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endo II > lecture 1: policies, access and working length > Flashcards

lecture 1: policies, access and working length Flashcards

1
Q

access procedure outline

A
  • draw on the tooth
  • create outline form through enamel
  • bur is somewhat perpendicular to lingual surface of tooth
  • stay shallow at this point just want <1mm
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2
Q

access procedure penetration

A
  • penetrate pulp chamber roof with bur angled approaching parallel to long axis of root in center of outline form
  • reach pulp by 7mm
  • confirm pulp canal entry with endodontic explorer
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3
Q

do you look for a canal with a bur

A

NO only with an explorer

endodontic explorer = DG16: PUSH

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4
Q

access procedure refining

A
  • refine access prep with safe ended diamond bur or endo-Z

- want a straight-line access to mid root (mostly in molars)

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5
Q

endo-Z bur

A

a side cutting instrument only

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6
Q

working length determination

**

A

correct WL is 1mm SHORT of the CANAL EXIT

**

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7
Q

what will happen if you don’t get the WL right

A

you get a poor outcome

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8
Q

how to find the canal exit

A
  • @hand: measure before you mount tooth
  • @mouth: start with average length
  • chart, apex locator and xrays
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9
Q

can you take xrays with a #10 file

A

no.. it is too thin and will not be seen in xrays

use a #15.

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10
Q

average root length of maxillary incisors

A

CI: 22.5
LI: 22

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11
Q

average root length of mand incisors

A

CI: 20.7
LI: 21.1

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12
Q

average root length of max and mand canine

A

max: 26.5 and mand: 25.6

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13
Q

average root length of max pm

A

1pm: 20.6
2pm: 21.5

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14
Q

average root length of mand pm

A

1pm: 21.6
2pm: 22.3

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15
Q

average root length of max molars

A

1M and 2M 20

1M = 20.8

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16
Q

average root length of mand molars

A

1m: 21
2m: 19.8

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17
Q

what hand file do you use when using the apex locator

A

15 hand file. used to estimate the canal length

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18
Q

between patency and WL.

A

1mm between the two

WL is critical

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19
Q

patency

A

where canal exits the root. 1mm short is the constriction and what your WL is.

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20
Q

what is a “blow out” and how does it happen

A
  • when it is too long and a blow out guarantees incomplete compaction at the apex and an explosion of sealer in the PA tissue.
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21
Q

you must have a reliable reference point… where are good locations to have a solid, reproducible location on the tooth

A
  • tip of incisal edge (ant)

- tip of cusp for which the canal is name (molar)

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22
Q

usual # of roots and root canals for max incisors

A

roots: 1

root canals: 1

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23
Q

usual # of roots and root canals for max C

A

roots: 1

root canals: 1

24
Q

usual # of roots and root canals for max pm

A

1pm root: 2
1 pm root canals: 2

2pm root: 1, maybe 2
2pm root canals: 1, maybe 2

25
Q

usual # of roots and root canals for max M

A

roots: 3

root canals: 3, maybe 4 or more

26
Q

usual # of roots and root canals for mand I

A

root: 1

root canal: 1, maybe 2

27
Q

usual # of roots and root canals for mand C

A

root: 1

root canal: 1

28
Q

usual # of roots and root canals for mand pm

A

root:1

root canal: 1, maybe 2

29
Q

usual # of roots and root canals for mand m

A

root: 2

root canals: 3, maybe 4 or more

30
Q

definition of access

A

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

31
Q

3 steps of access

A
  1. outline form
  2. coronal access
  3. radicular access
32
Q

requirements of access (4)

A
  1. visibility of pulp chamber and all canal orifices from a single vantage point
  2. straight-line access to mid-root for instrument placement
  3. complete removal of pulpal roof and pulp horns
  4. avoidance of unnecessary weakening of tooth
33
Q

wall of the coronal access should be ____ to the occlual

A

diverge

34
Q

why do you diverge the coronal access (3)

A
  1. better light
  2. better visualization
  3. helps with leak and contamination
35
Q

access shape of max CI

A

triangular access, with base at the incisal.

m and d marginal ridges are not invaded or weakened

36
Q

access shape of max LI

A

triangular/oval access

*the most difficult of max ant teeth

37
Q

access shape of max C

A

triangular/oval access

38
Q

access shape of mand I

A

oval access

  • very narrow M-D, easy to perforate so be careful.
39
Q

canals of mand I

A

40% 2 canals (type II)

60% 1 canal

40
Q

access shape of mand C

A

oval access

41
Q

canals of mand C

A

78% 1 canal

22% 2 canals

42
Q

access of max 1 PM

A

thin oval access

- access is always gained through the O approach on all post teeth

43
Q

canals of max 1 PM

A
  • 85% 2 canals
  • 9% one canal
  • 6% three canals
44
Q

access shape of max 2PM

A

thin oval

45
Q

canals of max 2PM

A

most often type I 1 root, 1 canal (75-85%)

  • 15-25% two roots
  • 3 roots is really rare
46
Q

access of mand 1PM

A

thin oval

47
Q

canals of mand 1PM

A

usually 1 root, 1 canal 73.5%

- type IV is 24%

48
Q

access of mand 2PM

A

thin oval

49
Q

canals of mand 2PM

A
  • one root, one canal type I 85.5%

- type III 11.5%

50
Q

access max 1 M

A

triangle

apex to palatal should not cross the oblique ridge

51
Q

canals of the max 1M

A

4 canals the majority of the time

52
Q

access of max 2M

A

similar to the first molar but more compressed MD
(triangle
apex to palatal should not cross the oblique ridge )

53
Q

access mand 1M

A

trapezoid preferred

54
Q

canals of mand 1M

A
  • 4 canals 64%

3 canals 29%

55
Q

access of mand 2M

A
  • trapezoid/triangle similar to first (trapezoid preferred )
56
Q

canals of mand 2M

A

81% 3 canals

11% 4 canals

endo II (7 decks)

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