ENDODONTICS – NOTES

MAXILLARY TEETH
Maxillary Central Incisor =>
Number of roots: 1
Number of root canals: 1
Maxillary Lateral Incisor =>
Number of roots: 1
Number of root canals: 1
Maxillary Canine =>
Number of roots: 1
Number of root canals: 1
Maxillary First Premolar =>
Number of roots: 2-1
Number of canals: 2-1
Maxillary Second Premolar =>
Number of roots: 1-2
Number of canals: 1-2
Maxillary First Molar =>
Number of roots: 3-2
Number of canals: 3-4
Maxillary Second Molar =>
Number of roots: 3-2
Number of canals: 3-4
MANDIBULAR TEETH
Mandibular Incisors =>
 Number of roots: 1
 Number of canals: 1-2
Mandibular Canine =>
 Number of roots: 1
 Number of canals: 1-2
Mandibular First Premolar:
 Number of roots: 1
 Number of canals: 1-2
Mandibular Second Premolar:
 Number of roots: 1
 Number of canals: 1-2
Mandibular First Molar =>
 Number of roots: 2-3
 Number of root canals: 3/4
Mandibular Second Molar =>
 Number of roots: 2
 Number of canals: 3/4
NOTES from lecture:
Objectives of access cavity preparation:
 Removal all caries; conserve sound tooth structure; unroof the pulp chamber
completely; remove all coronal pulp tissue (vital or necrotic); locate root canal
orifices.
 Achieve straight or direct-line access to the apical foramen or to the initial curvature
of the canal with no deflections.
 Access cavities on the anterior teeth are prepared through the lingual tooth surface;
and those on the posterior teeth are prepared through the occlusal surface.
 Handpieces and burs: long shank bur.
LECTURE: ENDODONTIC INSTRUMENTS –

Standard instruments (notes):

 Endodontic explorer
 Endodontic long-shank spoon excavator
 Endodontic locking forceps
 Broach (barbed broach) – removes pulp tissue from the canals.

 Endodontic file – k type (k file): for cleaning and contouring the inner walls of the
canal.
 Endodontic file – hedstrom: to clean and enlarge/smooth the inner walls of the canal.
 Endodontic file – reamer: to cut and smooth dentinal walls of the canal and to enlarge
the inner walls of the canal.
 Endodontic stoppers – to mark the working length of the canal.
 Endodontic ruler.
 Electronic apex locator – to determine the working length.
 Endodontic irrigating syringe.
 Sterile absorbent paper points – to dry the root canal.
 Gutta percha – to fill (obturate) the pulp chamber and root canals.
 Endodontic spreader – to help condense gutta percha laterally in the canal.
 Endodontic plugger – to help condense gutta percha vertically in the canal.

https://pocketdentistry.com/endodontic-instruments/
ENDODONTIC STEPS:
1. ACCESS CAVITY PREPARATION – identifies the root canal entrances and provides
adequate access to the root canals.
Straight line access should be achieved.

CLEANING AND SHAPING –

Irrigation –
 Flush out debris and lubricate instruments.
 Most commonly sodium hypochlorite (household bleach) – NaOCl at 2.5%.
 Chelating agents like EDTA soften dentin and help open up sclerosed/blocked canals.
  Organic acid such as citric acid can also dissolve organic material.
 The overall effect is achieved by alternating the irritants.

STEP-BACK TECHNIQUE:
=> We begin with K-files, with the smallest size Grey (8) or Purple (10). Then we determine
the working length.
=> Then we increase the size until we can’t put in a larger K-file which reaches the working
length. The last one before the K-file that doesn’t reach the working length is called the MAF
(master apical file).
=> After determining the MAF (minimum 25 usually), we continue using K files 1mm shorter
than the working length and 1 size bigger. So if the MAF is 25, we’d use 30, 35 and 40.
Success in endodontic therapy is dependent on adequate instrumentation, disinfection, and
obturation of the root canal system. The objective of obturation is to create a watertight seal
along the length of the root canal system from the orifice to the apical termination.
https://www.youtube.com/watch?v=CoQCOMhEQ3g

Obturation (filling) of the root canal –

 Gutta-percha cones.
 Paper points – used to dry the root canal space.
 Sealer – cement applied inside the root canal space to adhere the obturation material
(GP) to the root canal wall. Zinc-oxide eugenol typically used.
 Spreaders – for lateral condensation of gutta percha in the root canal space.
 Heat source – may be used for the warming of the gutta-percha.