endodontic instruments and materials E lec Flashcards
give examples of endodontic instruments and materials
anaesthesia isolation access to pulp canal intra canal medication temporisation obturation preparation: which involves mechanical and chemical
for endo treatment on a upper central incisor what LA would we need
buccal and palatal infiltration
with regards to an upper molar which areas would we need to anaesthetise
buccal and palatal infiltration
for a lower molar which blocks would we need
ID block
long buccal nerve
lingual block
why might the level of anaesthesia not be sufficient for pulp removal
hyperaemic pulp
infection
patient factors
why might a hyperaemic pulp not allow LA to work
increased vascularity which removes the LA solution more rapidly from the area
why might LA not work in areas of infection/inflammation
hyper-excitability of the nerves esp C fibres which means LA might not be able to block conduction
if LA was not able to work which additional techniques can we use
intraligamentary
intrapulpal
intraosseous of LA
or a sedative
what do we use to isolate the tooth during RCT
rubber dam
what are the main functions of rubber dam during endo treatment
protection of airway protection from irritants prevention of contamination improved visuals and access comfort of the patient
what else do we use during endo treatment
oraseal putty dental floss small flexible aspirator tip gauze wedgit
why do we use the gauze
for patient comfort
why do we use floss
to secure the dental clamp and prevent swallowing
why do we use wedgit
to secure rubber dam
why do we use oraseal
to seal the tooth from water
what equipment is used in endo treatment
mirror tweezers shank excavator flat plastic explorer probe plugger for gutta percha measuring device file stand
what should we consider before endodontic treatment starts
the cronw is restoration
caries and defective restorations removed
sound coronal restorations
what should we look for on the x ray
Number of roots Number of canals Morphology of roots/canals Extent of current restoration Presence of caries Presence of canal sclerosis/ pulp stones/ previous RCT/ fractured instruments
what are the aims of coronal access
remove the roof of pulp chamber no damage to pulpal floor straight line access conservative retentive for temp restoration
what do we need for finding canal
good light
magnification
explorer
what might also be used to remove dentine around canal orifces
ultrasonic instruments
what do we try to achieve in cleaning and shaping
remove as many bacteria as possible and allow for adequate filling or obturation
how do we prepare the root canals
mechanical + chemical= chemomechanical
how do we mechanically prepare the root
Coronal followed by apical preparation (step down)
Files and Gates Glidden burs used to produce a smooth and gentle taper.
Hand files and rotary files available
K-files
what do gates glidden burs do
to straighten to coronal portion of the canal
how do we carry out coronal preparation
Create a funnel shape
Removes bacteria and necrotic tissue and prevents this being carried apically
Keep the canal in the centre of preparation
Use files and then Gates - Glidden burs in the straight part of canal
Files are then used to prepare the remainder of the coronal 2/3 of the canal.
how many sizes do gates glidden burns come in
6 sizes- indicated by the grooves on the shank
how is the apical 1/3 prepared
with files- K flex files
how are files sized
according to the diameter at the tip
what is the small rubber stop on each file for
indicates the length of the canal as it moved
what are chelting agents used for
used with files to lbricate the canal and remove smear layer
give examples of chelating agents
EDTA
Fileze
give examples of irrigants
sodium hyprochlorite
describe the properties of sodium hypochlorite
destroys microorganisms dissolves organic matter wets the canal removes debris by flushing biocompatible-but not outside the tooth
what are intra canal mediacaments
materials placed in the root canal between visits
what are the requirements of intra canal medicaments
Antibacterial Aids periapical healing Therapeutic Anti inflammatory Long lasting Non-irritant Easy to use and remove Cheap
give examples of intra canal medicaments
calcium hydroxide
when might you use intra canal medicaments
Persistent infection Unable to dry prepared canal Incomplete apex Incomplete preparation Insufficient time for obturation
describe Ca(OH)2
Long lasting bactericidal action Aids repair Apexification Dissolves organic debris Easy to use (available in syringes with narrow cannulae) Relatively easy to remove
what is the aims of temporisation
seals the tooth
restores function
prevents over eruption/drifting
restores aesthetics
which materials can be used for interim restorations
gic
polycarboxylate cement
kalzinol- zincoxide eugenol
what is placed into the canal first before the temp restoration
a pleglet of cotton wool
what is the aim of obturation
three dimensional hermetic seal of the canal system. - orevents microorganisms reentering
what do we use to obturate the canals
gutta percha- contains zinc oxide
what do we use in conjunction with GP
sealers
why do we use sealers
root filling to the canal walls and fills small voids. Ideally a sealer should display antibacterial properties and be radio-opaque
give examples of sealer
calcium hydroxide
zincoxide eugenol
glass ionomer
