CSA endodontics 3 Flashcards
When is effective irrigation started?
• Canal irrigated throughout in prep phase to remove debris
- once final shape is achieved , then effective ir
Why irrigate ?
- Remove debris
- Tissue dissolution
- Biofilm removal
- Antimicrobial
What are choices of irrigants?
- LA/Water/Saline
- Iodine
- EDTA
- Chlorhexidine
- Sodium hypoclohrite –
What does water saline irrigant do ?
physical flushing
What does iodine irrigant do ?
stained canals & people had allergic reactions
What does EDTA do ?
Weak acid that dissolves inorganic tissue, dissolves calcium
What does Chlorhexidine ?
strongly antibacterial but doesn’t dissolve any tissue
What does Sodium hypochlorite do?
- Dissolves organic tissue
- Antibacterial
- Cheap
- Good flow properties
What is the benefit of irrigants?
- Safe, non toxiuc
- Cheap
- Stable
- Good flow properties
- Dissolve tissue
- Antibacterial
- No deleterious effect on dentine
Why is Sodium Hypochlorite bad ?
- Toxic
- Painful and leads to severe tissue necrosis if extruded under pressure
- Can damage dentine (removed collagen from dentine) SO Risk of fracture
What is Chlorhexidine ?
• Antibacterial at 2% -
• Has substantivity
• cheap
- Doesn’t dissolve tissue
Why can’t you mix Chlorhexidine with sodium hypochlorite
precipitate forms that’s carcinogenic and this will block up root canal
Why is EDTA Bad?
- Not directly antimicrobial
- Doesn’t dissolve organic tissue
- Neutralises sodium hypochloride
What is the irrigation protocol ?
• Irrigate w/ sodium hypochlorite throughout prep procedure – debris removed
How to get curved roots?
• Use GP point up and down (mapped to shape of canal)
What does Obturating do ?
- Reduces re infection and substrate leakage
- Defective coronal restorations, microcracks
- Opens dentinal tubules
- Accessory canals exposed by periodontal pocketing
- Fill entire pulp space & provide a barrier to re infection
What are necessary steps for obturation ?
- Canal fully prep and irrigated
- Canal dry
- Patient symptom free & any sinuses resolved
What dressing is used for RCT?
odontopaste
What do we use obturate ?
- Current Hutta percha w/ sealer bioceramic cements (its natural rubber latex)
What does obturation sealer do ?
Fills spaces that we cant get the Gp in
What are ideal properties of sealer?
Antimicrobials
Non-toxic
Easy to mix
What eugenol based sealer
- very antibacterial
* Not very compatible with composite resins
What resin based sealer
gets in with composite
What bioceramic sealer
• Promotes healing
How to obturate ?
• Cold lateral compaction –