Clinical endodontics II Flashcards

1
Q

what is the purpose fo root canal treatment

A

Maintain asepsis of root canal system or to disinfect it adequately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how do we do the root canal treatment

A

Undertake chemo mechanical prep of root canal system, obturate it and restore it
Shape root canals, clean root canals , fill root canals , then tooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is chemo mechanical preparation of root canal

A
  • Historically Filing away infected root dentine
  • Use chemical irrigants to decontaminate the canal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the difficulties of root canal

A
  • Sheer Complexity of root canal treatment
  • Curvature of root canals prevent us from shaping them and leading to procedural eros
  • Difficulties in getting the irrigants to all parts of the root canal system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what do we consider in radiographic assessment of RCT

A
  • Are roots curved
  • How many canals are there
  • Is the canal obvious or is it sclerosis
  • Is the apex damaged or open
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

do we need good moisture control for root canal treatment

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

why is rubber canal needed for RCT

A
  • good isolation of tooth
  • protects airway
  • prevents contamination by saliva
  • prevents irritants form being swallowed
  • can use oraseal if required for a tight seal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what happens when accessing the root canals

A
  • Once the tooth is situated, remove all caries and restorative material and assess restorability
  • Rule of thumb, if you can’t clamp it, you can’t fill it
  • If restoratabel, build back up to facilitate RCT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is done to figure out access strategy

A
  • use measuring tool on digital systems or old school wet film
  • place bur against wet film to measure how deep its got to go in
  • estimate distance to roof of pulp chamber and floor of pulp chamber
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what do we need to remember when accessing tooth

A
  • crown and root is not always aligned
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

where would you access on lower molar

A

distal canal - palatal canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

describe the access strategy

A
  • go through the roof of the pulp chamber and move to safe ended burs - ENDO BURS
  • remove all pulp chamber root until you can see all fo the pulp chamber floor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what outlines does a upper central incisor have

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how would you access upper central incisor

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

after accessing the upper central incisor - what do we do

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what do we do when the pulp chamber is found

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

for accessing canals what 4 things do we need

A
  • good isolation
  • good magnification
  • good pre operative assessment
  • knowledge of the anatomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

when accessing a restored tooth what do we do

A
  • Remove restoration to check restorability
  • Build back up to created a 4 walled access cavity- improve to irrigate tooth
  • Aim for the largest canal - distal in lower molar , palatal in upper molar
  • Break through the roof of the pulp chamber
  • Remove the roof of the pulp chamber using a safe ended bur
  • Ensure that you can see all of the pulp chamber floor
  • Remember how many canals you are looking for
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are we after after removing roof of pulp and pulp chamber

A
  • Ensure the tooth is restorable
  • Minimal removal of dentine to see the whole of the pulp chamber floor - maintain structure integrity
  • Minimal removal of dentine to enable files to reach the root apex without being beyond their limits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what does root canal preparation consist off

A
  • creating a shape that has smooth continuous taper tot he apex
  • facilities irrigation and obturation of the root canal
  • ## preserves dentine where possible
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is chemo mechanical preparation

A
  • chemically irrigate- flush out debris
    mehcncially file the root - remove debris
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what does canal shaping do

A
  • remove infected dentine but create shape we can clean
    continuous taper
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

describe this image

A

1- coronal promotion of tooth undertaking coronal flare
2- Then open up root canal and move to middle portion of root canal and flare tha part
3- only once the coronal and middle parts prepared then we go to apical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are mistakes made form coronal flaring

A
  • get file to go straight to apex without undertaking sufficient coronal flaring
    -this increases risk fo file fracture and carry debris down apical portion
    prepare root canal form CROWN DOWN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what hand instrumentation is used

A

hand fiels
- hedstorm
- k files
- stain less steel

GG- gates glide burs - safe ended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is the most common technique for RCT

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is the stem winding motion

A
  • file twisted and engaged walls and apical pressure maintained on canal and fuel is pulled out
29
Q

describe K files

A
  • made from stainless steel
  • made by twisting blank wire to create small flutes
  • variety of motions, balanced and step filling
30
Q

describe hedstrom fiels

A

more aggressive cutting flutes
- more procedural problems if not used right
- used in hand filling motion - in and out

31
Q

label this

A

cross sectional shape

32
Q

label this

A

handle

33
Q
A

stop

34
Q
A

file length

35
Q
A

file tip

36
Q

what does 35 mean in this file

A

tip of the file is 0.35 mm in diameter

37
Q

what 3 lengths do file come in

A

21
25
35

38
Q

which file length is most common

A

25

39
Q

what does the cross sectional shape tell about the file

A
  • square blank
  • K file
40
Q

what does a 2% Taper mean

A
  • for every 1mm back from the tip the diameter increases by 0.02mm
41
Q

what does the silicon stop on file do

A

measuring device

41
Q

what is typically the file length

A

21 or 25mm

42
Q
A

size 10 - tip 0.1 mm diameter

43
Q

what would a 6% taper mean

A

for every 1mm back the diameter would increase by 0.06mm

44
Q

who described the step-down preparations

A

Goerig 1982
- variations exist

45
Q

describe the step-down

A
46
Q

describe what the number fo bands indicate on a GG bur

A
47
Q

what does the long shank of GG bur allow it to do

A
48
Q

which GG bur is most common and why

A

most common - 2,3,4
GG 1- prone to fracture
5 and 6 - big and remove too much dentine

49
Q

what is the size of GG2 bur same as

A

size 70 file

50
Q

what is size of GG3 and GG4 same as

A

size 90 file
size 110 file

51
Q

how do we use the GG bur

A
  • brushing motion
  • cutting on the outstroke
  • brush away from furcation
  • bruhs away to area with most dentine
  • and take it further down
52
Q

what’s impotent when preparing teeth

A

TO IRRIGATE
- flush out debris

53
Q

how do we determine the working length

A
  • once the coronal flare completed
  • will already have idea from pre op
54
Q

label this

A
55
Q

how do we determine the working length

A
56
Q

how do we take a working length radiograph

A
57
Q

what else can we use for working length estimation

A
  • place file in tooth after estimating the working length
  • using stoppers to ensure accurate measurement
  • take radiograph
  • indicate where tip of file is relative to radiographic apex
58
Q

what is the problems with radiographs when finding working length

A
  • anatomy is not always what you think
  • point to establish is not visible radiographically
59
Q

describe how Electronic apex locator work

A
60
Q

describe how this works

A
  • when the file is out of the end of tooth = red light
  • wind file back when transition between red and green occurs
61
Q

how do we use clinical procedure to establish working length

A
62
Q

what do we do once working length determined

A

-file to length and work until loose apically

63
Q

what happens if the next file doesn’t go as easily to within 2mm of working elgnht

A
  • go back to previous file and work looser
  • irrigate between each file
  • as files get bigger in size , they get stiffer so need to be more careful manipulation
64
Q

what appends once master apical file is reached

A
65
Q

how do we create 5% taper or 10% taper

A
66
Q

when do we keep stepping back until

A
67
Q

what are the root canal preparation aims consist of

A
  • continuously tapering funnel form apex to access cavity
  • cross sectional diameter should be narrower at every point apically
  • the root canal prep should flow with shape of original canal
  • apical foramen should remain in. original position
  • apical opening should be kept as small as practical
68
Q
A