Endo

Lack of uniform flutes on file. Uneven files is a precursor to fracture

Length

Endo barbed broach: removes vital pulp tissue, cotton pellets, and other debris/material from root canal.

englarging canal space and should never bind to the canal.

Gates Glidden burs. Used to enlarge the coronal one third to one half of the canal space providing straight line access. Aids in cleaning and shaping.

Can't be used beyond first curve. Only #2 and #3 should be used in narrow roots such as mandibular incisors

1: 0.5

2: 0.7

3: 0.9

4: 1.1

5: 1.3

6: 1.5

Orifice opener which can be used in place of gates glidden for straight line access.

#20 tip and a taper of 0.08. 16 mm shaft. 0.75 MFD and 7 mm fluted length. Used at 300 rpm

Wave one gold instruments. Alternative approach to cleaning and shaping the canal.

Yellow: 20 tip/7% taper. size 15-20 file.

Red: 25 tip/ 7% taper. size 20-25 file

green. 35 tip/6% taper. size 30-35 file

White. 45 tip/5% taper. size 35-40 file

A single use system with an M wire. Prior to using a glide path is established with a size 20 file.

reciprocating. 30 degrees clockwise (disengages instrument), 150 degrees counterclockwise (advances instrument, engaging and cutting dentin. 3 reciprocating cycles complete one rotation.

Lentula spiral

Luer-Lok syringe with 27 guage needle. Needle should NEVER bind. forcing sodium hypochlorite beyond the apex will cause a sodium hypochlorite accident. ALWAYS know length of needle. Should be bent 1-2 mm short of CWL.

Endo spreaders. lateral compacting of gutta percha and root canal filling materia.

Locking cotton pliers

Endo spoon excavator

Endo 5/7 plugger. used for compaction of gutta percha

Glick #1

0.5 mm.

25 mm.

tooth length, root curvature, canal curvature, apical canal dilacerations, size of canal space, size of pulp chamber, apical development, calcification, resorption restorations.

straight on paralleling device

right angle

Right angle

mesial 20 degrees

Right angle

Mesial 20 degrees

distal 20 degrees

Mesial 20 degrees

Mesial 20 degrees

Distal 20 degrees

Beneficial in helping ID the third dimension.

Viewing multiple canals, determining the plane of root curvature

moving anatomical features away from roots, determination of horizontal root fractures.

NOTE: can cause foreshortening or over elongation of roots.

Anterior teeth: Middle of crown to coronal portion of pulp chamber

Posterior teeth: Occlusal surface to most coronal aspect of pulp chamber.

perforation or excessive removal of tooth structure.

Stop and take a parallel radiograph to assess the relationship of your preparation and the pulp space.

calculated by subtracting 1 mm from the reference point.

Relation of the actual foramen to the radiographic apex and magnification of the tooth due to the x ray beam.

If the access is difficult or maintaining longitudinal orientation is a concern. Rubber dam is placed after locating the chamber.

irrigants such as sodium hypochlorite hand instruments such as broaches and files cannot be used until rubber dam is applied.

spoon excavator, barbed broaches, and files. Never with a bur!

triangular in shape for young individuals due to pulp horns. ovoid in shape for older individuals.

1 canal in 100% of cases

ovoid in shape bc no pulp horns. DO NOT violate marginal ridges with access preparation.

1 canal in 100% of cases.

ovoid or elliptical. NEVER round

two canals (buccal and lingual) constrained in mesial distal direction due to mesial concavity.

Three roots with four canals. Mesial concavity at CEJ.

triangular in shape for young patients, ovoid for old patients

Facial because of facial inclination.

Two canals in 25% of cases

ovoid bc no pulp horns

Two canals 30% of time.

ovoid/elliptical access opening

Single canal: 70%. Two canal: 29%.

Rectangular in shape

two roots with three to four canals present

Lingual and Mesial

4 mm for flute and 4 mm for tapering portion of shaft. Serves as a guide during access preparation.

Under a shelf of the mesial wall and may be 1-3 mm lingual to the main MB canal.

proper outline form, proper location, all coronal pulp tissue removed, no excessive removal of tooth structure, chamber is completely de roofed, all caries have been removed, all canals are located, no perforations.

twiddling watch winding motion.

If unable to negotiate file to EWL using a twidding motion.

Removal of dentin coronal to the estimated working length with sequentially larger files at progressively shorter lengths.

Removes initial coronal interferences of dentin, which creates a glide path for future instrument use and enables use of larger files for the working length radiographic image.

If canal is large (size 15 file goes to EWL).

Root curvature, canal curvature and apical canal dilaceration

Slight: 1-30 degrees

Moderate: 31-60 degrees

Severe: 61-90 degrees

S shaped curves

The largest file that binds at the estimated working length after passive step back preparation. File must be tight in the canal so it doesn't move during film/image exposure.

#15.

Properly angled radiograph, visible radiographic apex, visible tip of the working length file in the apical portion of the tooth.

0.5 mm

Improperly angled radiograph, radiographic apex not visible, tip of file not visible, tip of working length file not in the apical portion of the tooth (ie 3.5 mm from EWL), file is extended through apex more than 1.0 mm.

To allow files to be placed without binding or deflection through the chamber to the first canal curvature in a curved root or the CWL in straight canals.

the first curvature

When the lingual bulge is removed.

size 30. want it to PASSIVELY bind.

Passive step back

MAF is no deflected off enamel significantly or off dentin and passes unimpeded to the apical CWL or to the first canal curvature.

Final apical enlargement with irrigant and smear layer removal followed by dry reaming with the FAF (no irrigant)

Smear layer removal followed by dry reaming with the MAF (no irrigant)

create a stop

proceed to smear layer removal (no apical enlargement or dry reaming).

passive step back and final apical enlargement.

Reaming is a 360 degree hand rotation.

Loosening of dentin chips which collect in the apical portion of the canal. Accomplished with a small file or MAF. Maintains canal patency. Followed by irrigation.

removal of dentin after MAF determination. Larger files are used in 0.5 increments at decreasing lengths. Until you get to 70. (for canal negotiation prior to MAF determination you do passive step back until you can get a size 15 file)

Preparation using larger to smaller SS instruments or gradually enlarging the canal with NiTi coronal to apical. technique produces a tapered shape in the coronal to apical orientation.

SS hand files or nickel titanium.

File must be manipulated around the periphery of the canal in a reciprocating motion. clean the full circumference of the canal by planing with the file laterally in all directions. Enlarge canals only on the pull stroke.

Know if it resulted in a proper taper if the finger spreader fits loosely or within 1 mm of the CWL.

Do passive step back again making sure the larger files go to CWL.

YES to ensure proper cleansing of the walls

Too large file length, excessive force, or by excessive use of small files at length.

The crown down technique.

The files are used in a very PASSIVE, in and out manner only to resistance (2-3 mm increments). Recapitulate between passes.

3 seconds

Recapitulate to CWL with SS K flex file size 15 0.02 taper after each nickel titanium file insertion to loosen debris.

Torsional which will bind the file and result in separation.

No you only LOOSEN debris and follow it with irrigation.

1. walls are glassy smooth

2. finger spreader easily fits at or within 1 mm of CWL without binding.

3. The apical configuration is identified.

irrigate and dry with paper points.

1. Glassy smooth walls.

2. No ledges no debris or irrigant in canal

1. Adequate spreader penetration

2. Apical configuration identified.

final apical enlargement/apical clearing.

Access opening

canal negotiation

passive step back

length determination

straight line access and MAF

Cleaning and shaping

Step back with SS files

recapitulation to corrected WL

Apical clearing-when indicated

Final apical enlargement

smear layer removal (EDTA/NaOCL)

dry reaming

preparation for obturation

obturation.

Access opening

canal negotiation

passive step back

length determination

straight line access and MAF
Cleaning and shaping

Insure there is a glide path with a size 20 SS file. Place wave one file into canal and progress toward resistance-use lubricant-remove file and clean flutes-recapitulate at corrected WL with small SS files-repeat until wave one reaches CWL.

Apical clearing-when indicated

Final apical enlargement

smear layer removal (EDTA/NaOCL)

dry reaming

preparation for obturation

obturation.

turn pull followed by "peripheral" filling to plane all canal walls

20

glycerin

The same cusp tip (MB is usually best for molars, buccal for premolars)

Loss of working length

transportation

apical perforations

lateral stripping

instrument breakage

Apical transportation

File breakage on MB. loss of working length on ML and D.

the root is narrow or exhibits a significant concavity.

2 and 3.

Stripping during straight line access

Apical transportation (zip) and perforation-mesial stripping performation

Inhibit bacterial growth in root canal thus supporting periapical healing.

In immature teeth, create an environment to permit the formation of apical hard tissue matrix against which gutta percha may be condensed.

calcium hydroxide

in teeth with pulp necrosis after an appropriate space is created by performing straight line access and determining MAF.

prior to placement of CaOH.

Irrigate with 17% EDTA (1 min) to remove inorganic hydroxyapatite components, followed by 3% NaOCL to remove remaining organic material and dry with paper points.

CaOH powder is mixed with water to form a thick paste. placed with a lentulo spiral on slow speed in forward (which will prevent separation of lenulo and cause paste to flow in not out of canal). Introduce to coronal portion of canal, never stop rotation. Should place until coronal third is packed (should see CaOH visually)

when you can see it visually in canal orifice (means coronal 1/3 is adequately packed)

Smear layer removal, prefilled syringes,remove the luer lock and plac ea drop of water in the navi tip and attack to syringe. deliver navi tip staying 2 mm short of CWL. keep delivery LOOSE in canal. Navi tip must never bind when placed in canal. Fill canal until visual. remove excess. temporize with cotton pellet and IRm.

Seal with a small cotton pellet and IRM or cavit. Place IRM in several increments NOT blob technique.

seal coronally, preventing ingress of oral fluids and bacteria

Satisfy esthetic requirements.

When RCT is not completed in one visit

When RCT is complete but final restoration will be replaced by another dentist.

Zinc-oxide powder with eugenol

Required when one or more marginal ridges are not intact or when extended periods of time between endo appointments exist.

STRONG

Zinc oxide and calcium sulfate

When interval between appointments is short and marginal ridges are intact such as access through a gold or porcelain crown.

Fluff powder, place one scoop and one drop of liquid on mixing pad. Replace top immediately. Spatulate the powder until smooth and thick. Want it thick enough to form a ball in fingers. If proximal surface is missing, a toffelmire matrix band can be placed. place cotton pellet.

Place a small cotton pellet and seal the pulp chamber with cavit. Then remove the dam and place IRM.

Squeeze material from tube. No mixing necessary. Place a very small cotton pellet in pulp chamber. Place cavit incrementally and wet with cotton pellet. Moisture required for setting.

glass ionomer for strength

double seal

Remove all remaining provisional materials. 1-2 mm of cavit is placed over obturated canal orifices followed by IRM. No cotton pellet. Place incrementally NOT blob.

Removes dentin and debris following cleaning and shaping to enlarge the canal at the CWL.

Only if there is an apical stop and a file size less than 40.

Instruments 2-4 sizes larger than MAF are used with irrigant in a reaming action to enlarge the apical portion of the canal at CWL.

FAF

Perform dry reaming.

Last file at CWL whether Apical clearing has been performed or not.

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