Root Canal Treatment: Cleaning and Shaping

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Questions and Answers

What is the main purpose of the STEP-BACK Technique?

To widen the root canal

To increase the working length

To prepare the apical constriction

To reduce the incidence of preparation errors (correct)

How many phases does the STEP-BACK Technique consist of?

Four

Two (correct)

One

Three

What is the Initial Apical File (IAF) used for?

To set the working length (correct)

To widen the canal

To irrigate the canal

To remove debris

What is the Master Apical File (MAF)?

The final file used at full working length Signup and view all the answers

What is the purpose of Recapitulation?

To remove debris from the apical part Signup and view all the answers

In Phase II, how much shorter is the working length for each subsequent instrument?

1 mm Signup and view all the answers

Why is it important not to skip instrument sizes?

To prevent preparation errors Signup and view all the answers

What is essential to do between placing each larger instrument?

Copiously irrigate the canal Signup and view all the answers

What is the primary goal of root canal treatment?

To reduce the level of microbial contamination Signup and view all the answers

What is the purpose of shaping in root canal treatment?

To produce a gradual smooth taper in the root canal Signup and view all the answers

What is the purpose of cleaning in root canal treatment?

To remove all intracanal material Signup and view all the answers

What is the recommended instrument for removing pulp tissue in sufficiently wide and straight canals?

Barbed broach Signup and view all the answers

What is the function of barbed broach in removing pulp tissue?

To hook and twist the pulp filament around itself Signup and view all the answers

What is the purpose of irrigating solutions in root canal treatment?

To dissolve organic remnants and destroy microorganisms Signup and view all the answers

What is the result of using endodontic instruments in root canal treatment?

The instruments contact and plane all walls to loosen debris Signup and view all the answers

What is the characteristic of a well-shaped root canal?

A continuously tapering funnel from the apex to the access cavity Signup and view all the answers

What is the primary purpose of the step-back technique?

To overcome procedural errors in curved root canals Signup and view all the answers

What is the primary difference between the standard technique and the step-back technique?

The ability to overcome procedural errors in curved root canals Signup and view all the answers

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 Signup and view all the answers

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 Signup and view all the answers

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 Signup and view all the answers

What is the purpose of using the step-back technique?

To overcome procedural errors in curved root canals Signup and view all the answers

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 Signup and view all the answers

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 Signup and view all the answers

What happens immediately after the instrument is withdrawn from the canal space?

The flutes are cleaned with wet gauze or an alcohol sponge. Signup and view all the answers

What is an advantage of using rotary systems?

Flexibility and less finger fatigue. Signup and view all the answers

What is a disadvantage of using rotary systems?

Expense is greater if one of the special motor systems is purchased. Signup and view all the answers

What is the purpose of pressing the MAF tip firmly against each wall on the outstroke?

To check for smooth walls after preparation. Signup and view all the answers

What is the primary criterion for evaluating canal preparation?

All of the above. Signup and view all the answers

What is the purpose of using a file smaller than the MAF at the working length?

To identify a seat or a stop. Signup and view all the answers

What is an example of a rotary system?

Light Speed system. Signup and view all the answers

What is the significance of Recapitulation and irrigation between each instrument size?

It is essential for effective debridement. Signup and view all the answers

What is the primary material used in the manufacturing of hand files and engine-driven instruments?

NiTi alloy Signup and view all the answers

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 Signup and view all the answers

What is the term used to describe securing an open pathway to the canal terminus?

Glide path Signup and view all the answers

What is the typical minimum glide path size required?

Size #15 to #20 K-file Signup and view all the answers

What is the primary purpose of rotary instrumentation?

To flare the canal Signup and view all the answers

What type of motor system is used with NiTi rotary instruments?

Low-torque, controlled speed motor system Signup and view all the answers

What is the purpose of using lubrication during rotary instrumentation?

To reduce friction and facilitate instrumentation Signup and view all the answers

What is the unique design of NiTi rotary instruments that resembles a Gates-Glidden drill?

Lightspeed Signup and view all the answers

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.

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Description

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.