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Endo II > L1- Policies, Access, and Working Length > Flashcards

L1- Policies, Access, and Working Length Flashcards

1
Q

what are the objectives of endo

A
  • correctly diagnose diseases as LEO
  • perform quality NS endodontic therapy
  • restore and document healed outcome
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2
Q

what is the extreme service to the patient in endo (goal)

A
  • relieve acute pain
  • retain otherwise lost natural tooth
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3
Q

most failures on WREBS and ADEC are due to:

A

poor access

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4
Q

what is the access procedure for the outline

A
  • create outline form just through enamel with number 2 round or 330 bur high speed
  • the bur is somewhat perpendicular to lingual surface of tooth
  • stay shallow, just through enamel - less than 1mm
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5
Q

what is the access procedure for penetration

A
  • penetrate pulp chamber roof with bur angled approaching parallel to long axis of root in center of outline form
  • you should reach the pulp in most cases by 7mm
  • confirm pulp canal entry with endodontic explorerDG16: PUSH
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6
Q

describe the access procedure- un-roofing

A
  • un-roof pulp chamber with brushing out-strokes. do not gouge axial walls
  • remove obstructions and smooth the walls
  • irrigate well (NaOCl): vision, remove debris, begin disinfection
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7
Q

what is the access procedure- refining

A
  • refine access prep with safe ended diamond bur or endo-Z bur to help provide straight line access to mid root - mostly in molar access
  • the non-cutting tip is simply a pilot
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8
Q

the endo - Z bur is a ____ cutting instrument only

A

side

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9
Q

after access, your next big task is:

A

working length

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10
Q

what is the correct WL

A

1mm short of the canal exit

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11
Q

when do you measure the canal exit

A

before you mount the tooth

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12
Q

how do you find the canal exit in the mouth

A
  • chart
  • apex locator
  • radiograph with a #15 file in canal
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13
Q

what is the average root length for central incisors

A
  • max: 22.5
  • mand: 20.7
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14
Q

what is the average root length for lateral incisors

A
  • max: 22.0
    -mand: 21.1
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15
Q

what is the average root length for canines

A
  • max: 26.5
  • mand:25.6
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16
Q

what is the average root length for first premolar

A
  • max: 20.6
  • mand: 21.6
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17
Q

what is the average root length for second premolar

A
  • max: 21.5
  • mand: 22.3
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18
Q

what is the average length for the first molar

A
  • max: 20.8
  • mand: 21.0
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19
Q

what is the average root length for the second molar

A
  • max: 20.0
  • mand: 19.8
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20
Q

what is the usual number of roots and canals for max incisors

A

1 and 1

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21
Q

what is the usual number of roots and canals for max canines

A

1 and 1

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22
Q

what is the usual number of roots and canals for max first premolars

A

2 and 2

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23
Q

what is the usual number of roots and canals for max second premolars

A

1 or 2 and 1 or 2

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24
Q

what is the usual number of roots and canals for max molars

A

3 and 3 or 4

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25
Q

what is the usual number of roots and canals for mand incisors

A

1 and 1 or 2

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26
Q

what is the usual number of roots and canals for mand canines

A

1 and 1

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27
Q

what is the usual number of roots and canals for mand premolars

A

1 and 1 or 2

28
Q

what is the usual number of roots and canals for mand molars

A

2 and 3 or 4

29
Q

why is the goal for the WL to be 1mm short of the canal exit

A

this places the WL in close proximity to the natural apical constrictin

30
Q

what is the result if the WL is too short

A

the canal is not well cleaned

31
Q

what is the result if the working length is too long

A
  • BLOW OUT
  • guaranteed incomplete compaction at the apex and an explosion of sealer in the PA tissues
32
Q

where is the reliable reference point usually loated

A
  • tip of incisal edge for anterior
  • tip of cusp for which the canal is named
33
Q

what is the next step after dx

A

access

34
Q

access to the pulp chamber facilitates:

A
  • locating the canals
  • negotiating the canals
  • gaining patency
  • establishing working length
  • maintaining apical constriction
  • a good outcome
35
Q

what problems can poor access cause

A
  • you will not have a predictable result
  • you will miss canals
  • you will not be able to clean properly
  • you will not be able to shape completely
  • you will not be able to fill adequately
36
Q

what is access

A

drilling a hole through coronal structure to gain entrance into the pulp chamber

37
Q

what is the objective of access

A
  • to create effective shape that is:
  • smooth
  • constantly tapering
  • respecting the shape of the natural canal
  • constricting near the terminus of the root
38
Q

what is the Coke bottle effect

A

the canal is bigger than the cervical access at some more apical point in the canal

39
Q

what are the requirements of access

A
  • visibility of pulp chamber and all canal orifices from a single vantage point
  • straight line access to mid root for instrument placement
  • complete removal of pulpal roof and pulp horns
  • avoidance of unnecessary weakening of tooth
40
Q

what is “Draw”

A

visbility of pulp chamber and all canal orifices from a single vantage point

41
Q

straight line access to mid root is required for:

A

instruments and obturating materials without regard to the long axis of the tooth

42
Q

what is the dentin triangle

A

cross hatched area of secondary dentin that should be removed to create better access to mesial root

43
Q

what do you use to remove the dentin triangle

A

a .25/.12 rotary file

44
Q

what are the steps of access

A
  • outline form - 2D surface shape
  • coronal access- extending into pulp
  • radicular access- adjustments to allow easy straight line entry to mid-root of each canal
45
Q

what bur should you use for outline form in molars? PM?

A
  • molars: #4
  • premolars: #2
46
Q

what else influences access besides ideal

A

canal anatomy and tooth damage can determine shape, size, and location of initial entry

47
Q

what is coronal access for

A

to allow unobstructed visualization of the pulpal floor and ALL canal orifices from a single vantage point

48
Q

what do you do in coronal access

A
  • reach pulp at 7mm and mark bur
  • extend bur within the outline form to remove pulpal roof
  • do NOT touch pulpal floor with access bur
49
Q

walls of the coronal access should:

A

DIVERGE to the occlusal

50
Q

why should the walls of the coronal access should diverge to the occlusal

A
  • better light
  • better visualization
  • your temporary restoration which is placed between visits will not be easily dislodged to leak and contaminate
51
Q

what is the purpose of radicular access

A

to allow straight line access to midroot for shaping instruments and obturation materials to observe canal path- not the long axis of the tooth

52
Q

what do you do in radicular access

A
  • flare into canals to remove obstructions and make instrument placement simple and foolproof without looking
  • facilitates crown- down procedure
53
Q

hand files generally require____ strokes/file before going to the next larger size file

A

100

54
Q

what is the access shape for the maxillary central incisor

A

triangular access from lingual about 3mm on each side

55
Q

what is the shape of access for the maxillary lateral incisor

A

triangular/oval access

56
Q

what is the shape of maxillary canine access

A

triangular/oval

57
Q

what is the shape of the access for mandibular incisors

A

oval

58
Q

what is the shape of the access for mandibular canines

A

oval

59
Q

how does inadequate access compromise shaping

A
  • induces unnecessary bending of file
  • creates apical transportation of canal
60
Q

what is the shape of access in maxillary first premolar

A

thin oval - width of #4 bur

61
Q

what is the shape for access of maxillary second premolar

A

thin oval- width of #4

62
Q

what is the shape for access of the mandibular first premolar

A

thin oval

63
Q

what is the shape of access of the mandibular second premolar

A

thin oval

64
Q

what is the shape of access of maxillary 1st molar

A

triangle- apex to palatal

65
Q

what is the shape for access of the mandibular first molar

A

trapezoid

66
Q

what is the shape for access of the mandibular 2nd molar

A

trapezoi/triangle

67
Q
A

Endo II (11 decks)

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