Phases of the endodontic treatment
l.Diagnosis (patient's history, clinical examination, x-ray).
2. Consideration
3. Local anaesthesia
4. Removal of old fillings and caries, restoration of the tooth if necessary
5. Dry operating field
6. Access to the pulp chamber
Phases of the endodontic
treatment
7. Opening of the root canals (coronal flaring
8. Root canal shaping and cleaning (irrigation^
9. Root canal filling
10. X- ray
11. Restoration
Access - opening of the pulp chamber
Round Burs
lenka.roubalikova@tiscali.cz
5
Preparation of the endodontic cavity -facilitating form
Dia trepan
Instruments with safe ended tips), Acc. to Batt
Fissure burs
lenka.roubalikova@tiscali.cz
lenka.roubalikova@tiscali.cz
7
Root canal access
	
	ii II11 b II
t Endodontic probes Microopeners	
Ultrasound
lenka.roubalikova@tiscali.cz
8
Opening of the root canal orifices
lenka.roubalikova@tiscali.cz
Peeso-Largo burs
9
lenka.roubalikova@tiscali.cz
10
Gates - Glidden:
lenka.roubalikova@tiscali.cz
11
Extraction of the content of the root canal - exstirpation
Pulpextraktor - made of soft wire
lenka.roubalikova@tiscali.cz
Canal shaping - instruments
lenka.roubalikova@tiscali.cz
15
lenka.roubalikova@tiscali.cz
Reamer
Cuting edges
Space for chips
Clockwise rotation
lenka.roubalikova@tiscali.cz
Files
1. K-file
2. K-flexofile, flexicut, flex-R - file
3. K-flex
4. H-file, S-file
lenka.roubalikova@tiscali.cz
K file
K-file
Filing and (or) rotation
Straight canals 45° - 90°)
ISO norma
> Diameter
> Length of the cutting part
> Taper
lenka.roubalikova@tiscali.cz
06 pink
08 gray 10 purple
15 white 45 white
20 yellow 50 yellow
25 red 55 red
lenka.roubalikova@tiscali.cz
26
Hand instruments
Made of stainless steel
Taper is 2% (higher taper is for NiTi
instruments — these are for power driven endodontics).
lenka.roubalikova@tiscali.cz
Instrumentation
Reaming action
(45°clockwise and contraclockwise)
K - reamer
lenka.roubalikova@tiscali.cz
Instrumentation
Rotation 45° slight pressure and pull motion
K - reamer
K- file
lenka.roubalikova@tiscali.cz
Instrumentation
Filing — push and pull motion. The instrument is in action during pull motion
H- file
K - file
lenka.roubalikova@tiscali.cz
Circumferential filing
H- file
The instrument is inserted into the root canal The working length is reached The instrument is pulled out- action Afterwards the instrument is rotated without any action in order to be in contact with the root canal wall Pull motion is applied again .
lenka.roubalikova@tiscali.cz
Circumferential filing
The purpose — root canal shaping around the root canal with respect to its natural shap mostly oval.
lenka.roubalikova@tiscali.cz
Balanced force technique
■ K file
The instrument is inserted into the root canal — the size of the instrument one size bigger than the instrument that can be inserted on complete working length.
Rotate with this instrument clockwise 90 - 180 ° Follow with slight pressure forward and rotate contraclockwise till 270°
Pull the instrument out of the root canal rotating clockwise again.
lenka.roubalikova@tiscali.cz
Step back method
We use endodontic instruments of increasing size during root canal shapin
The rigidity of instruments increases with the size. It can cause ledge in root canal wall and difficulties with reaching the working length.
Therefore we reduce working length of instruments for 1mm. This we do from the 4th instrument we use. See next slide.
lenka.roubalikova@tiscali.cz
p back
Example: the apical size at the beginning is ISO 15 20working lenghth 25 working lenghth 30 working length 35 1 mm less 40 2 mm less 45 3 mm less
Step back
intracanal complications —ledge especially when
the root canal is curved, extrusion of the filling material
lenka.roubalikova@tiscali.cz