Endo-Access, Cleaning, Shaping, Obturating Flashcards by Austin Shackelford

What is the material for removing the smear layer?

EDTA

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What is possibly the most demanding part of a root canal?

Access!

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Access: the walls should ______ toward the occlusal and try to achieve ______ line access

diverge…straight

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What burs can we use to look for oraficies?

Mueller burs!

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Back to anatomy I guess…What % of mand anteriors have 2 canals?

41%!!!

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MB2 is ALWAYS ______ and _____ compared to MB1!!!

Palatal and MESIAL

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More anatomy-what % of Maxillary molars have 4 canals?

90-95%

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What shape should your mand 1st PM have? What are my chances of finding a second canal?? (i experienced this first hand)

ovoid…35%

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When accessing, make sure to remove ALL sources of _______

bacteria

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The pulp chamber of a tooth is always located in the _______ of the tooth at the level of the ______

CENTER…CEJ

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The ORIFICES of the canals are ALWAYS located at the junction of the _____ chamber floor and the _______ chamber walls!

DARK floor….LIGHT walls

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The orifices of canals are usually located at the ______ of the “dark” floor angle.

vertex

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The orifices of the canals are SYMMETRICAL with respect to a line drawn in a _____-______ direction at the level of the _____

Mesio-Distal direction at the CEJ

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The orifices of canals are _______ with respect to each other

SYMMETRICAL

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There is 1.0 x 10^__ to 1.0x10^__ bacterial cells in the infected root canal, ______ instrumentation reduces the number 100-1000 fold

10 to the 2nd to 10 to the 8th

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Purpose for IRRIGATION! Wetting the canal walls and flushing of ______ from the canal

debris

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Purpose for IRRIGATION! Destruction of ________

microorganisms

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Purpose for IRRIGATION! Dissolution of ______ matter

organic

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Purpose for IRRIGATION! Removal of the ______ layer and softening of ______

SMEAR….dentin

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Purpose for IRRIGATION! to clean mechanically ________ areas

inaccessible

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ANTIMICROBIAL effects of Irrigants-________ introduced as an Endo tx by Coolidge in 1919.

Sodium Hyp-O-Chlor-ITE

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ANTIMICROBIAL effects of Irrigants-NaOCl shows SUPERIOR ________ action

antibacterial

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ANTIMICROBIAL effects of Irrigants-NO difference seen in efficacy between ___ and ___ %

0.5 and 5%

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ANTIMICROBIAL effects of Irrigants- Copious irrigation with NaOCL in conjunction with mechanical instrumentation eliminated bacteria in ___% of cases in controlled studies

50%

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What size needle do we use to irrigate with?

27g

YOU need to be VERY CAUTIOUS not to force irritants out the _____ of the root!

APEX

What are the two "appropriate" irrigants?

NaOCl & EDTA

Whats the typical [ ] of NaOCl used in dentistry?

5.25% or 2.6%

What are the two functions of NaOCl?

1.Anti-bacterial 2.Dissolves tissue

What are the two functions of EDTA? What is it used in conjunction with?

1. Chelating agent 2.REMOVES SMEAR LAYER....used in conjunction with NaOCl

What type of temperature should the irrigant be?

Warm..remember his coffee pot trick?

EXAM Q: What are the two functions LUBRICATION do NOT do?

Lube does NOT kill Bacteria nor Remove Debris..its for friction reduction and its a chelating agent

What does EDTA stand for?

Ethylene Di-amine Tetra-acetic Acid

PROLUBE is what type of chemical?

Carbamide Peroxide

What are the 6 steps for the final EDTA technique?

1.Irrigate with NaOCl 2.Evacuate NaOCl 3.EDTA in 4.Evacuate EDTA 5.Rinse with NaOCl 6.Final since with water

NOTE: "It's MORE important what you get ____ of the canal than what you put ___"

GET OUT....put in

Our .02 files are made of

stanless steel

Our .04 and .06 files are made of

nickel titanium

With a 16mm diameter file with an .02 taper you will see a ____mm change

.32 (16 x .02)

Stainless steel advantages: ________ and _______ resistant, flexible, good bio_______

corrosion and fracture resistant....biocompatable

The #2 Gates Gladden drill is designed to break at the ______ vs the #1 GG can break at the _____

#2 at the shaft/shank....#1 at the tip

The primary goal of canal preparation is to shape the canals from the orifice to the apical constriction in a continuously ______ form to thoroughly clean the space and aid in filling the canal space.

tapering

We will be utilizing a modified passive step _____ & crown ______ technique

STEP BACK & CROWN DOWN

The radiographic length is not the actual but an estimated length. You should subtract approx. ___to____ mm from this measurement

1to1.5mm

A _______ force technique works in both directions. First rotated ___ degrees clockwise, then ____ degrees with apical pressure.

BALANCED force.....180 degrees...120 degrees w. pressure

Oh crap. Slides say minimum of _____ after rotary, but manual says ______...

30.04.... 35.04

Instrument fatigue-BOTH how many ____ you use the file AND how the file was _____

times...used

Minimize Fx-use plenty of _____/____.....establish a _____ rest...

irrigation/lubrication....finger rest

Minimize Fx-Only use rotaries to point of divergence/_____spots...use a _____ motor!

trouble...torque

What type of motion is used with the motor rotary files?

pecking motion

When starting out with the rotary, stay ___mm short of working lenght

5mm oops, never did that

THE MINIMUM SIZE for the APICAL PORTAL OF EXIT is a ___.04 taper or .06 taper file.

30.04

What can you fix a strip perf with?

MTA

HEY DUMBASS. Never FIT GP in a ____ canal.

DRY. haha if you fucking read, Dr. L won't think your a dumbass.

Before obrutation, the Pt should be _______ to purcussion

asymptomatic

If the canal has been cleaned out properly, you can fill it with sterile ______ and it will turn out fine.

bird crap

What are the two obturation materials?

1.Solid core-GP 2.Sealer

What are the three types of CORE obturation materials?

1.GP-predominant 2.Silver points-pure silver 3.G.I.-for strengthening a cracked tooth!

Properties of GP-Minimal _____ toxicity, _____-like material that adapts to irregularities in prepared canals, easily _______ mechanically or with solvents

tissue....latex....removed

Properties of GP- DOES NOT ______ to dentin!!!, DOES NOT provide impermeable ______

ADHERE...seal

EXAM QUESTION: What are the three components of GP?

1) 75% ZINC OXIDE 2) 20% Gutta Percha 3) 5% Other

3 components of GP- Gutta Percha provides _______

plasticity

3 components of GP- Zinc Oxide provides ________

Stability

3 components of GP- Other provides _____, _____, and ______

RadioOpaquer, Coloring, and Binders

HEY THIS WOULD HAVE HELPED TO PAY ATTENTION TO: Fit the GP cone __-__mm short of the WL on LARGE STRAIGHT canals and ___mm short in CURVED canals

1-1.5 short in large straight canals....0.5 in curved canals

NEVER force a ______ against a canal wall when condensing

pluggers

What are the 4 types of Sealer? Which type do we use at ASDOH?

1) Zinc Oxide-Eugenol *Roths 801=OUR Clinic 2)Resin 3)Calcium Hydroxide 4) Silicone

What is the main POWDER component to the Roths 801 sealer? What is the main Liquid component?

power-Zinc oxide, liquid-eugenol

Warm Vertical Condensation ADV: excellent apical ____, excellent ____ fill, well ____ technique, easily ________

seal, 3-d fill, studied, retreated

Warm Vertical Condensation DISadv: Difficult to _____, frequent ____-extension, prone to ______ while condensing

MASTER....over-extension, FRACTURE root

Ideal obturation: within __mm of the apex and not overextended, NO GP/Sealer ABOVE the ____

1mm...CEJ