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2nd YR- CSA- Endodontology > Clinical Endodontics part 2 > Flashcards

Clinical Endodontics part 2 Flashcards

1
Q

Once we have identified and located the canals what can wedo?

A

We can do:
1 Hand preparation
2. Machine driven preparation
To chemo mechanically clean the root canal

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2
Q

Which of the 2 methods of mechanically preparing the root canal is safer and easier?

A

Using a machine driven device as hand techniques can lead to more procedural errors like making a ledge or blocking the canal

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3
Q

What is are aim when we are preparing the root canal?

A

Our aim is to create a shape that has a smooth continuers taper to the apex and a shape that facilitated both irrigation and obturation of the root canal
We need to preserve as much dentine as well can

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4
Q

What can happen if we don’t shape the canal properly?

A

Harder to obturate as you’ll be left with voids when filling your canal
These voids allow bacteria to re infect the canal

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5
Q

What happen if we remove a lot of dentine when preparing our root canal?

A

The tooth can be susceptible to fracture

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6
Q

All root canal preparations should be C______ _______

A

Crown Down

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7
Q

What does it mean when we say all our root canal prep should be crown down?

A

Means we start at the top make the coronal bit wider then the middle bit wider and then the apex wider

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8
Q

Why do we follow a crown down preparation method?

A

As it is easier to access from the top

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9
Q

Where is the majority of the bacteria in the root found?

A

In the coronal third

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10
Q

When mechanically preparing the canal what do we do first?

A

Coronal flaring to making the canal wider

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11
Q

Give the 3 stages of mechanically preparing the canal

A
  1. Coronal Flare
  2. Middle flare
  3. Apical preparation
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12
Q

Name the most commonly used hand instrumentation technique to prepare the canal

A

The step-down technique

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13
Q

What is eh end product of a successful root canal preparation

A

Maintaining the same shape of the canal but but making it wider to be able to obturate

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14
Q

Name the 3ways we can manipulate/ use our filed to prepare the root canal

A
  1. Filing motion
  2. Stem winding motion
  3. Balanced force
  4. Anti curvature filing technique
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15
Q

Which of the three fine techniques do we use the most?

A

The stem winding technique

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16
Q

What is anti curvature filing?

A

When you are filing away from the curvature of the root canal

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17
Q

What can happen if you file near the curvature of the root canal and why?

A

As the curvature of the root canal has a thin wall if you file their you risk creating a strip perforation

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18
Q

What is a strip perforation?

A

When you file towards the curvature of the root and end up filing out the side of the root

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19
Q

Name the two ways we can classify the files we can use

A
  1. The materials they are made up of

2. The flute types

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20
Q

Which material scan files be made up of?

A
  1. Stainless steel

2. Nickel titanium

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21
Q

Which of the 2 material of files is less likely to break?

A

Nickel titanium as if you bend it it’ll return back to its original shape making git more flexible

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22
Q

How do we classify files using their flute type?

A
  1. K type

2. H type

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23
Q

Describe K flexo files

A
  1. They have a rhomboidal cross section

2. Made by twisting metal wires

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24
Q

What is the main difference between K and H files?

A

H files are made by cutting the flutes into the metal wire whereas k files the flutes are twisted into the metal

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25
Q

What are the drawbacks of using H files

A

They can break easily as the machine used to make them creates micro cracks

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26
Q

What are the benefits of H type files?

A
  1. They have a sharper cutting edge so you ca remove more dentine
  2. They are better for the straighter part of the tooth
  3. They allow for a quick rapid preparation
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27
Q

What does the H stand for in H files?

A

Hedström

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28
Q

Name the various components of a file

A
  1. Handle
  2. Size is written on
  3. Stop
  4. File length
  5. Tip
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29
Q

What does the size stamped onto the handle of a file mean?

A

Dividing the side stamped on the handle by 100 gives you the size of the tip in mm

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30
Q

If 35 is stamped onto a file what does that mean?

A

Means the tip of the file is 0.35mm

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31
Q

State the three standard file lengths

A
  1. 21mm
  2. 25mm
  3. 31mm
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32
Q

What is the same on every file we use

A

The cutting length is always 19mm

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33
Q

What is the cutting length of all of our files

A

19mm

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34
Q

Why are there 3 different file lengths when the cutting length of the files are always 19?

A

As there are varying lengths of root canals

35
Q

Which file length should we always use and why?

A

The shortest file length that will do the job as this will give you the most tactile sense and more control

36
Q

What is the cross sectional shape of a standard k file?

A

Square

37
Q

What is the cross sectional shape of a K flex file?

A

Triangle

38
Q

What is the cross sectional shape of a K flexo file ?

A

Rhomboidal

39
Q

Is the tip of a file cutting or non cutting?

A

can be either

40
Q

Is the tip of a K flexo file cutting or non cutting?

A

Non cutting

41
Q

Is the tip of a Hedström file cutting or non cutting?

A

Cutting

42
Q

How much taper do hand files have?

A

2%

43
Q

What is a 2% taper?

A

It means for every 1mm back from the tip the diameter increases by 0.02mm

44
Q

What taper does an protaper F2 rotary file have?

A

A 7% taper

45
Q

What is the cutting length of all of our files

A

19mm

46
Q

Briefly descrvje

A

Prepare the straight, coronal portion of the canal first (Coronal flare)
Flare the apex
Blend the two flares together

47
Q

When preparing the coronal flare what do you need to make sure you dont do?

A

Do not try and force the files into the apex as this will cause them to break

48
Q

Where can Gates-Glidden burs be used?

A

Use only in the straight portion of the tooth

49
Q

Describe a Gates-Glidden burrs

A
  1. Long shank

2. Number of bands on the handle to indicate size

50
Q

How big is the bud (the cutting end) of Gates-Glidden 2?

A

The same as a size 70 file

51
Q

How big is the bud (the cutting end) of Gates-Glidden 3?

A

The same as a size 90 file

52
Q

How big is the bud (the cutting end) of Gates-Glidden 4?

A

The same as a size 110 file

53
Q

How do you use the Gates-Glidden burrs

A

Use in a brushing motion cutting on the out stroke

54
Q

What will happen if you use a Gates-Glidden burr aggressively?

A
  1. You might break the burr

2. You’ll remove to much dentine

55
Q

What do you need to do every time you put a file or burr into the canal?

A

IRRIGATE

56
Q

Why do we need to irrigate?

A

To remove all debris to avoid blocking the canal

57
Q

Before starting the apical preparation what do you need to do?

A

Determine the working length

58
Q

How can we determine the working length?

A
  1. Use an apex locator

2. Take a working length radiograph

59
Q

Which file size do we use to determine the working length using an apex locator ?

A

Use wither a size 10 or 15 to length and work until loose

60
Q

Talk through the steps of apical preparation

A
  1. Determine the working length
  2. Take the first file to length and work until loose apically
  3. Take the next file size up and again take it ti length and work until loose
  4. Once the Master Apical File is reached, need to step back to blend with coronal flare
  5. Take a size 35 file 0.5 mm from the apex
  6. Take a size 40 file another 1mm from the apex
  7. Keep stepping back until the files no longer engage and you have blended into the coronal flare
61
Q

What should you do if a bigger file size doesn’t go into the canal when you are doing your apically prep?

A

Insert one size smaller file and try and increase the size of the canal

62
Q

Between each file you place into the canal what should you do?

A

IRRIGATE

63
Q

What happens to the files as you increase their size?

A

They get stiffer so you need more careful manipulation

64
Q

Generally which size file will be the last file you use to prep the apex?

A

A size 30 file

65
Q

What percentage taper do you want to achieve when preparing the apex?

A

At least a 6% taper

66
Q

Why is tapering the canal important when we are preparing the apex?

A

To allow for effective irrigation

67
Q

What is a half mm step back?

A

When you increase the file size by one and simultaneously move each file 0.5mm back from the apex

68
Q

How much taper does a half mm step back create

A

Stepping back 0.5mm creates a 10% taper

69
Q

How much taper does a 1mm step back create

A

Stepping back 1mm creates a 5% taper

70
Q

Summarise the aims of preparing the canal

A
  1. Continuously taper fun from the apex to the access cavity
  2. The cross sectional diameter should be narrower at every point apically
  3. The root canal preparation should flow with the same of the original canal
  4. The apical foramen should rain in its original position
  5. The apical opening should be kept as small as practical
71
Q

How do e create a taper in the root canal?

A

By doing a step back technique

72
Q

What is the purpose of instrumentation during preparation of the canal?

A

To create a shape we can clean and then obturate

73
Q

What plays the biggest role in decontaminating the canal?

A

IRRIGATION

74
Q

What should you do if you are going to do your root canal treatment over several appointments?

A

You’ll need to medicate the canal between appointments

75
Q

What is the purpose of medicating between appointments?

A

Is to reduce inflammatory products or to reduce microbial load

76
Q

What is the purpose of obturation?

A

To prevent re infection/ re contamination

77
Q

What is the quality of the obturation dependent on?

A

On how well the canal has been prepared

78
Q

Name the most widely used technique used to obturate

A

Most widely used technique is cold lateral compaction

79
Q

Briefly go through the steps of obturation

A
  1. Choose the largest finger spread that will go within 2 mm of the working length
  2. Choose a GP point that is the same size as the master MAF
  3. Dry the canal with paper points
  4. Coat the GP point with sealer
  5. Place the mater cone into the canal and then place the finger spreader alongside it
  6. Apply lateral and apical pressure for 15 seconds and then twist and withdraw the finger spreader
  7. Fill the resulting space with an accessory GP point matched to the spreader size used and coated in sealer
  8. Continue thus process until you can’t put the finger spreader back in
80
Q

What material do e use to obturate the canal?

A

Gutta percha

81
Q

Why do we need to work quickly when obturating?

A

Work quickly as the space will be lost due to elastic recoil of the GP already placed

82
Q

After you’ve obturated the canal what should you do?

A

Take a mid fill radiograph to make sure there’s no voids in your canal

83
Q

After you’ve completely filled your canal and don ea mid fill radiographs what should you do?

A

Try and placed the definitive restoration straightaway

84
Q

Summarise root canal treatment

A
  1. Access the root canal system
  2. Widen the coronal portion of the root canal (Coronal flare)
  3. Step back apically to blend in the coronal and apical flare
  4. IRRIGATE
  5. Obturate (Cold lateral compaction)
  6. Cut back the GP to remove everything from the pulp chamber
  7. Seal the GP coronally
    8 Coronal restoration

2nd YR- CSA- Endodontology (4 decks)

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