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CLEANING AND SHAPING OF THE ROOT CANAL
Introduction  ,[object Object],[object Object]
[object Object],ACCESS CAVITY PREPERATION CLEANING & SHAPING ,[object Object],[object Object],[object Object],OBTURATION
Objectives of Canal Preparation ,[object Object]
[object Object],[object Object],[object Object],The canal is  Cleaned primarily by irrigation Shaped primarily by instrumentation Hence cleansing and shaping
1.Remove the infected soft and hard tissue. Basic Objectives in cleaning and shaping of the root canal: (cohen)
[object Object]
[object Object]
4. Retain the integrity of radicular structures. X X X
OBJECTIVES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
WORKING  LENGTH  DETERMINATION
Definition and significance ,[object Object]
significance ,[object Object],[object Object],[object Object],[object Object],[object Object]
Anatomical considerations and terminology  ,[object Object]
Anatomic apex and  Radiographic apex Anatomic apex  : Is the tip or the end of the root determined morphologically, Radiographic apex :  Is the tip or end of the root determined radiographically
Apical constriction( minor apical diameter) ,[object Object],[object Object],[object Object]
prerequisite ,[object Object],[object Object],[object Object],[object Object],[object Object]
Different techniques ,[object Object],[object Object],[object Object],[object Object],[object Object]
Radiographic methods ,[object Object],[object Object],[object Object],[object Object],[object Object]
GROSSMAN’S METHOD  Actual length of tooth = Actual length of instrument X radiographic length of tooth  Radiographic length of instrument  Actual length of tooth  Actual length of instrument Radiographic length of instrument  Radiographic length of tooth =
INGLE’S METHOD ,[object Object]
2. Subtract at least 1.0 mm “safety allowance” for possible image distortion or magnification. 3. Set the endodontic ruler at this tentative working length and adjust the stop on the instrument at that Level. 4. Place the instrument in the canal until the stop is at the plane of reference unless pain is felt.
INGLE’S METHOD ,[object Object],[object Object],[object Object]
INGLE’S METHOD ,[object Object],[object Object],[object Object]
INGLE’S METHOD
IN RESORPTIVE CASES (As modified by Franklin S Weine)
Digital tactile method ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Paper point evaluation Indications : Root canal with immature apex  Cases in which apical constriction has been lost.  Paper point evaluation, by addition of mm markings 18, 19, 20, 22, 24mm from tip and can be used to estimate working length.
By apical periodontal sensitivity ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Electronic apex locators Connections of the electrodes To file & cheek File placed to length indicated at “zero” by apex locator  Apex indication in different apex locators
DETERMINING LENGTH OF TOOTH
 
First generation ,[object Object],[object Object],[object Object],[object Object]
Second generation ,[object Object],[object Object],[object Object],[object Object]
Third generation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
[object Object]
 
 
Eliminating or minimizing  the influence of affecting factors ,[object Object],[object Object]
Techniques of pulp space preparation Hybrid technique  Step back step down combination procedure Apical coronal preparation technique  Step back preparation & modifications. Coronal to apical preparation technique   Step down tech
Standardized  preparation   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],Hourglass preparation
STEP BACK PREPARATION (Telescopic, Serial root canal prep) ,[object Object],[object Object],[object Object]
WL established ,1 st  active instr 8,10, 15 lubricated Motion- watch winding Apical preparation upto the file #25(MAF)to full WL With recapitulation using prior size
Stepping back in increments with recapitulation using # 25 file to ensure patency to the constriction with irrigation (step back up the canal 1mm and 1larger instr at a time)
For coronal and mid root  preparation  Gates Glidden drills  Nos 2,3,4 along with lubrication
Return to # 25 last file (MAF) Short of working length to smooth the step back  with vertical push- pull strokes  (circumferential filing) H files used.
 
Advantages  ,[object Object],[object Object],[object Object],[object Object]
Disadvantages  ,[object Object],[object Object]
MODIFICATIONS OF STEP BACK ,[object Object]
CORONO APICAL PREPARATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
STEP DOWN TECHNIQUE
Step down technique Principle- coronal aspect of the root canal is prepared and cleaned before the apical part  coronal preparation using gates glidden, smaller hand instruments to the apex
K-File Series Step-Down Technique.   Starting with a No. 50 instrument (for example) and working down the canal to, say, a size No. 15, the instruments are used in a  watch-winding motion   until the apical constriction (or working length) is reached.  When resistance is met to further penetration, the next smallest size is used. Irrigation  should follow the use of each instrument and  recapitulation  after every other instrument. To properly enlarge the apical third, and to round out ovoid shape and lateral canal orifices, a reverse order of instruments may be used starting with a No. 20 (for example) and enlarging this region to a No. 40 or 50(for eg).
Balanced force 1985   (ROANE ) TECHNIQUE ,[object Object],[object Object]
[object Object],[object Object],[object Object]
 
 
Advantages ,[object Object],[object Object],[object Object],[object Object],[object Object]
THREE DIMENSIONAL CLEANING AND SHAPING CONSERVATION OF MAXIMUM TOOTH STRUCTURE
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Step back  Crown down ,[object Object],[object Object],[object Object],DISADVANTAGES : Increased removal of tooth structure
Procedural Accidents
Procedural accidents in endodontics are those unfortunate occurrences that happen during treatment, some due to inattention to detail, and others totally unpredictable. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],LOSS OF WORKING LENGTH
LEDGING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ZIPPING OR ELLIPTICATION Transportation or transposition of the apical portion of the canal
PERFORATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Perforation
 
Classification based on the location Mid – root  Apical Cervical
SEPARATED INSTRUMENTS The incidence of separation is 2-6%
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Cleaning and shaping the root canal system

  • 1. CLEANING AND SHAPING OF THE ROOT CANAL
  • 2.
  • 3.
  • 4.
  • 5.
  • 6. 1.Remove the infected soft and hard tissue. Basic Objectives in cleaning and shaping of the root canal: (cohen)
  • 7.
  • 8.
  • 9. 4. Retain the integrity of radicular structures. X X X
  • 10.
  • 11.
  • 12. WORKING LENGTH DETERMINATION
  • 13.
  • 14.
  • 15.
  • 16. Anatomic apex and Radiographic apex Anatomic apex : Is the tip or the end of the root determined morphologically, Radiographic apex : Is the tip or end of the root determined radiographically
  • 17.
  • 18.
  • 19.
  • 20.
  • 21. GROSSMAN’S METHOD Actual length of tooth = Actual length of instrument X radiographic length of tooth Radiographic length of instrument Actual length of tooth Actual length of instrument Radiographic length of instrument Radiographic length of tooth =
  • 22.
  • 23. 2. Subtract at least 1.0 mm “safety allowance” for possible image distortion or magnification. 3. Set the endodontic ruler at this tentative working length and adjust the stop on the instrument at that Level. 4. Place the instrument in the canal until the stop is at the plane of reference unless pain is felt.
  • 24.
  • 25.
  • 27. IN RESORPTIVE CASES (As modified by Franklin S Weine)
  • 28.
  • 29. Paper point evaluation Indications : Root canal with immature apex Cases in which apical constriction has been lost. Paper point evaluation, by addition of mm markings 18, 19, 20, 22, 24mm from tip and can be used to estimate working length.
  • 30.
  • 31.
  • 32. Electronic apex locators Connections of the electrodes To file & cheek File placed to length indicated at “zero” by apex locator Apex indication in different apex locators
  • 34.  
  • 35.
  • 36.
  • 37.
  • 38.
  • 39.
  • 40.  
  • 41.  
  • 42.
  • 43. Techniques of pulp space preparation Hybrid technique Step back step down combination procedure Apical coronal preparation technique Step back preparation & modifications. Coronal to apical preparation technique Step down tech
  • 44.
  • 45.
  • 46.
  • 47. WL established ,1 st active instr 8,10, 15 lubricated Motion- watch winding Apical preparation upto the file #25(MAF)to full WL With recapitulation using prior size
  • 48. Stepping back in increments with recapitulation using # 25 file to ensure patency to the constriction with irrigation (step back up the canal 1mm and 1larger instr at a time)
  • 49. For coronal and mid root preparation Gates Glidden drills Nos 2,3,4 along with lubrication
  • 50. Return to # 25 last file (MAF) Short of working length to smooth the step back with vertical push- pull strokes (circumferential filing) H files used.
  • 51.  
  • 52.
  • 53.
  • 54.
  • 55.
  • 57. Step down technique Principle- coronal aspect of the root canal is prepared and cleaned before the apical part coronal preparation using gates glidden, smaller hand instruments to the apex
  • 58. K-File Series Step-Down Technique. Starting with a No. 50 instrument (for example) and working down the canal to, say, a size No. 15, the instruments are used in a watch-winding motion until the apical constriction (or working length) is reached. When resistance is met to further penetration, the next smallest size is used. Irrigation should follow the use of each instrument and recapitulation after every other instrument. To properly enlarge the apical third, and to round out ovoid shape and lateral canal orifices, a reverse order of instruments may be used starting with a No. 20 (for example) and enlarging this region to a No. 40 or 50(for eg).
  • 59.
  • 60.
  • 61.  
  • 62.  
  • 63.
  • 64. THREE DIMENSIONAL CLEANING AND SHAPING CONSERVATION OF MAXIMUM TOOTH STRUCTURE
  • 65.
  • 66.
  • 68.
  • 69.
  • 70.
  • 71. ZIPPING OR ELLIPTICATION Transportation or transposition of the apical portion of the canal
  • 72.
  • 73.  
  • 74. Classification based on the location Mid – root Apical Cervical
  • 75. SEPARATED INSTRUMENTS The incidence of separation is 2-6%