2 End Odontology
2 End Odontology
2 End Odontology
Instruments
Endodontics
1987 the American Association of Endodontists defines Enodontics as
the field of dentistry concerned with the morphology, physiology and
pathology of the human pulp and the periradicular tissues.
Scope:
1. differential diagnose and treatment of pulpal and periradicular disease
2. vital pulp therapy - pulp capping
3. Root canal therapy pulpectomy, non-surgical treatment of root canal
systems with or without periradicular pathosis of pulpal origin,
obturation of the root canals
4. selective surgical removal of pathological tissues resulting from pulpal
pathosis
5. intentional replantation and replantation of avulsed teeth
6. surgical removal of tooth structures such as apicectomy, root
amputation, hemisection
7. Internal bleaching
8. Retreatment of previously endodontic treated teeth
9. Coronal restoration posts placement and core build- ups
Endodontic treatment
Diagnostic phase cause of disease is
established
- treatment plan is prepared
Preparatory phase cleaning and shaping the
root
canal in purpose to remove its
content
- root canal is shaped to receive a
three- dimensional filling
Obturatory phase root canal is filled with an
inert
material to ensure a tight sealing
Indications
All teeth can be treated
endodontically
Contraindications
True
False
True contraindications
1. Insufficient periodontal support
Advanced periodontal disease
Bone resorption -lost of
periodontal support -> loose
2. Inadequate crown-root ratio
True contraindications
3. Caries of the root and furcation
4. Internal resorption with perforation
False contraindications
1. Fractured instruments
Possibility to bypass the instrument=> clean
shape
fill
Instrument blocking the apex => endodontic
surgery -> creating a flap-> obturation
through the flap
False contraindications
2. The presence of calcifications
Pulp inflamed -> calcified -> dies
Direction corono-apically
The apical third is negotiable
Useful tool operating surgical
microscope
- ultrasound inserts
designed for endodontic treatment
False contraindications
3. Extreme curvatures of root canals
Precurved files
Fine files
Microscope
4. Difficulties of retreatment
Silver points on the root canals
5. Size of the periapical lesion
Up to 2cm2 =granuloma
Bigger then 2cm2 = cists
treatment
lesions of endodontic
etiology -> endodontic
True indications
Age
Health condition diabetes
- leukemia
- cancer
- heart diseases
Pregnancy temporization legal
issues
Instruments
Classiffied by way of action in:
Hand instruments
Mechanic- rotativ instruments
Classified by purpose:
Instruments for examination
Instruments for cleaning and shaping
Instruments for obturation
The files
Files are hand instruments used for
cleaning and shaping the root canal
Tip
Working part
Shaft
Handle
system
16mm
ISO
Standardization
Stopper
Pro File 29
Motions of K files
Filing - push and pull motion
Reaming - clockwise rotation
Watch winding motion
30- 60 clockwise followed by
30 60 counterclockwise while the
instrument is pushed forward in the canal
Reamers
Triangular/rectangular in
cross section
Tipp cutting
Number of blades from
the number of blades of a
K file
Less cutting efficient
Less debris
Used:
Straight root canals
Removal of debris
Enlargement of root canal
Reamers motions
Rotation moderate pressure
- straight root
canals
Passive insertion to a depth
permitted by the canal
diameter and a quarter
clock-wise rotation with
simultaneous extraction of a
few millimeters. =>cutting
action during the withdrawal
phase. Repetitive
Not 360o rotation => risk of
fracture
Barbed broaches
hooks
Rotary instruments
Steel - Gates Glidden drills
- Paeso Reamers
Ni-Ti rotativ instruments Pro File
Pro Taper
Lightspeed
Quantec
Hero Shaper
K3