Endo note 18 ledge formation

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Dr. Özkan ADIGÜZEL

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  • Nice presentation and simple explanation. Thanks for sharing
    Please refer to slide no. 10
    The captions are interchanged
    Maybe considered for correction
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Endo note 18 ledge formation

  1. 1. Challenges in Endodontics9/22/2009 Endo 18 1
  2. 2. Two distinctions should be recognized1.This is the only dental treatment that depends heavily on the tactile sensation of the fingers of the operator.2.The inability of the clinician to visualize three dimensionally the anatomy of the pulp. 9/22/2009 Endo 18 2
  3. 3. 9/22/2009 Endo 18 3
  4. 4. 9/22/2009 Endo 18 4
  5. 5. Curved canals offer a wide range of anatomicalshapes that can lead to procedural errors such as, ledge formation Zipping strip perforation apical perforation transportation during cleaning and shaping9/22/2009 Endo 18 5
  6. 6. Not extending the access cavity sufficiently Incorrect assessment of the root canal direction Erroneous root canal length determination Complete loss of control of the instrument Forcing and driving the instrument into the canal Using noncurved S/S instrument Failing to use the instrument in sequential order9/22/2009 Endo 18 6
  7. 7. Instrumentation technique Root canal curvature Type of tooth Canal location Re-treatment Undergraduate work9/22/2009 Endo 18 7
  8. 8. Clinical Straightened the curve canal No sensation of curve Dead end feeling Tip binding is loss No tactile sensation of tensional binding Radiological Instrument point away from the lumen File deviated from the natural pathway9/22/2009 Endo 18 8
  9. 9. Careful and attentive instrumentation Learn from own mistake and others mistake Appropriate preoperative and post operative X- Ray Copious irrigation Pre-curved files Incremental instrumentation Careful attempting to remove blockage9/22/2009 Endo 18 9
  10. 10. Williams - 1951 Heling and Karmon - 19769/22/2009 Endo 18 10
  11. 11. 1. Knowledge of root canal anatomy2. Typical variations from normal.3. Knowledge of variations that will not be visible on radiographs4. Probing floor of pulp chamber with endodontic explorer5. Digital perception with hand instrument in canal. 9/22/2009 Endo 18 11
  12. 12. 1. Pulp chamber anatomy and relationship to occlusal anatomy2. Estimated root canal lengths33. Root curvature (morphology)4. Root canal diameter ( preparation technique required) and Stage of root development (open apex, etc)5. Canal obstructions, calcifications 9/22/2009 Endo 18 12
  13. 13. 1.Remove all the carious dentine and bad restorations2.Remove gum polyp3.Place matrix band and holder4.Restore with GIC5.Place rubber dam / isolate with cotton role9/22/2009 Endo 18 13
  14. 14. 1. Remove the entire roof of the pulp chamber2. Provide direct-line access to the apical third of the root canals.3. Avoid damage to floor of the pulp chamber.4. Enable a temporary seal to be placed.5. Conserve as much sound tooth tissue9/22/2009 Endo 18 14
  15. 15. 9/22/2009 Endo 18 15
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  17. 17. 1. Average tooth length 2. Radiographic length 3. First bound length 4. Pain length 5. Apex locator length Calculate Provisional working length Operative radiograph +/- 2mm to apex; Used formula & repeat the x-ray9/22/2009 Endo 18 17
  18. 18. 1. Dissolve organic debris 2. Flush out inorganic and organic debris 3. Lubricate endodontic instruments 4. Eliminate micro-organisms 5 5. Bleaching of tooth to prevent staining 0.05-5% Sodium Hypochlorite9/22/2009 Endo 18 18
  19. 19. 1. Easier to insertion of file2. Reduced the stress to the file3. Assist to remove debris44. Soften the dentin5. Remove the smear layerEDTA, Silicone, glycerin and wax lubricant paste 9/22/2009 Endo 18 19
  20. 20. ANTI CURVATURE FILING CIRCULAR FILING9/22/2009 Endo 18 20
  21. 21. 9/22/2009 Endo 18 21
  22. 22. ZippingWhen a curved foramen is filedwith a small file with pressureagainst the outer side of thecurvature, repeated filing Zips andtransport the foramen.The curved area of the foramen isnot cleaned and retains tissuedebris. Foramen cannot beobturated totally and failure of theRCT is certain. 9/22/2009 Endo 18 22
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  26. 26. 9/22/2009 Endo 18 26
  27. 27. 9/22/2009 Endo 18 27
  28. 28. 9/22/2009 Endo 18 28
  29. 29. Strip perforation9/22/2009 Endo 18 29
  30. 30. File separation9/22/2009 Endo 18 30
  31. 31. In the straight portion of the canal, Loosen it with a H file or an ultrasonic instrument and pull the part out with a H file or with a curved mosquito forcep or a locked tweezer.It may even be flushed out if loosened sufficiently.9/22/2009 Endo 18 31
  32. 32. Special instruments Are available to disengage hold and . remove separated instruments from root canals. Eg. Cancellier instruments Trepanbur, Messerann extractors IRS Instrument remover (Dentsply) etc.9/22/2009 Endo 18 32
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  34. 34. 9/22/2009 Endo 18 34

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