Endodontic Isolation & File I.D. Flashcards
The rubber dam protects the patient from…
swallowing or aspirating instruments and materials
The dental dam is defined as the…
standard of care
Effective isolation is crucial to…
- RCT Success
- Patient Protection
- Provider Protection
NEVER place anything small enough to be swallowed or aspirated into the mouth without…
the protection of an effective dental dam
It is simply impossible to eliminate micro-organisms in the presence of _________ with its multitude of micro-organisms
saliva
ONLY a properly applied Dental Dam can insure the absence of ________ in the surgical field
saliva
__________ Contamination turns out to be a major factor in controlling Aerosol danger of droplet contamination in dental treatment.
Salivary
What can happen if saliva contamination?
potential for life threatening cellulitis by introducing additional micro-organisms which can greatly complicate the infection.
____% NaOCl is commonly used for flushing out debris and cleaning the prepared canal system.
8.3
If ______ is not effectively sealed by your dam placement, you can be assured that NaOCl will leak into the mouth as you irrigate.
saliva
What should be placed on all clamps to avoid accidental loss of clasp into esophagus or trachea?
safety ligature (floss)
Non-latex Nitrile Dam is available in the Clinic and is necessary to prevent problems arising from…
latex allergies
How many teeth do you dam for endo?
Isolate ONLY the tooth to be treated IF POSSIBLE
Whatever approach you take, Leave Rubber Dam & Frame ON when taking…
Radiographs
The _____________ Clamp useful for most anterior teeth and even for some premolars.
“Butterfly” Labial
Rubber dam clamp #____ is designed for an anterior tooth.
212
The use of a winged clamp allows…
clamp and dam to be safely placed as a single unit.
Once the Dam is securely placed below the height of contour of the tooth, it is necessary to…
push the dam off the wings of the clamp
Here’s where the Clamp should rest at the cervical line below the _______________ to be adequately retained.
height of contour
Even after the Dam is released from the wings of the clamp, it may be necessary to use some type of ______________ to caulk around the tooth to insure isolation.
sealing agent
What is the caulk-seal agent used in UMKC?
Oraseal® by Ultradent
If unable to achieve 100% effective isolation of the tooth to be treated:
- Provisionally restore tooth to obtain isolation base
- Clinical Crown lengthening procedure
- Refer to endodontic specialist.
- If none of the above works consider alterante treatment modality
If you cannot place an effective rubber dam, you…
cannot do a RCT on the tooth.
A badly broken down tooth often cannot be isolated following complete caries removal. How can you fix this?
first do a build-up before RCT
Sometimes a badly broken down tooth requiring RCT is covered over with…
hyperplastic gingiva
It may be possible to excise hyperplastic gingiva with…
electrosurgery, laser, or conventional surgery
Why are there different types of files?
- Each file type has unique attributes
- Each file type can benefit us in a specific way when used correctly
- Each type is important to consistent RCT success
What are the features of a stainless steel hand file?
- Takes a sharper edge
- Is fairly flexible up to #20
- Can be pre-curved easily to negotiate very curved canals (Retains the shape)
- Increases geometrically in stiffness as diameter increases
- Efficient when used by hand
- Separates if overused or abused, usually with some warning
What are the features of a nickel-titatnium motor driven?
- Edge not as sharp (Motor driven for efficient shaping)
- Is extremely flexible (super elastic but difficult to pre-curve)
- Has nearly perfect shape memory (will NOT hold a curve)
- Works efficiently in engine driven handpieces
- Separates if overused or abused, usually with NO warning
An SS K-type hand file is made of…
twisted tapered Stainless Steel Wire having a square, triangular or diamond shaped cross section
Basically SSK Hand Files are…
SCREWS
What type of file is this?
SS K-type hand file
Continual clockwise rotation will cause an SS K-type hand file to…
- Screw itself to & out the end of the root . . . or
- Become locked in dentin and fracture
The SSK Hand File is nothing more than a slightly tapered screw and it will behave pretty much the same as any screw EXCEPT…
it can be easily fractured (especially in smaller sizes) when it is locked in dentin and torque continues
Counterclockwise rotation of an SSK hand file will generally…
unlock the engagement in dentin
What are SSK hand files used for?
Hand Files are basic to endodontic shaping. They are essential for:
-Scouting the canal (#10 or #08)
- Creating a Glide Path (#10 to patency and #15 to WL only)
- Bypassing a ledge, blockage or separated instrument
- Gaining length
Hand Files used will be _________________ sizes for most cases but also larger sizes if doing Serial Step Back for larger canal gauges.
10 and maybe #15
Hand Files generally come in sizes…
.08 to .140
What is the color order of the SSK hand files?
grey, purple, white, yellow, red, blue, green, black
- sometimes ignore grey and purple
Hand Files are typically supplied in ___________ mm lengths.
21, 25, and 31
No matter the length of the hand file, the fluted portion of the file is ___mm long
16mm
All standardized K-Type hand files are ____ Taper
.02
D0 to D16, the diameter increases regularly by ____ mm in diameter for each 1mm. that one travels from D0 toward D16.
.02
If we look at a .10 file, the diameter at D0 is ___mm. diameter.
.10 mm
If we look at a .10 file, the diameter at D0 is .10mm diameter. At D1 (1mm Back from the tip), the diameter increases .02mm and now becomes ____mm Diameter
.12mm
What are the sizes of hand files from white, yellow, red, blue, green, and black?
.15 .20 .25 .30 .35 .40
starts over
.45 .50 .55 .60 .70 .80
If an SSK hand file is bent too sharply what can happen?
it cannot be bent back to a useful shape and must be discarded before placing in a tooth
HAND FILES are BASICto all RCT and their use must be __________ to enjoy RCT success.
MASTERED
Hand Files can ______ within the canal when mistreated
BREAK
HAND FILES are probably the __________ intra-canal instrument that we have in our arsenal when used in a watch-winding motion
SAFEST
HAND FILES give us the GREATEST ____________ of all intra-canal shaping instruments and serve as Pathfinders & basic instrumentation to negotiate Canal Curves & Blockages.
TACTILE SENSE
Don’t go to the next larger file until you have worked the smaller file to the point that the next larger file goes to the desired length…
WITHOUT PUSHING
Never place a STRAIGHT file in a _______ canal
curved
Gently curve ____ hand files when entering a canal
ALL
Try to match or slightly exceed the greatest curve you observe in the…
radiograph of the canal
If you slightly exceed the curvature of the canal, the file (upon insertion) will track the _____ wall of the curve and be conformed to the actual curve of the canal
inner
If you place a straight file in a curved canal,(remember ALL canals are curved) the file will track the ______ wall of the curve and gouge the canal at that point creating what we call a ___________
outer
Ledge
Why is a ledge a bad thing?
it may be difficult or impossible to regain the true canal as subsequent file insertions tend to more easily follow the path of the Ledge
What can happen if you force a file from a ledge?
lead from a ledge to a root perforation or separated instrument and probable failure of the case
When a scouting file fails to advance but is LOOSE in the canal what does that mean?
not push but simply realize that the canal takes a bend at this point
What do you do if a scouting file fails to advance but is loose?
place a 45˚ bend in the most terminal flutes
Once the path is discovered to patency, it may be smoothed and carefully enlarged (#15) as a…
“Glide Path”
Hand Files are the ONLY way to ______ a canal.
“scout”
________ are the ONLY way to bypass a ledge or separated instrument.
Hand Files
Hand Files are the ONLY way to negotiate and smooth a tight curve to smooth the…
Glide Path or to Regain Lost Length
Most engine driven reciprocal and rotary files are made of…
Nickel Titanium (Ni-Ti) and related Alloys
What makes the engine driven reciprocal and rotary files useful?
- quality of performing in a “Super-Elastic” manner
- Easily follow a smoothly created “Glide Path” and immediately return to their designed shape when stress is removed
What is a downside of wave one gold files?
They tend to PUSH MATERIAL AHEAD of the file
Wave one gold files are used in 3 passes to PREVENT…
pushing debris out the end of the root where it would cause inflammation
What type of file are wave one gold files?
MOTOR-DRIVEN RECIPROCAL FILES
The .25/.12 Vortex Rotary Ni-Ti File is a ______________ file used to perfect straight-line access in the Wave One Technique following the 2nd (Mid-root) pass.
orifice opening
What is the maximum flute diameter of a .25/.12 Vortex Rotary Ni-Ti File (size #120)?
1.20 mm
The .25/.12 may not be appropriate to enlarge a __________ canal
smaller
Vortex Blue files tip sizes are identified by the…
color of the ring
The taper of the file is identified by the number of…
black bands