Endodontics
Course Review
Enoch Ng, DDS 2014
K3 technique
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After achieving working length, apically enlarge to MAF
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Initial radiographs – straight on and angled (Mx incisors only require straight on shot)
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Parallel film optimal for working length estimation
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Estimated working length on radiograph
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Access chamber – irrigate with 1-2mL NaOCl
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ID canal orifices
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“scout” coronal 2/3 of canal with size #10 file
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Coronal flare with Gates Gliddens burs
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Measure chamber floor depth on GG burs
Advance #4 < depth of bur head (~2mm), irrigate 1-2mL NaOCl
Advance #3 3mm past orifice, irrigate 1-2mL NaOCl
Advance #2 6mm past orifice, irrigate 1-2mL NaOCl
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Hand file to size #20 to create glide path, irrigate 1-2mL between files
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Estimated working length with #20 file, get CWL
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If >1mm change, expose new radiograph
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Once working length is established, measure EVERYTHING placed into canal
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Use these files to resistance, irrigate and recapitulate with #10 file after each rotary file
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25/.10 (tip diameter/taper)
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25/.08
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35/.06
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30/.04
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25/0.6 – if does not reach CWL, repeat sequence
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Apically enlarge canals with .04 taper (small/curved canals) or .06 taper (large/straight canals) to MAF size
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Use all files at 300 RPM – special torque controlled motors
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Final apical file radiograph – made with
HAND FILE
corresponding to MAP
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Final irrigation with >3mL NaOCl per canal
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Dry canal with paper points
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Apical clearing – passive 1/3 turn clockwise rotation with sterile MAF at CWL to remove debris
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No cutting, just load flutes with debris for removal
Summary
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Straight line access and glide path necessary for successful rotary instrumentation
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Irrigation and recapitulation provide many benefits
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Bacteria cause disease, eliminating them gives patient’s immune system chance to heal