problem solving Flashcards
what errors can poor access lead to?
pulp not completely removed
missed canals
ledger canals
how to prevent poor access
evaluate pre op xrays
remember ideal outline form/anatomy
be sure pulp chamber is unrooted and horns removed
STRAIGHT LINE ACCESS
how to prevent missed canals
pre op xrays
good access, review anatomy
good magnification and lighting
CBCT
what is a ledged canal
deviation from original canal without communication with PDL, creates a “short point”, may be impossible to achieve ideal
how to prevent ledged canal
all the usual stuff, dont force files, careful advancement thru file sequence
how to manage ledged canal
try to bypass with small files, curve or bend the end of the file to try to advance around ledge
what are instrumentation problems
ledged canals creation of artificial canals/root perf transported canals strip perforations separated instruments
what is a zipped canal
result of the tendency for the instrument to straighten inside a curved root canal
sequelae of ledge in canal:
ledge in canal —- misdirected pressure and force —-artificial canal —-apical or mid root perforation
management of zipped canal
attempt to bypass with small, curved files
may need to repair with MTA
prepare pt for possibility of apical surgery
blocked canal prevention
good access, copious irrigation, recapitulation
blocked canal management
attempt to bypass with small files, copious irrigation, ultrasonically activated irrigation
what causes a strip perforation
over preparation, straightening of a curved canal
if you separate an instrument, whats the best location for it to happen
the more coronal the better (dont try to remove if they are in apical third)
how is a separated rotary file removed
with ultrasonic instruments, optimum visualization is key (use a microscope)
