Dr. Özkan ADIGÜZEL

1. Challenges in Endodontics
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2. Two distinctions should be recognized
1.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.
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5. Curved canals offer a wide range of anatomical
shapes that can lead to procedural errors such as,
ledge formation
Zipping
strip perforation
apical perforation
transportation
during cleaning and shaping
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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 order
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7. Instrumentation technique
Root canal curvature
Type of tooth
Canal location
Re-treatment
Undergraduate work
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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 pathway
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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 blockage
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10. Williams - 1951 Heling and Karmon - 1976
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11. 1. Knowledge of root canal anatomy
2. Typical variations from normal.
3. Knowledge of variations that will not be visible on
radiographs
4. Probing floor of pulp chamber with endodontic
explorer
5. Digital perception with hand instrument in canal.
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12. 1. Pulp chamber anatomy and relationship to occlusal
anatomy
2. Estimated root canal lengths
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3. Root curvature (morphology)
4. Root canal diameter ( preparation technique required)
and Stage of root development (open apex, etc)
5. Canal obstructions, calcifications
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13. 1.Remove all the carious dentine
and bad restorations
2.Remove gum polyp
3.Place matrix band and holder
4.Restore with GIC
5.Place rubber dam / isolate with cotton role
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14. 1. Remove the entire roof of the pulp
chamber
2. 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 tissue
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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-ray
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18. 1. Dissolve organic debris
2. Flush out inorganic and organic debris
3. Lubricate endodontic instruments
4. Eliminate micro-organisms
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5. Bleaching of tooth to prevent staining
0.05-5% Sodium Hypochlorite
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19. 1. Easier to insertion of file
2. Reduced the stress to the file
3. Assist to remove debris
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4. Soften the dentin
5. Remove the smear layer
EDTA, Silicone, glycerin and wax lubricant paste
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20. ANTI CURVATURE FILING CIRCULAR FILING
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22. Zipping
When a curved foramen is filed
with a small file with pressure
against the outer side of the
curvature, repeated filing Zips and
transport the foramen.
The curved area of the foramen is
not cleaned and retains tissue
debris. Foramen cannot be
obturated totally and failure of the
RCT is certain.
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29. Strip perforation
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30. File separation
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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.
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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.
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