Endodontic Armamentarium PDF
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Uploaded by SuperiorAntigorite4686
LMU College of Dental Medicine
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Summary
This document provides a comprehensive overview of endodontic armamentarium, covering various tools and procedures used in root canal treatment. It details examination and diagnostic techniques, isolation procedures, access preparation methods, canal location and measurement, instrumentation, irrigation, obturation, and coronal seal procedures. It also includes the armamentarium for performing apicoectomy procedures and handling incisions and drainage.
Full Transcript
Endodon%c Armamentarium • Goal: chemo-mechanically debride, disinfect, and shape the root and obturate the root by sealing all portals of entry and outlet, while preserving adequate structure so the tooth is restored to func9on • Examina9on and Diagnos9cs o Exam tools normally used for decay and per...
Endodon%c Armamentarium • Goal: chemo-mechanically debride, disinfect, and shape the root and obturate the root by sealing all portals of entry and outlet, while preserving adequate structure so the tooth is restored to func9on • Examina9on and Diagnos9cs o Exam tools normally used for decay and periodontal issues (and DG16- Endo explorer) o Visual aids, loupes, microscope (op9onal): fiberop%c light o X-ray: BW, FMX, PA, Cone beam tomography CBT* o Tooth Slooth, methylene blue dye*, coLon roll o EPT, Endo Ice, ice s9cks pulse oximeter,* laser doppler flowmeter* • Isola9on: control envt we are working in to protect pt o Clamps o Clamp forceps o Frame o Rubber dam (vinyl or nitryl) o Dam punch o Floss, Wedgets* • Access o Includes entry into the pulp chamber AND loca%ng/uncovering the root canals (DG 16 Endo explorer) o Type and size of access instrument (bur, diamond, etc) depends on which tooth and type of material being penetrated. o Specialized long shank burs used to remove pulp stones and dystrophic calcifica%on (ter9ary den9n) § Ex of long shank burs: Munce, Mueller, Swiss LN • Canal loca9on and measurement o Most important: Electronic apex locator o PA x-ray with file in place at es9mated apical constric9on o Digital radiography measuring systems * o CBT o Endodon9c ruler o File stops • Canal instrumenta9on o Barbed broach o Hand files: K-files Hedstrom files, Reamers (made from stainless steel) o Rotary files (made from nickel-%tanium, more flexible) o Gates-glidden drills o Peeso reamer o Ultrasonic instruments • Irriga9on: MUST remove debris and smear layer DO NOT mix NaOCL and Chx: o Normal saline -a brown precipitate forms o Sodium hypochlorate -NaOCL will dissolve 9ssue -MUST remove one completely before placing o Chx- will not dissolve 9ssue the other in a canal. o EDTA- ethylenediaminetetraace9c acid o Citric acid o MTAD (EDTA + detergent)- adding this will help clean out smear layer o Methods of irriga9on § Syringe irriga9on with manual agita9on (file) § Rotary agita9on § Endo Vac system (Nega9ve pressure delivery and high speed suc9on combo) • Obtura9on: MUST clean pulp chamber floor o Sealer- Bioceramic*, AH plus o Lentulo spiral o GuLa percha cones o Spreaders o Pluggers o Heat source o Ultrasonic vibrator • Coronal Seal o Residual sealer/filling material removed from chamber (coLon pellet with isopropyl alcohol) o Dry coLon pellet and non-eugenol sealing material § Cavit § GI cement o If not bleaching, or a crown is the final restora9on, then a permanent restora9on can be placed in access opening • Incision and drainage armementarium o Mirror o Scapel handle (#11, #15 blades) o Periosteal elevator o Needle holder (curved needle/3-0 silk) o Suc9on 9p o Irriga9on syringe (18ga needle) o Sterile rubber dam drain o Anesthesia apparatus • Apicoectomy armementarium o Scalpal: ini9al incision into gum o Periosteal elevator: to raise the flap of gum o Straight handpiece and bur: cut into bone to expose and excise the infected apex o Mithcells Trimmer: to scrape out the infected 9ssue o Then, check if more root canal filling ma9ral is needed (ex. GIC or Bioceramic): § retrograde root filling carriers, pluggers, carvers o Suture Needle and silk o Needle Holder or Spenser Wells forceps