Endodontics Step-Back Technique Quiz and Flashcards

Study Notes

Step-Back Technique in Endodontics

Emphasizes keeping the apical preparation small, in its original position, and producing a gradual taper coronally
Involves preparation of the apical third initially, followed by the middle and coronal third of the canal using larger instruments

Phases of Step-Back Technique

Phase I: Apical Preparation
- Evaluate the carious tooth before initiating endodontic treatment
- Prepare the access cavity, locate the canal orifices, and establish the working length
- Use a pathfinder to establish the working length
- Insert the first instrument into the canal with a watch winding motion, remove, and irrigate
- Lubricate the instrument to emulsify fibrous pulp tissue
- Recapitulate the canal with previous smaller number instruments to break up apical debris
- Repeat until a size 25 K-File reaches the working length
Phase II: Preparation of Remainder of the Root Canal
- Gradually step back while increasing in size
- Insert the instrument into the canal with a watch winding motion, remove, irrigate, and recapitulate
- Use Gates Glidden to prepare the coronal root area
- Refine the root canal with a master apical file using push-pull strokes to achieve a smooth taper form

Procedures in Step-Back Technique

Set rubber stops on files #15, 20, 25, 30, and 35 at the working length
Insert files in sequence, filling the root canal with sodium hypochlorite, and using a push-pull stroke with a circumferential motion
Set rubber stops on files #40, #45, #50, etc., ½mm, 1mm, 1.5mm shorter than the working length, respectively

Important Reminders in Step-Back Technique

ALWAYS WORK IN A WET FIELD
IRRIGATE OFTEN
RECAPITULATE OFTEN

Advantages and Disadvantages of Step-Back Technique

Advantages

Better tactile awareness
Keeps apical preparation small in its original position with a gradual taper
Ability to prepare a proper apical stop

Disadvantages

Chances of pushing debris into periradicular tissues
Tendency to straighten the curved canal
Time-consuming
Difficult to insert instruments in canal

Types of Step-Back Technique

Modified Step-Back Technique
- Preparation is completed in apical third of the canal
- Procedure is started 2-3 mm short of minor diameter/apical constriction for parallel retention form at apical area
Passive Step-Back Technique
- Combination of hand and rotary instruments for adequate coronal flare and apical part preparation
- Provides gradual enlargement of the root in an apical to coronal direction
- Reduces procedural errors like transportation of the canal, ledge, or zip formation

Description

This quiz covers the Step-Back Technique in Endodontics, a method of root canal preparation that emphasizes maintaining a small apical preparation and gradual taper coronally. Learn about the steps involved and the importance of this technique in dentistry.