Circumferential Filing Technique Quiz
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Questions and Answers

What is the first step in the crown-down or step-down technique protocol?

  • Access preparation to remove cervical bulges (correct)
  • Eliminate pulp chamber obstructions
  • Explore canal with small instruments
  • Introduce progressively smaller files into the canal
  • What is done after the coronal to mid-root enlargement using larger instruments in the protocol?

  • Flare the coronal one third of the canal with Gates Glidden drills
  • Establish final apical preparation size
  • Introduce large files to coronal part of canal (correct)
  • Establish working length with small instrument size
  • How is the working length established in the crown-down or step-down technique protocol?

  • By placing a large file in the canal
  • Using apex locator or radiograph (correct)
  • By irrigating the canals
  • Using Gates-Glidden sizes 4, 3, 2
  • What is the purpose of irrigating during the instrumentation process?

    <p>To clean and disinfect the canals (B)</p> Signup and view all the answers

    When is the final apical preparation size established in the protocol?

    <p>After introducing progressively smaller files into the canal (D)</p> Signup and view all the answers

    Which part of the canal is flared with Gates Glidden drills or rotary files of greater taper?

    <p>Coronal one third (A)</p> Signup and view all the answers

    What determines when sequentially smaller files are introduced into the canal?

    <p>Resistance encountered during instrumentation (C)</p> Signup and view all the answers

    How is a large file (#70) placed in the canal according to the protocol?

    <p>With a watch winding motion (B)</p> Signup and view all the answers

    Why are Gates-Glidden sizes 4, 3, and 2 used during the protocol?

    <p>To enlarge canal orifices (C)</p> Signup and view all the answers

    Study Notes

    Objectives of Root Canal Preparation

    • Confine instrumentation to the root canal apex
    • Avoid forcing necrotic material beyond the foramen during canal preparation
    • Remove all pulp tissue, bacteria, and their by-products, debris from the root canal system
    • Create sufficient space to receive intra-canal medicament and for irrigants to flow

    Cleaning and Shaping of Root Canal System

    • Cleaning refers to the removal of all contents of the root canal system before and during shaping
    • Includes removal of:
      • Organic substances
      • Microflora
      • Bacterial by-products
      • Caries
      • Pulp stones
      • Dense collagen
      • Previous root canal filling material
    • Shaping refers to a specific cavity form with specific objectives, such as:
      • Three-dimensional access into the canal
      • Creating an apical preparation
      • Permitting final obturation instrument and materials to fit easily

    Schlider's Mechanical Objectives

    • Develop a continuously tapering cone
    • Make the preparation in multiple planes, introducing the concept of "flow"
    • Make the canal narrower apically and widest coronally
    • Avoid transportation of the foramen
    • Keep the apical opening as small as possible

    Clinical Objectives of Cleaning and Shaping

    • Direct access should be obtained along the straight lines
    • The length of the tooth should be accurately determined
    • Instruments should be used in a sequence of sizes with periodic recapitulation and without skipping of the sizes
    • Instruments should be used with a quarter to half turn and withdrawn with a full stroke
    • Barbed broaches should be used cautiously and only when the root canal is wide enough to permit their insertion and rotation without binding

    Instrumentation Techniques

    • Circumferential filing: moving the file around the circumference of the canal space while stroking the instrument in a 1-3 mm amplitude
    • Reaming: using a clockwise or right-hand rotation of an instrument with spiral cutting edges
    • Step-back technique: refining the root canal by using a master apical file and circumferentially filing the canal walls to achieve a smooth taper

    Advantages and Disadvantages of Step-Back Technique

    • Advantages:
      • Less likely to cause periapical trauma
      • Facilitates removal of more debris
      • Allows creation of a small apical preparation with larger instruments
      • Facilitates packing of additional gutta percha cones
      • Minimizes procedural errors
    • Disadvantages:
      • Significant apical extrusion of debris
      • Apical blockage
      • Canal deviation
      • Time-consuming
      • Alteration of working length
      • Apical extrusion of debris during root canal instrumentation may be associated with postoperative pain or discomfort

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    Description

    Test your knowledge on the circumferential filing technique used in root canal treatment with H-Files. Learn about the process of moving the file around the canal space while applying lateral pressure to engage it with the dentin walls.

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