Week 2 PP Flashcards
Endodontic Treatment & Procedures
- Root Canal Therapy
- Endodontic Surgery
- Pulpal Therapy
What is the first step/stage of Root Canal Thereapy?
Debridement - the process by which the pulpal tissue is completely
removed from the tooth, and the canal or canals cleaned and
shaped to receive the filling material
What is the second stage of Root Canal Therapy?
Obturation
* the process by which the pulp canals and chamber are filled
so that the tooth cannot be re-infected through the apical
foramen and the tooth does not remain hollow
Steps for Root Canal Therapy..
- review medical history
-review chart and radiographs
-topical/local anesthetic
-isolation (dental dam)
-disinfection
-Accessing the Pulp
-Tissue Removal
What type of Local Anesthetic is used for RCT?
-Acute infection - high epinephrine/long lasting anesthetic
-Severe Anesthetic - Anesthetic directly into pulp
-Necrotic tooth - no anesthetic
What items are to be disinfected?
-Tooth
-Clamp
-Surrounding area
- Solution
- Iodine
- Sodium hypochlorite
- Peroxide
- Instruments
- Cotton forceps
- Cotton pellet
How to Access the Pulp for RCT?
Posterior teeth - by occlusal
Anterior teeth - lingual (near the cingulum)
What instruments/materials are needed for Access Preparation?
Instruments
* High-speed handpiece
with long shank fissure
bur
* Slow-speed handpiece
with long shank round
bur
* Endo explorer
Materials
-Suction
-water
Tissue Removal for RCT
Coronal pulp is removed - this should enable the dentist to see or locate the radicular canals
Instruments/Materials required for Tissue Removal for RCT
- long shanked round bur
-spoon excavator
-endo explorer
How is the radicular pulp removed?
The radicular pulp is removed using barbed broaches - * depending on whether
the pulp is necrotic or
newly infected, it will
have different
appearances
What is Chemical Debridement?
- Once the pulp has been removed from the
canals, the dentist will
destroy the bacteria
present in the canals
What solution is used in the Irrigating Syringe?
With solution such as Sodium Hypochlorite, peroxide, or iodine
How is the Length of the Canal measured?
Using files or apex locator
Instruments used for measuring the length of the canal?
-Endo files
-File Stoppers
MM Endo Ruler
-PA X-ray Film
-Or an Apex Locator
Measuring File Length
- the canals must be cleaned completely free of all pulpal tissue, bacteria eliminated and the canals properly shaped to receive the gutta percha filling material
- the length of each canal must be accurately measured so that debridement is performed to the apex - not short of perforated through the foramen
What is the traditional way to measure?
The traditional way to measure is to place small files into each canal to the depth of the estimated apex of the root, then take a radiograph to see if it is
correct
Measuring the Canal Length
-The dentist uses the diagnostic x-ray to measure the canals – a small sized file is chosen for each canal and the rubber stopper set at the desired length
* A periapical x-ray is taken, and the position of the files observed – the dentist will either continue to use the initial length for further debridement, or will adjust the length the files are set to
What is the second xray called?
Working Length Xray
What is an Apex Locator?
an apex locator device uses sonar type waves to locate the apex for the dentist
* The apex locator still relies on a file being placed into the canal
* The electrode of the apex locator is attached to the file and sonar type waves created
– as the file nears the apex of the tooth, the gauge notes changes in the ‘rebound’ and
indicates when the file reaches the apex
What if the length of the canal is not properly determined?
The dentist may either leave pulpal material in the ends of the canals, or perforate the apex
- A perforated apex allows the root canal sealer to exit the tooth and may cause irritation in the alveolar bone
- Neither situation allows the apical bone to properly heal
K-Type File
-comes in various sizes
-looks like an auger
-
*colour coding system is consistent across ALL endodontic files
3 Types of Files?
-K–Type File
-Hedstrom (H) File
-Reamer File
What is a Glates-Glidden Bur?
Attaches to a slow speed handpiece
-can put it in top of canal to make it wider/open it up
-size is determined by line indentation at bottom