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Objectives of Canal Preparation
Start with the end in mind
Objectives of root canal preparation
The root canal system must be:
• Cleaned of its organic remnants
• Shaped to receive a three
dimensional filling of the entire
root canal space
Objectives of root canal preparation
The canal is
• Cleansed primarily by irrigation
• Shaped primarily by instrumentation
Five Mechanical objectives
•Develop a continuously
tapering conical form in the
root canal preparation
•Make the canal narrower
apically, with the narrowest
cross-sectional diameter at
its terminus
•Make the preparation in
multiple planes
•Never transport the
foramen.
•Keep the apical foramen as
small as possible Herbert Schilder
The real key to
obturation is
Cleaning and Shaping
Cleansing of the root canal
Objectives
• Removal of organic and
inorganic debris
• Elimination of bacteria
Instruments
Instruments differ according to:
• Metal
• Tip design
• Cross sectional geometry
• Length of cutting blades
• Sizing
• Taper
Metals
Nickel titanium Stainless steel
Excellent flexibility Less flexible
Conforms to canal Straightens and
curvature transports canal
No deformation Permanent
deformation
ISO-Symbols
= K-Reamer
= K-File
= H-File
= Rat Tail File
= Nervbroach
= Paste Filler
METHODS OF DETERMINING
WORKING LENGTH
• Radiographic Methods
• Digital Tactile Sense
• Apical Periodontal Sensitivity
• Paper Point Measurement
• Electronics
Clinical Technique
Actual WL determination
• Radiograph
• Apex locator
Clinical Procedure
Apex Locator
Clinical Procedure
Actual WL determination
Preparation should terminate at
• Apical constriction
• 1 mm short of radiographic apex
Clinical Procedure
• Estimate working length
• Parallel radiograph
• Estimated working length is the distance from
the reference point to the radiographic apex
• Apico coronal techniques( standardized
,step-back, balanced force )
• Corono-apical techniques ( step-down ,
Double flared, crown-down-
pressureless)
Root canal preparation
• Standard technique
• Step-back technique
• Serial shaping technique
• Anti-curvature filing
• Balance force preparation
• Crown down technique
Instrumentation
• Motion of instrumentation:
Filing and Reaming
• Combination with reaming and
filing:
1. Turn-and-Pull
2. Watch-Winding
3. Watch-Winding-and-Pull
• Anti-curvature filing
Step-back technique
Step-back technique
Master Apical File
• Take a radiograph with MAF in place.
This confirms:
– Length
– Placement
RECAPITULATION
Repeated reintroduction and reapplication
of instruments previously used
throughout the cleaning and shaping
process in order to create well-designed,
smooth, unclogged, evenly tapered root
canal preparations.
Apical Patency
Maintain a pathway
through the apical constriction
with a small K-file (#10 or #15)
during cleaning and shaping
Other methods ;
Crown Down Technique
•Coronal third Orifice shapers
•Middle third 0.06 taper rotary Profiles
•Apical third 0.04 taper hand Profiles
Crown Down Technique
• The coronal portion is prepared before the apical
portion
• Reduces effect of canal curvature
• Improves tactile awareness during apical
preparation
• Allows more effective irrigation
• Removes majority of tissue and microbes before
apical third is approached
• Reduces change in working length during apical
preparation
Anti-curvature filing
Irrigation
An ideal irrigant:
• Is nontoxic
• Dissolves vital and necrotic tissue
• Is bactericidal
• Lubricates the canal
• Sodium Hypochlorite:
• Lower concentrations (e.g., 0.5% or1%) dissolve mainly necrotic
tissue
• Chlorhexidine:
• A broad-spectrum antimicrobial agent effective against gram-
negative and gram-positive bacteria
• A cationic molecular
• binds to hydroxyapatite
Iodine Potassium Iodide:
• an oxidizing agent by reacting with free sulfhydryl groups of
bacterial enzymes
• MTAD
• EDTA
• Hydrogen peroxide
Cleaning---Irrigation
• Sodium Hypochlorite?
• Dissolves organic debris ✔
• Has a powerful anti-bacterial action ✔
• Lubricates the use of files ✔
• Disinfects & cleans where files don’t reach ✔
• The tissue-dissolving ability of 5.25-1%
What irrigant should we use?
Sodium hypochlorite
• Dissolves vital and necrotic tissue
• Is bactericidal
• Lubricates the canal
Smear layer
• What is the smear layer ?
• Remove ?
Prolube
• Facilitates placement of file
• Entraps debris
• Aids in removal of the smear layer
EDTA and carbamide peroxide in
a water soluble base
Good luck

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Canal preparation for RCT

  • 1. Objectives of Canal Preparation Start with the end in mind
  • 2. Objectives of root canal preparation The root canal system must be: • Cleaned of its organic remnants • Shaped to receive a three dimensional filling of the entire root canal space
  • 3. Objectives of root canal preparation The canal is • Cleansed primarily by irrigation • Shaped primarily by instrumentation
  • 4. Five Mechanical objectives •Develop a continuously tapering conical form in the root canal preparation •Make the canal narrower apically, with the narrowest cross-sectional diameter at its terminus •Make the preparation in multiple planes •Never transport the foramen. •Keep the apical foramen as small as possible Herbert Schilder The real key to obturation is Cleaning and Shaping
  • 5. Cleansing of the root canal Objectives • Removal of organic and inorganic debris • Elimination of bacteria
  • 6. Instruments Instruments differ according to: • Metal • Tip design • Cross sectional geometry • Length of cutting blades • Sizing • Taper
  • 7. Metals Nickel titanium Stainless steel Excellent flexibility Less flexible Conforms to canal Straightens and curvature transports canal No deformation Permanent deformation
  • 8.
  • 9.
  • 10.
  • 11. ISO-Symbols = K-Reamer = K-File = H-File = Rat Tail File = Nervbroach = Paste Filler
  • 12.
  • 13.
  • 14.
  • 15.
  • 16. METHODS OF DETERMINING WORKING LENGTH • Radiographic Methods • Digital Tactile Sense • Apical Periodontal Sensitivity • Paper Point Measurement • Electronics
  • 17. Clinical Technique Actual WL determination • Radiograph • Apex locator
  • 18.
  • 20. Clinical Procedure Actual WL determination Preparation should terminate at • Apical constriction • 1 mm short of radiographic apex
  • 21. Clinical Procedure • Estimate working length • Parallel radiograph • Estimated working length is the distance from the reference point to the radiographic apex
  • 22. • Apico coronal techniques( standardized ,step-back, balanced force ) • Corono-apical techniques ( step-down , Double flared, crown-down- pressureless) Root canal preparation
  • 23. • Standard technique • Step-back technique • Serial shaping technique • Anti-curvature filing • Balance force preparation • Crown down technique
  • 24. Instrumentation • Motion of instrumentation: Filing and Reaming • Combination with reaming and filing: 1. Turn-and-Pull 2. Watch-Winding 3. Watch-Winding-and-Pull • Anti-curvature filing
  • 27. Master Apical File • Take a radiograph with MAF in place. This confirms: – Length – Placement
  • 28. RECAPITULATION Repeated reintroduction and reapplication of instruments previously used throughout the cleaning and shaping process in order to create well-designed, smooth, unclogged, evenly tapered root canal preparations.
  • 29. Apical Patency Maintain a pathway through the apical constriction with a small K-file (#10 or #15) during cleaning and shaping
  • 31. Crown Down Technique •Coronal third Orifice shapers •Middle third 0.06 taper rotary Profiles •Apical third 0.04 taper hand Profiles
  • 32. Crown Down Technique • The coronal portion is prepared before the apical portion • Reduces effect of canal curvature • Improves tactile awareness during apical preparation • Allows more effective irrigation • Removes majority of tissue and microbes before apical third is approached • Reduces change in working length during apical preparation
  • 34. Irrigation An ideal irrigant: • Is nontoxic • Dissolves vital and necrotic tissue • Is bactericidal • Lubricates the canal
  • 35. • Sodium Hypochlorite: • Lower concentrations (e.g., 0.5% or1%) dissolve mainly necrotic tissue • Chlorhexidine: • A broad-spectrum antimicrobial agent effective against gram- negative and gram-positive bacteria • A cationic molecular • binds to hydroxyapatite Iodine Potassium Iodide: • an oxidizing agent by reacting with free sulfhydryl groups of bacterial enzymes • MTAD • EDTA • Hydrogen peroxide
  • 36. Cleaning---Irrigation • Sodium Hypochlorite? • Dissolves organic debris ✔ • Has a powerful anti-bacterial action ✔ • Lubricates the use of files ✔ • Disinfects & cleans where files don’t reach ✔ • The tissue-dissolving ability of 5.25-1% What irrigant should we use?
  • 37. Sodium hypochlorite • Dissolves vital and necrotic tissue • Is bactericidal • Lubricates the canal
  • 38. Smear layer • What is the smear layer ? • Remove ?
  • 39. Prolube • Facilitates placement of file • Entraps debris • Aids in removal of the smear layer EDTA and carbamide peroxide in a water soluble base