cleaning and shaping of root canal system
DESCRIPTION
the procedure for rct , detail.TRANSCRIPT
-
Cleaning and Shaping of the Root Canal System. Part IIEdit by Hou Tiezhou02988088507
-
Root Canal InstrumentationEstimate working lengthVerify canal patencyEstimate canal sizeEstablish actual working length
-
Root Canal InstrumentationCrown down preparationCoronal thirdMiddle thirdApical third
-
Armamentarium
-
Armamentarium
-
ArmamentariumStainless steel size 10 K-filesUsed to explore canal patencyFiling or quarter turn pull motion Do not rotate through 360 degrees
-
ArmamentariumStainless steel size 15 and 20 K filesUsed to establish actual working length
-
Armamentarium
-
ArmamentariumProfile orifice shapersUsed to prepare the coronal one third of the root canal
-
Profile Orifice Shapers
-
ArmamentariumProfile 0.06 taper rotary filesUsed to prepare the middle third
-
Armamentarium
-
ArmamentariumProfile 0.04 taper hand NiTi filesUsed to prepare the apical third of the root canal
-
Armamentarium
-
Estimated Working LengthEstimated working length is the distance from the reference point to the radiographic apex, as measured on a parallel preoperative radiograph
-
Estimated working lengthTake a pre-operative parallel radiographClinically, use a XCP film holder
-
Estimated working length Length from incisal edge to radiographic apexOnly an estimate because of radiograph distortion
-
Estimate canal sizeRadiographic appearanceCrown/root morphologyStandardized sizes (See table in manual)
-
Estimate canal size
-
Explore Canal PatencyEnsure that canal can be negotiated to radiographic apexSelect #10 K filePrecurve file if necessary
-
Explore Canal Patency
-
Explore Canal Patency
-
Establish Actual Working lengthInstrumentation should terminate at:The apical constriction1 mm short of radiographic apexActual WL = Estimated WL 1 mm
-
Establish actual working lengthWL can be established using:RadiographsApex locator
-
Establish Actual Working Length
-
Establish Actual Working Length
-
Establish Actual Working Length
-
Establish Actual Working Length
-
Crown Down Preparation
-
Crown Down Preparation
-
Crown-down preparationPlastic incisor with transparent root
-
Crown-down preparationPlace SS K file into canal until the tip is just visible at the apex
-
Actual Working LengthRemove file from canalSubtract 1 mmThis is the actual working lengthIn this case the WL is 20 mm
-
Actual Working Length
-
Preparation of Coronal Third
-
Preparation of Coronal ThirdThe coronal third measurement is WL minus 8 mm, that is 12 mmProfile OS do not have rubber stops however the cutting flutes measure 10 mmThe goal is to work the largest OS to 12 mm
-
Preparation of coronal third
-
Preparation of coronal third
-
Preparation of the coronal thirdRotate OS at 300 rpmNote: Orifice shaper should be rotating at 300 rpm before it is placed in the canalAdvance the OS in 1 mm incrementsWhen resistance is encountered retract OS while still rotating Never force any instrument apically
-
Preparation of coronal thirdBlue (#60) OS extends to approx. 9 mm
-
Preparation of coronal third
-
Preparation of coronal third
-
Preparation of coronal thirdGold (#50) OS reaches 12 mm
-
Preparation of coronal thirdProgress from larger to smaller orifice shaperEach smaller OS will extend further into canalRepeat the sequence until the largest OS extends to 12 mm
-
Preparation of coronal thirdBlue (#60) OS extend to WL 8 mm = 12 mm
-
Preparation of Middle ThirdProfile 0.06 taper series 29 rotary files
-
Preparation of Middle ThirdProfile 0.06 taper series 29 rotary filesThe middle third measurement is WL minus 4 mm, that is 16 mmThe aim is to work the brown (#7) file to 16 mm
-
Preparation of Middle ThirdProceed from larger to smaller fileEach smaller file will extend further into the canalRepeat the sequence until the largest file extends to 16 mm
-
Preparation of middle third
-
Preparation of middle third
-
Preparation of middle third
-
Preparation of middle third
-
Preparation of middle third
-
Preparation of middle third
-
Preparation of middle third
-
Preparation of middle third
-
Preparation of middle third
-
Preparation of middle third
-
Preparation of apical thirdProfile 0.04 taper nickel titanium hand files
-
Preparation of apical thirdProfile 0.04 taper nickel titanium hand filesThe measurement is the full working length, that is 20 mm
-
Preparation of apical thirdMeasure working length on #15 fileSet rubber stop at that lengthLubricate the canal with Prolube
-
Preparation of apical thirdAdvance size 15 file to working lengthRotate file through 360 degreesIrrigate copiously with NaOCl after each file
-
Preparation of the apical thirdAdvance size 20 file to working lengthContinue through sequence, seating each file to working length
-
Preparation of apical thirdProgress from smaller to larger filesEach file is fully seated at working lengthSmall canals prepared to a minimum of ISO 35 or 40Large canals prepared to a minimum of ISO 40 50
-
Preparation of apical third
-
Preparation of apical third
-
Preparation of apical third
-
Preparation of apical third
-
Preparation of apical third
-
Preparation of apical third
-
Preparation of apical third
-
Preparation of apical third
-
Preparation of apical third
-
Preparation of apical third
-
Preparation of apical third
-
Preparation of apical third
-
File kit on completion of instrumentation
-
Master Apical File (MAF)The largest file that extends to working lengthMAF film is exposed to confirm length and placement
-
Master Apical FileFor large canals minimum MAF #40 - 50For small canals minimum MAF #35 - 40
-
Master Apical FileTake a radiograph with MAF in place. This confirms:LengthPlacement
-
Mission Accomplished