4. Chemomechanical Disinfection Flashcards

1
Q

What is meant by shaping the root canal?

A

Controlled removal of dentine to give a tapering shape that can be sealed throughout its length with a root canal filling.

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2
Q

What are the stages in mechanical preparation of the root canal?

A
Preparation of tooth
Access cavity
Straight-line access
Initial negotiation
Coronal Flaring
Working length determination
Apical preparation
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3
Q

What is meant by cleaning the root canal?

A

Removal of organic pulpal debris, microorganisms and toxins.

You clean the main canal, dental tubules, isthmuses and lateral canals.

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4
Q

Why can you not clean a root canal by mechanical means alone?

A

Must use chemical means as well because there is lateral canals, fin like extensions and webbing between canals.

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5
Q

What are the objectives of using irrigants during root canal treatment?

A
To disinfect root canal
Dissolve organic debris
Flush out debris
Lubricate root canal instruments
Remove endodontic smear layer
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6
Q

What equipment do you use to irrigate a canal?

A

Luer lock syringe

27 gauge endodontic-tipped needle

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7
Q

What is the action of sodium hypochlorite?

A

Antimicrobial
Dissolves pulp remnants and collagen
Dissolves necrotic & vital tissue (only irrigant to do this)
Helps disrupt smear layer by acting on organic component

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8
Q

What concentration of Sodium Hypochlorite (NaOCl) is used?

A

Between 0.5 and 6%

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9
Q

Why must you be careful not to get sodium hypochlorite into the patients mouth or around their face?

A

Unpleasant taste
Toxicity
*Always ensure dental dam is well sealed

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10
Q

What concentration of EDTA is used?

A

17%

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11
Q

What is EDTA?

A

Ethylenediaminetetraacetic Acid.

A chelating agent that is capable of removing the smear layer when used with NaOCl.

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12
Q

How long should you use EDTA for?

A

1 minute contact time necessary

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13
Q

What is chlorhexidine digluconate?

A

Positively charged
Lipophilic
Hydrophobic

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14
Q

What does chlorhexidine digluconate do to individual cells?

A

Interacts with phospholipids a lipopolysaccharides on the bacterial cell membrane.
Also alters the cells osmotic equilibrium.

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15
Q

What properties does chlorhexidine digluconate have?

A

Antibacterial activity
Anti fungal activity (less than NaOCl)
Somewhat active against biofilms but unable to disrupt them.

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16
Q

Why must you clean the canal of CHX before you irrigate with NaOCl?

A

Interaction of CHX and NaOCl produces parachloroaniline.
This substance is cytotoxic and carcinogenic.
It also has uncertain bioavailability.

17
Q

Once canal preparation is complete, the canal should be irrigated with…

A

1x syringe sodium hypochlorite
1x syringe EDTA/citric acid
1x syringe sodium hypochlorite

18
Q

What is the purpose of intra-canal medicaments?

A

Placed in root canal between treatment appointments in an attempt to destroy microorganisms and prevent reinfection.
Reduce inflammation & exudate.
Control of root resorption.

19
Q

How do you decide if you will complete the treatment in a single visit or multi-visits?

A

Case-by-case basis
Vital cases often suitable for single visits
Non-vital cases are more complex so an inter-appointment dressing will be necessary

20
Q

What inter-appointment medicaments are available?

A

Anti-microbial paste

Non-setting calcium hydroxide

21
Q

What is anti-microbial paste?

A

Paste containing corticosteroid & tetracycline
Can aid in reduction of pulpal inflammation
Used in management of ‘hot pulp’
Can facilitate follow up Rx
Effective for 5-7 days

22
Q

What is the pH of non-setting Calcium Hydroxide?

A

12.5

23
Q

What are the actions of non-setting calcium hydroxide?

A

Prolonged antibacterial activity
Hydrolysis of lipopolysaccharide thus reducing its inflammatory potential
Removes tissue debris
Treatment for 7 days

24
Q

What materials can be used for an inter-appointment temporary dressing?

A

Cavit
IRM
Polycarboxylate cements
Glass ionomer cements