Root canal treatment

1. avoid cusp tips and marginal ridges

1. Lingual surface
   1. anterior teeth
2. Occlusal or biting surface
   1. posterior teeth
3. What burr?
   1. Round or tapered in high speed handpiece

1. Number of canals / Shape
   1. Incisors
      1. 1 canal (LLI tends to have 2)
      2. Triangular
   2. Canines
      1. Ovoid/oval
      2. 1 canal
   3. Premolars
      1. 1 or 2 (1st MPM)
      2. Oval
   4. Upper molars
      1. 3 or 4 (MB2)
      2. Blunted triangle or romboidal
   5. Lower molars
      1. 3*

         Annotations:

         • - The distal root usually has 2 canals - Not so often: 4 canals is possible with 2 canals in each root
      2. Trapezoidal

Annotations:

• .02 taper means that the file gets .02 milimeters THICKER in diameter for each milimeter you go down from the tip

1. K files (Kerr)
   1. Twisted square
   2. Watch winding method
2. H files (Hedstrom)
   1. Spiral cone
   2. Cuts only in retraction
3. Color scheme
4. File dimensions
   1. D16 = size file + convexity*k (k=16mm)

      Annotations:

      • F.ex: Size file 15, convexity 0.2 --> D16= 0.15 mm + 0.2*16mm = 0.47 mm

1. open orifice for straight-line access

1. entangle and remove things that are caught or stuck in the root canal

1. Twisted triangle

1. irrigant

Annotations:

• dissolves GP in retreatment

1. Bacteroides

   Annotations:

   • GM obligated anaerobes

1. Enterococcus faecalis

   Annotations:

   • GP facultative anaerobic

1. Gutta-percha (GP)
   1. Match the size of the GP to the last file you used (color)
2. Sealer (ZOE)
3. Condensation tecniques
   1. Warm vertical
      1. Plugger
   2. Cold lateral
      1. FInger spreader and tiny accessory cones

1. Surgical opening in SOFT tissue
   1. Realeases exudate and pressure

1. SUrgicsl opening in HARD tissue

1. Achieving acces through the apex to seal anterograde
   1. Apicoectomy: Resect 3 mm of root tip
      1. Use ultrasonic tip to instrument the canal 3 mm
         1. Mineral Trioxide Aggregate (MTA)
            1. Suture soft tissue and let the bone heal