40 Questions
What is the main purpose of the STEP-BACK Technique?
To reduce the incidence of preparation errors
How many phases does the STEP-BACK Technique consist of?
Two
What is the Initial Apical File (IAF) used for?
To set the working length
What is the Master Apical File (MAF)?
The final file used at full working length
What is the purpose of Recapitulation?
To remove debris from the apical part
In Phase II, how much shorter is the working length for each subsequent instrument?
1 mm
Why is it important not to skip instrument sizes?
To prevent preparation errors
What is essential to do between placing each larger instrument?
Copiously irrigate the canal
What is the primary goal of root canal treatment?
To reduce the level of microbial contamination
What is the purpose of shaping in root canal treatment?
To produce a gradual smooth taper in the root canal
What is the purpose of cleaning in root canal treatment?
To remove all intracanal material
What is the recommended instrument for removing pulp tissue in sufficiently wide and straight canals?
Barbed broach
What is the function of barbed broach in removing pulp tissue?
To hook and twist the pulp filament around itself
What is the purpose of irrigating solutions in root canal treatment?
To dissolve organic remnants and destroy microorganisms
What is the result of using endodontic instruments in root canal treatment?
The instruments contact and plane all walls to loosen debris
What is the characteristic of a well-shaped root canal?
A continuously tapering funnel from the apex to the access cavity
What is the primary purpose of the step-back technique?
To overcome procedural errors in curved root canals
What is the primary difference between the standard technique and the step-back technique?
The ability to overcome procedural errors in curved root canals
What is the purpose of using a No. 15 file in Step One of the passive step-back technique?
To estimate the working length of the root canal
What is the purpose of using Gates-Glidden drills in Step Three of the passive step-back technique?
To plane and flare the coronal region
What is the purpose of using Peeso reamers in Step Four of the passive step-back technique?
To prepare the apical region of the root canal
What is the purpose of using the step-back technique?
To overcome procedural errors in curved root canals
What is the purpose of using No. 10 or 15 K-type files in Step Two of the passive step-back technique?
To carry files into the canal passively
What is the purpose of using a No. 2 Gates-Glidden drill in Step Three of the passive step-back technique?
To plane and flare the coronal region
What happens immediately after the instrument is withdrawn from the canal space?
The flutes are cleaned with wet gauze or an alcohol sponge.
What is an advantage of using rotary systems?
Flexibility and less finger fatigue.
What is a disadvantage of using rotary systems?
Expense is greater if one of the special motor systems is purchased.
What is the purpose of pressing the MAF tip firmly against each wall on the outstroke?
To check for smooth walls after preparation.
What is the primary criterion for evaluating canal preparation?
All of the above.
What is the purpose of using a file smaller than the MAF at the working length?
To identify a seat or a stop.
What is an example of a rotary system?
Light Speed system.
What is the significance of Recapitulation and irrigation between each instrument size?
It is essential for effective debridement.
What is the primary material used in the manufacturing of hand files and engine-driven instruments?
NiTi alloy
What is the primary purpose of using a small hand file (No. 10 stainless steel) in the canal?
To explore the canal to the corrected length
What is the term used to describe securing an open pathway to the canal terminus?
Glide path
What is the typical minimum glide path size required?
Size #15 to #20 K-file
What is the primary purpose of rotary instrumentation?
To flare the canal
What type of motor system is used with NiTi rotary instruments?
Low-torque, controlled speed motor system
What is the purpose of using lubrication during rotary instrumentation?
To reduce friction and facilitate instrumentation
What is the unique design of NiTi rotary instruments that resembles a Gates-Glidden drill?
Lightspeed
Study Notes
Cleaning and Shaping the Root Canal System
- The aim of root canal treatment is to reduce microbial contamination and entomb remaining microorganisms with an effective three-dimensional seal.
Cleaning
- The purpose of cleaning is to remove all intracanal material, including vital or necrotic pulp tissue and microorganisms, from the root canal system.
- Barbed broach is recommended for removing vital pulp tissue in sufficiently wide and straight canals.
- Necrotic pulp tissue and microorganisms are removed using irrigating solutions and the mechanical action of endodontic instruments.
Shaping
- The shape of the root canal should be a continuously tapering funnel from the apex to the access cavity.
- The STEP-BACK Technique is used to prepare the canal, dividing it into two phases: apical preparation and preparation of the remainder of the canal.
- Phase I involves using an Initial Apical File (IAF) and subsequent larger files to widen the canal, and Phase II involves stepping back with larger instruments while increasing the instrument size.
Passive Step-Back Technique
- This technique uses a combination of hand instruments (files) and rotary instruments (Gates-Glidden drills and Peeso reamers) to achieve adequate coronal flare before apical root canal preparation.
Rotary Instrumentation
- The introduction of NiTi alloy for manufacturing hand files and engine-driven instruments has altered canal shaping procedures drastically over the past two decades.
- NiTi rotary file systems have been developed by different manufacturers, and various designs of NiTi instruments are available.
- Techniques using NiTi rotary instruments include the step-back and crown-down methods, and a glide path is established before rotary instrumentation.
Evaluation Criteria
- There are three criteria for evaluating canal preparation: debridement, taper, and apical preparation.
This quiz covers the aim and process of root canal treatment, including reducing microbial contamination and creating a three-dimensional seal through shaping and cleaning.
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