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Mirror, Scissor, DG16 Endo Probe, D-11 T Spreader, 5-7 Endo Plugger, Tweezer
What is the point of using handfile despite of it not clearing out canals properly?
What is “Access”?
High Speed Tapered diamond bur Perpendicular to Lingual Surface @ depth of 2mm Turn bur as close to
long axis of tooth Refine outline of access
Instrument should enter the canal freely with minimal curving, bending or obstruction by the coronal structure
Why remove restoration on tooth before accessing the pulp chamber? To ensure:
- Assess restorability
- Den Invaginatus (rare) OR Den Evaginatus (common – sticking out) referral recommended)
- Access should be ‘Mesial to Transverse Ridge – ridge crossing the occlusal surface
from Buccal to Lingual’
Typically: MB1, MB2 (70% of the time), and DB canals should be present
Must follow the (1) midline/developmental groove on pulpal floor and (2)
Symmetry in relation to crown outline
Variation:
2 Canals ONLY
C-Shape canal
KEY: MB canal is the MOST difficult canal to access DUE TO its location and angulation
What size hand file do you use to take X- ray? What do you look for on X-ray?
Size 15
Technique to read multiple files in the canal – tilt the x-ray beam slightly mesial or distal
- ONLY useful for “working radiograph”; DON’T USE for Pre-Op and Post-Op radiographs
Red: 25/07 (4 nothches) KEY: ONLY goes 5-6mm away from working length
Blue: 30/05
Green: 35/04
Black: 40/04
White: 45/04
Blue: 60/04
All hand files have what % tapering?
2%
Barbed Broaches and Rasps: have sharp projecting barbs that cut or snag tissues
Watch-winding movement w/ “quarter-turned-and-pull” motion and gentle apical force to reach working length
What is the material used for modern rotatory file? Why is it good?
Nickel Titantium Alloy very elastic; allows larger tip size and tapering & retain canal curvature better than stainless
steel
RPM (Rotations Per Minute) – how fast instrument rotates during function [250-350 RPM avg]
Torque – force that motor exerts to TURN the instrument inside the canal
How does intra-canal fracture occur?
- Path of least resistance for rotary instruments established by hand instruments (often to radiographic
working length)
What is the minimum apical size required for mechanical removal of canals?
Size 35/04
- If the file cuts the last 3mm of dentine from apex, it’s MAF
Ideally, use larger apical size to ensure that apical part of canal is fully cleaned BUT ask yourself if it
will weaken the structure
- Easy to obturate
A device detects the presence of periodontal ligament (PDL); accuracy higher than radiograph
- Because Tip of the file DOES NOT cut; giving us 0.5 mm lee way
Tip of the instrument bind tightly inside canal but coronal portion continues to turn
Fracture once force exceeds metal strength (unwinding, winding until it breaks)
- Fracture due to repetitive flexing at one point (rotating around sharp curve)
- Discard file after specific number of uses (or after severe curvature)
What is Crown-Down technique? What are the advantages?
- Early coronal prepreation is done (including flaring) before apical preparation, followed by incremental
removal of dentine from coronal to apical
Advantages include:
- Better access
- To fill the root canal (that’s fully instrumented to remove bacteria) so nutrients can’t reach the apex and
biofilm can’t form
Gutta Percha (GP) – made of 75% Zinc Oxide and 25% rubber (trans-form)
- Compact GP sideways by inserting smaller GP cones to fill up the gap using “spreader”
- X-ray you take before sealing the chamber to check length and density of obturation
- System B
- Obtura Unit
- BeeFill
- Elements