Endo note 18 ledge formation

Dr. Özkan ADIGÜZEL

1. 1 Challenges in Endodontics 9/22/2009 Endo 18

2. 2 Two distinctions should be recognized 1.This is the only dental treatment that depends heavily on the tactile sensation of the fingers of the operator. 2.The inability of the clinician to visualize three dimensionally the anatomy of the pulp. 9/22/2009 Endo 18

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5. 5 Curved canals offer a wide range of anatomical shapes that can lead to procedural errors such as, ledge formation Zipping strip perforation apical perforation transportation during cleaning and shaping 9/22/2009 Endo 18

6. 6 Not extending the access cavity sufficiently Incorrect assessment of the root canal direction Erroneous root canal length determination Complete loss of control of the instrument Forcing and driving the instrument into the canal Using noncurved S/S instrument Failing to use the instrument in sequential order 9/22/2009 Endo 18

7. 7 Instrumentation technique Root canal curvature Type of tooth Canal location Re-treatment Undergraduate work 9/22/2009 Endo 18

8. 8 Clinical Straightened the curve canal No sensation of curve Dead end feeling Tip binding is loss No tactile sensation of tensional binding Radiological Instrument point away from the lumen File deviated from the natural pathway 9/22/2009 Endo 18

9. 9 Careful and attentive instrumentation Learn from own mistake and others mistake Appropriate preoperative and post operative X- Ray Copious irrigation Pre-curved files Incremental instrumentation Careful attempting to remove blockage 9/22/2009 Endo 18

10. Williams - 1951 Heling and Karmon - 1976 9/22/2009 Endo 18 10

11. 1. 2. 3. 4. 5. 11 Knowledge of root canal anatomy Typical variations from normal. Knowledge of variations that will not be visible on radiographs Probing floor of pulp chamber with endodontic explorer Digital perception with hand instrument in canal. 9/22/2009 Endo 18

12. 1. 2. 3. 3 4. 5. Pulp chamber anatomy and relationship to occlusal anatomy Estimated root canal lengths Root curvature (morphology) Root canal diameter ( preparation technique required) and Stage of root development (open apex, etc) Canal obstructions, calcifications 9/22/2009 Endo 18 12

13. 1.Remove all the carious dentine and bad restorations 2.Remove gum polyp 3.Place matrix band and holder 4.Restore with GIC 5.Place rubber dam / isolate with cotton role 9/22/2009 Endo 18 13

14. 1. 2. 3. 4. 5. Remove the entire roof of the pulp chamber Provide direct-line access to the apical third of the root canals. Avoid damage to floor of the pulp chamber. Enable a temporary seal to be placed. Conserve as much sound tooth tissue 9/22/2009 Endo 18 14

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17. 1. 2. 3. 4. 5. Average tooth length Radiographic length First bound length Pain length Apex locator length Calculate Provisional working length Operative radiograph +/- 2mm to apex; Used formula & repeat the x-ray 9/22/2009 Endo 18 17

18. 1. 2. 3. 4. 5. 5 Dissolve organic debris Flush out inorganic and organic debris Lubricate endodontic instruments Eliminate micro-organisms Bleaching of tooth to prevent staining 0.05-5% Sodium Hypochlorite 9/22/2009 Endo 18 18

19. 1. 2. 3. 4. 4 5. Easier to insertion of file Reduced the stress to the file Assist to remove debris Soften the dentin Remove the smear layer EDTA, Silicone, glycerin and wax lubricant paste 9/22/2009 Endo 18 19

20. ANTI CURVATURE FILING CIRCULAR FILING 9/22/2009 Endo 18 20

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22. Zipping When a curved foramen is filed with a small file with pressure against the outer side of the curvature, repeated filing Zips and transport the foramen. The curved area of the foramen is not cleaned and retains tissue debris. Foramen cannot be obturated totally and failure of the RCT is certain. 9/22/2009 Endo 18 22

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29. Strip perforation 9/22/2009 Endo 18 29

30. File separation 9/22/2009 Endo 18 30

31. In the straight portion of the canal, Loosen it with a H file or an ultrasonic instrument and pull the part out with a H file or with a curved mosquito forcep or a locked tweezer.It may even be flushed out if loosened sufficiently. 9/22/2009 Endo 18 31

32. . Special instruments Are available to disengage hold and remove separated instruments from root canals. Eg. Cancellier instruments Trepanbur, Messerann extractors IRS Instrument remover (Dentsply) etc . 9/22/2009 Endo 18 32

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