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Restorative > Access And Advances > Flashcards

Access And Advances Flashcards

0
Q

What is the first stage of endo treatment? And what does this entail?

A
  1. Access

2. Consider pulpal anatomy and need to remove the pulpal roof but do not damage pulpal floor. Identify canal orifices

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1
Q

What are the factors which would indicate if a tooth can be root treated?

A

General factors to consider: adequate access, poor OH, general health, attitude of patient

Local factors: PROVE + signs of resorption, unsusl anatomy

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2
Q

What must you ensure with regards to the access cavity?

A

It is divergent

It allows straight line access

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3
Q

What is the purpose of straight line access?

A

Allows for good instrumentation and irrigation

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4
Q

What is the problems with using radiographs to obtain information from?

A

Heavily restored dentition: restorations may mask anatomical information

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5
Q

What shoud the access cavity reflect?

A

The shape of the pulp chamber

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6
Q

When shoud the rubber dam be put on?

A

Once the access cavity is made

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7
Q

What percentage of upper second molars have two mesio buccal root canals?

A

65%

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8
Q

Where should you look for the second MB canals?

A

Need to look for a fissure which often extends from the main MB canal to the P canal

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9
Q

T/F C shaped canals may split part way down the canal?

A

T

They may also be continuous

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10
Q

Which burrs can be used to access the root canal?

A

Blunt tips,
Long shanks and
very small round head burs

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11
Q

What can be used to identify the canal orifice?

A
  1. Ultrasonic
  2. Magnification
  3. DG16 probe
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12
Q

What is the purpose of orifice engagement?

A

Aids straight line access to apical third
Removes heavily infected material
Reduces the effective curvature
Improved irrigation

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13
Q

What instruments can be used to enlarge the orifice?

A

Hedstrom
Gates glidden
Rotatary orifice shaper

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14
Q

How can you enlarge the orifice using the crown down approach?

A
  1. Hedstrom file first if size 3 GG cannot pass into canal
  2. Select the largest GG burr that will pass freely into canal
  3. Cut on out stroke
  4. Use progressive smaller gates glidden in the straight portion of the canal only
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15
Q

What are the aims of canal prep?

A

Clean / remove bacteria and organic debris

and shape : produce an ideal shape to receive obturating material

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16
Q

What solutions can be used to clean irrigate and librciate the canals?

A
  1. Sodium hypochlorite
    2: LA
  2. CHX 2% and new R4 20% which can be used as an antibac dressing
  3. Cheating agent eg EDTA
  4. Potassium iodide
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17
Q

What percentage solution is sodium hypochlorite used in?

A

0.5-5%

18
Q

What are the properties of sodium hypochlorite?

A
  1. Antibac
  2. Dissolve organic debris
  3. Non irritant to vital tissue at low concentrations
19
Q

What are the features of CHX as a Cana irrigant?

A
  1. Acts as a lubricant as the hibisscrub formula
  2. Low toxicity
  3. Broad spectrum
  4. Substantive
20
Q

Which lubricating pastes can we use?

A

Canal plus, Glude

21
Q

What are libricating pastes?

A

They are a group of material that improve the cutting effeciency of the file

22
Q

What does Glyde contain?

A

10% urea peroxide
15% EDTA
Water soluble base

23
Q

What is the purpose of Glyde?

A
  1. Lubrication which increases cutting efficiency of k files by 200% and Hedstrom files by 30%
  2. Acts as a chelating agent and removes the smear layer
24
Q

Which chelating agents can we use?

A

EDTA 17% removed rhe smear layer

Citric acid solution

25
Q

Which size irrigating needles do we use?

A

27 gauge side delivery needle which avoids extrusion through the apex

26
Q

What are the areas for advances in canal preparation?

A
  1. File design
  2. Hand preparation technique
  3. Mechanised prep technique
27
Q

What are the development in file designs?

A
  1. NiTi files
  2. Increased taper files
  3. Greater taper files
  4. Slow rotary files
  5. Bud shaped cutting file used in light speed
  6. Orifice enlarging files with greater taper design
28
Q

What is the advantage of NiTi files?

A

They have improved flexibility and they only engage in the area of dentine that needs removing
Elastic behaviour
Use in slow rotation
Reduced straightening of curved canals

BUT sudden fracture and cost

29
Q

What are the tapers of the increased taper files?

A

0.4 and 0.6

30
Q

What are the tapers of the greater taper files?

A

;06, .08, .10, .12

31
Q

How does the traditional step back technique work?

A
  1. Apical region prepared to MAF of ISO 25/30
  2. Canal flared towards coronal aspect by placing successively larger files 1mm short of previous instrument
  3. Recapitulate between all files
32
Q

What are the problems encountered with step back technique?

A
  1. Diffcult to maintain CWL in curved canals
  2. Iriigation limited by narrowness of coronal orifice
  3. Debris forced apically
33
Q

What have been the advances and modification to step back?

A

Hand filing

  1. Modified step back
  2. Anticurvatjre filing
  3. Crown down
  4. Balanced force

Mechanised

  1. Light speed
  2. Endo sonics
  3. Slow rotary: profile , hero , quantec, GT rotary, protaper
34
Q

During the modified step back what happens first?

A

Canal patency is checked first using a size 10k with a watch winding technique to the apex
The orifice is then enlarged and this is where the coronal part of the curve is opened away from the Furcal wall and this the effective curvature is reduced

35
Q

What is another name for anti curvature filing?

A

Abou rass

36
Q

What is the main aim behind the AC filing?

A

Filing is directed away from the inner curvature of the canal and avoids strip peroration

37
Q

When is AC filing mainly used?

A

In very curved canals

38
Q

What filing ratio is used in AC filing?

A

3:1

Outer wall : inner wall

39
Q

What is the disadvantage of AC filing?

A

Need copious irrigation and recapitulation

40
Q

What must be done to the files for AC?

A

Bend them around a mirror handle of around the special instrument

41
Q

What filing action is used with AC?

A

Push pull

DO NOT ROTATE

42
Q

How are the tips of modern files shaped?

A

They are blunted to prevent them from gouging into dentine

Restorative (45 decks)

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