General

Question 1

Name steps of RCT (step back technique)

Answer 1

1. Pre-operative radiograph
2. Access cavity and removal of caries.
3. Coronal prep w/ SX file = 2/3rd of EWL (1mm less than radiographic apex)
4. Irrigation and patency (0.5mm beyond radiographic apex on pre-op)
5. Use EAL w/ size 15 file to determine diagnostic working length
6. Working length radiograph to determine definitive working length
7. Begin serial stepback w/ files 15-25 at DWL until apical gauge is attained. Irrigation and patency throughout
8. Begin increment stepback with files. Irrigation and patency throughout.
9. Determine Master GP at WL. Should be tug back in a wet canal.
10. Dry canal w/ paper points. Place sealer on master GP and begin filling canal w/ accessory points, decreasing the length by 1mm each time.
11. Take mid-fill radiograph w/ 2-3 accessory points in canal. Should be <2mm away from apex
12. Complete obturation.
13. Seal the canal using machtou plugger and heat 1mm below canal orifice
14. Take post-op radiograph
15. Place definitive restoration.

Question 2

5 steps to RCT

Answer 2

1. Access Cavity
2. Removal of pulp contents
3. Biomechanical Prep of canals
4. Obturation of canals
5. Definitive restoration

Question 3

e. What is the international criteria for determining the success of endodontic treatment (RCT) (4 marks)

And assessing quality?

Answer 3

• Tooth functional with no swelling or sinus tract
• Patient free from symptoms
• Radiographic evidence of normal peri-radicular tissue
• Radiographical evidence of healing if there has been a periapical lesion at the start

In terms of assessing quality of RCT:
* Good condensation (no voids)
* Good taper
* Good length