn’t go beyond working length.

Question 26

If the file pushes beyond your final working length, you DO NOT have an apical stop. Prepare the canal at least

Answer 26

one file size larger and repeat the apical stop check. Take a radiograph with the final file in place at your FINAL WORKING LENGTH.

Question 27

When you start cutting dentin, stop cutting at

Answer 27

2 sizes larger.

Question 28

Recapitulation –

Answer 28

return to smallest file between each file used. Keeps apex from being clogged from debris.

Question 29

Gates glidden – 2 corresponds to

Answer 29

60 file.

Question 30

Gates glidden – 5 corresponds to

Answer 30

120 file.

Question 31

Recapitulation is at

Answer 31

working length,

Question 32

patency is

Answer 32

1mm beyond working length

Question 33

Choke bore is the

Answer 33

apical stop

Question 34

Black stripes indicate —-. 1 stripe is

Answer 34

taper

0.02.

Question 35

2 stripes is

Answer 35

0.04

Question 36

Size at tip – indicated by the

Answer 36

colored stripe. These coordinate with the color system that files go with. Yellow is 20, 25 is red, 30 is blue, 35 green, 40 black, 45 white (restart)

Question 37

If you finish your preparation with the 35/.04 file at 21 mm you would record the information as follows

Answer 37

21/35/.04

length/final apical size/taper

Question 38

Rotary files must be utilized with a

Answer 38

lubricant. Running them in a dry canal greatly increases the risk of file separation.

Question 39

What kind of files

Answer 39

Vortex - not vortex blue. This is a NiTi M-wire.

NiTi = nickel titanium

Question 40

What is M-wire?

Answer 40

Thermally treated, has increased flexibility.

Question 41

Rotary motor should be set to

Answer 41

500RPM for vortex.