| refers to removal of all contents of root canal system before and during shaping that is organic subtracts, microflora, bacterial by products, food debris, caries, denticles pulpstones previous root canal filling materials and dentinal shavings | CLEANING |
| refers to specific cavity form with five design objectives | SHAPING |
| MAJOR OBJECTIVES OF ROOT CANAL TREATMENT | To remove the contents of the pulp space and shape the walls of the canal to receive the filling material |
| 5 PHASES OF ROOT CANAL SHAPING: Phase I | Negotiating the canal- "patency filling" |
| 5 PHASES OF ROOT CANAL SHAPING:Phase II | Coronal pre enlargement |
| 5 PHASES OF ROOT CANAL SHAPING:Phase III | Working length measurement |
| 5 PHASES OF ROOT CANAL SHAPING:Phase IV | Root canal shaping techniques |
| 5 PHASES OF ROOT CANAL SHAPING:Phase V | Root canal working width |
| OBJECTIVES OF CLEANING AND SHAPING:Remove ____ and _____ | infected soft; hard tissue |
| OBJECTIVES OF CLEANING AND SHAPING:Give disinfecting irrigants ____ to the apical canal space | access |
| OBJECTIVES OF CLEANING AND SHAPING: Create space for the ____and ______ | delivery of medicaments; subsequent obturation |
| OBJECTIVES OF CLEANING AND SHAPING:Retain the _____ of radicular structures | integrity |
| "Herbert Schilder's Five Mechanical Objectives:
Develop a ___________- in the root canal preparation" | Continuously tapering conical form |
| Herbert Schilder's Five Mechanical Objectives:Make the canal ______, with the narrowest cross- sectional diameter at its ____ | narrower apically; terminus |
| Herbert Schilder's Five Mechanical Objectives:Make the preparation in _____. | multiple planes |
| "Herbert Schilder's Five Mechanical objectives: Never ________--" | Transport the foramen |
| "Herbert Schilder's Five Mechanical Objectives:
Keep the apical foramen as ___ as is ____" | Small;practical |
| Biological objectives:To completely debride the pulp space from | Pulp tissue, Bacteria / Microorganisms, Dentinal debris, Endotoxins |
| prevent the ingress of bacteria into the RC system to prevent failure of treatment. | Coronal seal |
| TRUE OR FALSE: A "complete coronal seal" during the last half of treatment phases with temporary restorations and following completion of rootcanal filling with permanent restoration | FALSE |
| To prevent the ingress of tissue fluid which could provide nutrients and support growth of bacteria that have been left in the canal or that have entered the canal through a defective coronal seal | APICAL SEAL |
| METHODS USED TO REDUCE ENDODONTIC MICROFLORA:disinfected field of operation, sterile instruments, etc. | ASEPTIC TREATMENT PROCEDURES |
| METHODS USED TO REDUCE ENDODONTIC MICROFLORA: remove caries, mechanical instrumentation of root canal, drainage if required | DEBRIDEMENT |
| METHODS USED TO REDUCE ENDODONTIC MICROFLORA:disinfecting agents | IRRIGATION |
| METHODS USED TO REDUCE ENDODONTIC MICROFLORA:Antimicrobial dressings | MEDICATIONS |
| METHODS USED TO REDUCE ENDODONTIC MICROFLORA: of teeth and access cavities | TEMPORIZATION |
| METHODS USED TO REDUCE ENDODONTIC MICROFLORA:SEALING OF CANAL TO PREVENT RE-ENTRY OF PATHOGENS | OBTURATION |
| METHODS USED TO REDUCE ENDODONTIC MICROFLORA: may be indicated in some cases | SYSIEMIC ANTIBIOTICS |
| METHODS USED TO REDUCE ENDODONTIC MICROFLORA:to ensure long-term coronal seal | FINAL RESTORATION |
| RADIOGRAPHIC HINTS:CANAL SUDDENLY STOPS IN THE RADICULAR REGION | assume that the canal has bifurcated or trifurcated into much finer diameter canals |
| RADIOGRAPHIC HINTS:LATERAL RADIOLUCENCIES | may indicate lateral accessory canals |
| RADIOGRAPHIC HINTS:image at the root end indicates the root apex curves towards or away from the film | A "KNOB-LINE" |
| REASONS FOR MANDATORY REMOVAL OF THE EXISTING RESTORATION FROM FIRST APPOINTMENT?___ developed as a result of breakdown of the existing restoration's marginal | Pulp disease |
| REASONS FOR MANDATORY REMOVAL OF THE EXISTING RESTORATION FROM FIRST APPOINTMENT? There may be _____ underneath the restoration which cannot be seen w/o removing the old restoration. These crack s are possible pathways for _____, they should be removed. | enamel and dentin cracks; bacterial entry |
| REASONS FOR MANDATORY REMOVAL OF THE EXISTING RESTORATION FROM FIRST APPOINTMENT?If these pathways are not removed prior to endo treatment, ____ can enter the tooth system throughout the treatment and thus lead to _____. | more bacteria; failure |
| REASONS FOR MANDATORY REMOVAL OF THE EXISTING RESTORATION FROM FIRST APPOINTMENT? The feasibility of restoring the tooth again after endo treatment has beedn completed cannot be assessed until the ______. | old resto is removed |
| REASONS FOR MANDATORY REMOVAL OF THE EXISTING RESTORATION FROM FIRST APPOINTMENT?The type of restoration required can be ____ and ____ | assessed; planned |
| The type of temporary restoration utilized will depend on the amount of _____ and the ____ requirement | tooth structure remaining; esthetic |
| The canal orifices should be protected with a thin layer of _____to prevent temporary filling materials from entering the canals | cotton wool |
| ACCESS PREPARATION ENDODONTIC TRIAD : | BIOMECHANICAL PREP, MICROBIAL CONTROL, & COMPLETE OBTURATION |
| STAGES OF CLEANING AND SHAPING: Analysis of tooth anatomy, surrounding tissue, root canal system | PRE-ACCESS ANALYSIS |
| LAW OF CENTRALITY | The pulp chamber of every tooth is at the CENTER OF THE TOOTH AND @ the LEVEL OF THE CEJ |
| LAW OF CONCENTRICITY: | The walls of the pulp chamber are concentric to the external outline of the tooth at the level of the CEJ. |
| STEPS TO DO BEFORE ACCESS PREP:STEP 1. | Identify the shape and position of the CEJ by using a perio probe |
| STEPS TO DO BEFORE ACCESS PREP:STEP 2 | Determine the angulation of the tooth |
| STEPS TO DO BEFORE ACCESS PREP:STEP 3. | Measure the cusp tip to furcation ( Cusp-pulp-floor distance) |
| Measure the cusp tip to furcation ( Cusp-pulp-floor distance) tp prevent | peforation |
| STEPS TO DO BEFORE ACCESS PREP:STEP 3. The bur should be directed towards the _____, ____ to the long axis of the tooth | center of the CEJ; parallel |
| STEPS TO DO BEFORE ACCESS PREP:STEP 4. Select the initial access penetration by using: | CEJ perimeter, Angulation of the long axis, Cusp-pulp floor distance |
| TRUE OR FALSE: Occlusal access is variable | TRUE |
| TRUE OR FALSE: Access on pit or fossa | FALSE |
| TRUE OR FALSE: Access point may be on a cusp in cases of drifted teeth | TRUE |
| dictates the outline form of the access cavity | Internal anatomy |
| REMOVAL OF PULP CHAMBER ROOF:STEP 1 | REMOVE ALL DEFECTIVE RESTORATION & CARIES |
| REMOVAL OF PULP CHAMBER ROOF:STEP 2 | CHOOSE BUR (#4 CARBIDE OR DIAMOND ROUND) (OR #557 FISSURE BUR) |
| REMOVAL OF PULP CHAMBER ROOF:STEP 3 | Drop the bur the center of mentally imaged CEJ |
| A drop can only be felt when the chamber is at least _____depp | 2mm |
| Evaluation for treatment or referral is influenced by CRFD or _______ | chamber roof floor distance |
| If chambers are calcified - consider ____ | referral |
| REMOVAL OF PULP CHAMBER ROOF:STEP 4 | COMPLETE REMOVAL OF CHAMBER ROOF |
| this is the goal of access prep | COMPLETE REMOVAL OF CHAMBER ROOF |
| LAWS OF CANAL ORIFICE LOCATION | Law of symmetry, Law of color change, Law of orifice location |
| LAW OF SYMMETRY: Except for maxillary molars, orifices are ____from a line drawn in a _______ of pulp chamber floor | equidistant; mesio-distal direction |
| LAW OF SYMMETRY: Except for maxillary molars, orifices lie on a line _____ to a line drawn mesiodistally through the _______floor | perpendicular; center of the pulp chamber |
| Pulp chamber floor is always darker than the walls | Law of color change |
| Law of orifice location:Orifices are always located at the ____of the walls of the floor of the chamber | junction |
| Law of orifice location:Orifices are located at the _____ of the floor-wall junction | vertices |
| Law of orifice location: Orifices are located at the ____ of the root ________ | terminus; developmental fusion lines |
| Helps focus on precise location of orifice | Law of orifice location |
| help to identify the number and position of the orifices. | Law of orifice locations 1 &2 |
| All orifices can only be found along the ______- | floor-wall junction |
| Ignore other indications (_____) to prevent perforation at the walls or floor | black or white dots |
| If the canal is calcified - the ____ of the floor wall indicate where to penetrate to remove reparative dentin | vertex |
| 2ND CANAL OF MB ROOT OF MAXILLARY MOLAR: Locate using the laws of ________ | orifice location 1 &2. |
| 2ND CANAL OF MB ROOT OF MAXILLARY MOLAR: The 2nd canal is usually located _________-. | b/n the MB and Palatal orifices |
| Access is complete when floor-wall junction can be seen ______- around the chamber | @ 360 deg. |
| important factor in access- if can't be achieved, consider referral. | Identifying floor-wall junction |
