Endo 101

Question 1

What is are the 12 steps of the Root canal procedure

Answer 1

1. Diagnosis
2. Infection Control and Isolation
3. Access
4. Debridement
5. Working Length Measurements
6. Canal Preparation
7. Irrigation
8. Drying
9. Medicamentation
10. Temporary Restoration
11. Obturation
12. Restoration

Question 2

Root Canal Procedure - Explain Step 1 Diagnosis

Answer 2

• Use Endo-Ice to see if the tooth has a response

- Test the tooth prior to getting a crown

Question 3

Root Canal Procedure - Explain Step 2 Infection Control and Isolation

Answer 3

• Use of dental dam to
  a. Isolate the tooth
  b. Prevent contamination of tooth
  c. Better visualization of the tooth
  d. Prevents accidental dropping of instruments into the patient’s mouth

Question 4

Root Canal Procedure - Explain Step 3 Access

Answer 4

-Use a 557 Bur: for entry into most pre-molars or molars
-Use #2 Surgical Lenth friction grip bur
-Non-end cutting or a safer end carbide bur
all of these instruments help you Dr. gain access to the tooth

Question 5

Root Canal Procedure - Explain Step 4 Debridement

Answer 5

• Debridement: Removal fo the microorganisms that have entered the pulp
• Main goal of a Root Canal procedure is to debride the canal of the invading microorganisms

Question 6

Root Canal Procedure - Explain Step 5 Working Length Measurements

Answer 6

• Exact measurement of the tooth from the top of the tooth, to the end of the root
• Don’t want to be “too short” leaving microorganisms behind
• Don’t want to be “too long” pushing the disinfectants out of the tooth
• Most accurate way to measure working length of a tooth is via electronic Apex Locator

Question 7

Root Canal Procedure - Explain Step 6 Canal Preparation

Answer 7

• The shaping of the canal is performed using hand files initially to create a glide path
• Use rotary instruments to further refine the shaping of the canal
• While shaping the canal create a smear layer, when finished with this part remove smear layer with EDTA Solution applied to the canal and left in place for approximately 1 min

Question 8

Root Canal Procedure - Explain Step 7 Irrigation

Answer 8

• Use canal pro-NaOCl as the primary disinfectant for irrigation/debridement of root canals
• If the need presents itself finish irrigation with 1 min application of 2% chlorhexidine

Question 9

Root Canal Procedure - Explain Step 8 Drying

Answer 9

• Remove endodontic irrigants from the canal
• SurgiTip-endo: Endodontic aspirator tip for the root canal small suction that removes most of the irrigants from the canals
• Do a final drying using sterile paper points

Question 10

Root Canal Procedure - Explain Step 9 Medicamentation

Answer 10

• Apply calcium Hydroxide to the canal (to the tooth if the procedure has to be done in more than one visit)
• Anit inflammatory, bacterial, viral properties help with the stopping of bleeding and puss draining in the canal

Question 11

Root Canal Procedure - Explain Step 10 Temporary Restoration

Answer 11

-After applying Calcium hydroxide, the dentist can apply a temporary restoration to the tooth ex. DuoTEMP

Question 12

Root Canal Procedure - Explain Step 11 Obturation

Answer 12

• Obturation: Filling of the canal space
• Use Gutta Percha points and a sealer (Gutta Flow) to fill the canal
• Gutta Flow: Prevents microleakage of microorganisms or bacteria either from the bottom of the root (the apex) or the top (the orifice)

Question 13

Root Canal Procedure - Explain Step 12 Restoration

Answer 13

-Dr. finishes up by restoring the tooth with their choice of filling

Question 14

What is the number one cause of Endodontic failure?

Answer 14

Coronal leakage

Question 15

What is Coronal Leakage?

Answer 15

Leakage from the top of the tooth into the debrided, clean root canal space

Question 16

What are some choices of filling for the restoration step in the root canal process?

Answer 16

• Composites
• Bonded composites
• Glass ionomers
• Or a combination of the two