This document provides an overview of the basic steps for performing endodontic treatment on undergraduates. The key steps include: 1. Taking a history and diagnosis to localize the source of pain. Diagnosis methods include x-rays, clinical exams, and anesthesia tests. 2. Gaining anesthesia and isolating the tooth with a rubber dam. Preparing the tooth by removing caries and exposing the pulp chamber. 3. Controlling any pain or bleeding within the tooth before beginning instrumentation of the root canal. 4. Cleaning and shaping the root canal system using files and irrigants like saline, before filling and sealing the canal.

1. ALL ABOUT BASIC ENDO!
BASIC STEPS FOR UNDER-GRADUATES !
Dr. Mariam Zeynel

2. Endodontic treats steps include:
• History & diagnosis
• Anesthesia & pain control
• Isolation
• Peripheral caries removal and access cavity design (including good vision)
• Cleaning and shaping the pulp chamber and root canal system
• Irrigation
• 3d obturation (good coronal & apical seal)
• Final restoration

3. LOCALIZINGTHE CAUSE OF PAIN
• Usually, patients can’t localize the tooth that causes pain, in lower jaw
specifically.
• The responsibility of localizing pain is related to the clinician by using
different diagnosing methods including: X-ray, clinical examination,
percussions, anesthesia, endo frost etc…

4. AFTER LOCALIZINGTHETOOTH
• Starting with good anesthesia (IAN block, infiltration).
• Single tooth or multiple rubber dam isolation (according to the case).
• Preparing the tooth (conservatively), removal of all peripheral caries (hard +
soft), reduction to cusps, removal of unsupported enamel. (WHY?)
• Exposing to the pulp with large hand-piece round bur

5. AFTER EXPOSURE!
TOO MANY OPTIONSTO CONTROLTHE PAIN AND BLEEDING INCLUDING:
1. Washing with normal saline
2. Eugenol + cotton +good pressure
3. Deroofing/ removal of lingual shoulder
4. Intracanal injection + pulp extirpation
5. Good irrigation with normal saline

6. STARTING INSTRUMENTATION
• Negotiating the canal with K-file 6 and always with lubricator (explaining)
• Estimating working length by both apex locator and x-ray
• Starting instrumentation (manual / rotary)
• Always remember reacptulation and irrigation between files
• Guidance is white, clear, chalky dentine
• Final recap is with k-file 10 + scrubbing the canal walls with MAF

7. IRRIGATION
• The main purpose of irrigation is to remove smear layer caused by the
shaping and cleaning of the canal walls.
• The tooth was endodontically treated because of microorganism invasion at
first place so disinfecting the canal system is the key to a successful RCT!
• NACL is the irrigant of choice of all times
• Irrigation system should be applied before obturation, after cone fitting and
x-rays
• Irrigation system includes (NaCl, EDTA, ClX & N.S)

8. OBTURATION !
• Obturation in a nutshell is filling the canal system with a biocompatible
material with good coronal and apical sealing and without any voids in
between the material and the canal walls.
• GP is the material of choice + sealers
• Too many methods for obturation (discuss)

9. HOWTO PROVIDE A GOOD SEAL?
• Apical seal is provided through GP’s tug-back
• Whilist coronal seal is provided by good condensing of GP’s cone + using
either therycal of flowable composite for excellent seal !

10. FINISHING WITH !
• CLEANINGTHE CAVITY FROM ALLTHE SEALER DEBRIES USING A PIECE
OF COTON AND ClX SOLUTION .