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CLEANING & SHAPING

CLEANING & SHAPING. ENDODONTIC STORY. THE ENDO STORY. Successful endodontics. DIAGNOSIS. Biomechanical preparation. Root canal obturation. BIOMECHANICAL PREPARATION. RC.INSTRUMENTATION. RC.PREPARATION. CHEMICOMECHANICAL. CLEANING & SHAPING. Cleaning:.

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CLEANING & SHAPING

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  1. CLEANING & SHAPING

  2. ENDODONTIC STORY

  3. THE ENDO STORY

  4. Successful endodontics DIAGNOSIS Biomechanical preparation Root canal obturation

  5. BIOMECHANICAL PREPARATION RC.INSTRUMENTATION RC.PREPARATION CHEMICOMECHANICAL CLEANING & SHAPING

  6. Cleaning: Is the removal of all potential irritants from the root canal . This includes: 1-Bacteria. 2- Infected material. 3- Organic remenants.

  7. The goal is achieved through: 1)Proper instrumentation. 2) Use of irrigants.

  8. Shaping: Refers to the specific shape, which is a continuously tapered form from the canal orifice to the apical constriction, given to the canal tobe compatible with the filling material and techniques.

  9. BLACKS PRINCIPLES • IRRIGATION. • RESISTANCE FORM. • RETENTION FORM. • EXTENSION FOR PREVENTION.

  10. Biological objectives for cleaning & shaping: • Totally clean root canal system. • Avoid pushing debris beyond the apex. • Confine all your instrument within the root canal. • Do no harm.

  11. Mechanical objective for cleaning & shaping: Develop a continuous tapering conical form, from the canal orifice to the apical foramen. Make the canal narrower apically with the narrowest cross section diameter at its terminus. Make preparation in multiple planes. Never transport foramen. Keep the apical foramen as small as practical.

  12. Tooth length determination

  13. The optimum length is cleaning until the constriction.

  14. Methods for tooth length determination

  15. 1. Radiographic method. • The file is inserted to the estimated working length, which is determined by: a)Average length of the tooth. b)Preoperative radiograph. c) Tactile sensation. d) Crown- root ratio.

  16. Buccal objective rule for tooth length determination for posterior teeth. This rule states that the most distant object from the cone moves towards the direction of the cone.

  17. 2. Electronic apex locator.

  18. ELECTRONIC APEX LOCATOR A tool that : • Locates the end point of dentin. • Locates the minor diameter of the foramen. • Not affected by the presence of soft tissues. • Not affected by the presence of fluids. • Minimizes radiation exposure. • Accurate , painless and safe. • Shortens the preparation time . • Affordable.

  19. Role of irrigant in cleaning & shaping.

  20. Quality: ANTIMICROBIAL LUBRICATION ORGANIC SOLVENTS INORGANIC SOLVENTS DEBRIDEMENT Quantity: 2-3 cc / time. 12- 18 min Canal soaking ( WEINE F.) IRRIGATION

  21. IRRIGANTS • ANTIMICROBIALS • LUBRICATION • ORGANIC SOLVENTS • INORGANIC SOLVENTS • DEBRIDEMENT

  22. Types of irrigant: Saline. Sodium hypochlorite. Hydrogen peroxide. Organic acid irrigants. Calcium hydroxide. Chlorohexedin gluconate.

  23. SALINE • ANTIMICROBIAL X • MECHANICAL DEBRIDMENT • ORGANIC SOLVENT X • IN-ORGANIC SOLVENT X • LUBRICANT X

  24. SODIUM HYPOCLORITE0.5 – 5.25 % • ANTIMICROBIAL • MECHANICAL DEBRIDMENT • ORGANIC SOLVENT • IN-ORGANIC SOLVENT X • LUBRICANT

  25. HYDROGEN PEROXIDE 3% • ANTIMICROBIAL • MECHANICAL DEBRIDMENT • ORGANIC SOLVENT X • IN-ORGANIC SOLVENT X • LUBRICANT X

  26. ORGANIC ACIDS-CHELATORSEDETA • ANTIMICROBIAL • MECHANICAL DEBRIDMENT • ORGANIC SOLVENT X • IN-ORGANIC SOLVENT • LUBRICANT

  27. CALCIUM HYDROXIDE • ANTIMICROBIAL • MECHANICAL DEBRIDMENT • ORGANIC SOLVENT • INORGANIC SOLVENT X • LUBRICANT X

  28. CHLOROHEXIDINE • ANTIMICROBIAL • MECHANICAL DEBRIDMENT • ORGANIC SOLVENT X • INORGANIC SOLVENT X • LUBRICANT X

  29. ANTIBIOTICS • MTAD - TETRACYCLINS • FLAGYL - METRONIDAZOL

  30. FACTS Root canal irrigants do not penetrate more than 3-5 mm beyond needle tip & Apical canal segments benefit from irrigants at the end of the preparation. Senia et al . Oral Surg. 1971 Baker et al . JOE 1977

  31. TECHNICAL CHALLENGES

  32. If all root canals were smooth funnel-shaped from the foramen to the orifice, without curvatures, ramifications and the foramen was located exactly at the radiographic apex, endodontic procedure would be much simpler.

  33. TUBULAR BLUNDERBASS

  34. INDISCREMINATE CUTTING + - + -

  35. PROBLEM SOLVING MODIFICATION IN INSTRUMENTS . MODIFICATION IN INSTRUMENTATION

  36. Modification in instruments: • Modification in cross section e.g.K-flex. • Modification in tip design e.g.flex-R-file. • Modification in blade length e.g.canal master. • Modification in taper e.g.profile 0.04, 0.06. • Modification in numbering system e.g. Golden medium files. • Modification in standardisation e.g.profile series.

  37. Modification in material

  38. Nickel-Titanium Files

  39. Instrumentation techniques

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