ROOT CANAL TREATMENT

can be divided into 3 phases

1. ROOT CANAL OPENING /

ACCESS CAVITY PREPARATION
2. ROOT CANAL WASH /CLEANING
DEBRIDEMENT AND SHAPING
OF ROOT CANAL
3. ROOT CANAL FILLING /
OBTURATION
 ACCESS CAVITY PREPARATION
 ENDODONTIC CORONAL CAVITY PREPARATION
 OUTLINE FORM
 CONVENIENCE FORM

REMOVAL OF REMAINING CARIOUS DENTINE

TOILET OF CAVITY

 ENDODONTIC RADICULAR CAVITY PREP.

OUTLINE FORM
CONVENIENCE FORM

TOILET OF CAVITY

RETENTION FORM

RESISTANCE FORM

EXTENSION FOR PREVENTION

 CORONAL CAVITY PREPARATION

 OUTLINE FORM
Entire working length of RC from cavosurface to
root apex
3 important factors
a. SHAPE OF PULP
CHAMBER
b. SIZE OF THE PULP
CHAMBER
c. NUMBER, POSITION AND CURVATURE OF ROOT
CANAL
STRAIGHT LINE ACCESS: instrument should approach the apical
foramen undeflected
 CONVENIENCE FORM

a. Unobstructed access to canal orifice

b. Direct access to apical foramina

c. Expansion to accommodate filling

techniques

d. Complete authority over enlarging

instruments
Straight line access

 First bend of the instrument

In apical third of the canal with
First curvature of the canal
REMOVAL OF REMAINING CARIOUS
DENTINE
This is done to:
 ELIMINATE MECHANICALLY BACTERIA
 ELMINATE DISCOLOURED TOOTH
STRUCTURE
 ELIMINATE POSSIBILITY OF SALIVA
LEAKING INTO PREPARED CAVITY

 TOILET OF THE CAVITY

Wash with irrigants as 2.6% sodium hypochlorite or
saline to remove all carious material and soft debris
RADICULAR CAVITY PREPARATION

It has two objectives :

 THOROUGH CLEANING AND DEBRIDEMENT

OF ROOT CANAL
 SHAPING OF ROOT CANAL SUCH THAT IT
RECEIVES THE FINAL FILLING

The steps outline form to toilet of cavity are the same

 RESISTANCE FORM
The objective is to :
• Provide resistance to overfilling

• Provide a barrier against which to condense

Apical stop is formed at most constricted part of canal

i.e. 0.5 – 1mm short of outer surface of root.
Failure to establish apical stop may lead to:
 Acute inflammation of peri radicular tissue

 Chronic inflammation b/c of continued presence of

foreign body
 Inability to compact the root canal filling
APICAL STOP APICAL SEAT OPEN APEX BLUNDER BUSS
CANAL
RETENTION FORM
Apical 2– 3 mm walls are near parallel to
provide retention to master GP point.
Coronally cavity walls are flared.

 EXTENTION FOR PREVENTION

Canals are extended to make ideal endodontic
cavity as described by Schilder to be round,
evenly tapered space with minimal opening at
apex so that it receives 3D hermetic filling
A. Radiographic
Apex
B. Resistance Form
(Apical Stop)
C. Retention Form
(Apical 2-3 mm)
D. Convenience
Form
E. Outline Form
PRE OPERATIVE PROCEDURE
 LOCAL ANAESTHESIA (OPTIONAL)
 RUBBER DAM APPLICATION (MANDATORY)
 HIGH SPEED SLOW SPEED HANDPIECE
MOUNTED

STEPS
1. TO GAIN ENTRY INTO CHAMBER
ACCESS MAY BE THROUGH CARIES,
RESTORATION, SOUND TOOTH OR CROWN
INITIAL ENTRY WITH TUNSTEN CARBIDE
ROUND ENDED TAPERRED FISSURE BUR/
JET # 331, IN HIGH SPEED HANDPIECE
WHERE TO APPLY THE BUR FOR ENTRY
??
BUR WILL FEEL TO ‘DROP’ OR ‘SINK’
SWITCH TO SLOW SPEED ROUND BUR

LONG SHANK (26mm) ARE USEFUL IN

ENDODONTICS

# 2 ---- mand. ant & max. premolars

# 4 ---- max. ant & mand. premolars
#6 ---- for molars with large pulp chambers
2. DEROOFING OF PULP CHAMBER

Cut using WITHDRAWAL STROKES

(upward & outward)
remove the entire roof to expose the
whole pulp chamber
UPTO WHAT EXTENT DO WE HAVE TO
REMOVE THE ROOF OF THE CHAMBER ??
Till you expose all orifices and have straight line
access
3. SMOOTHENING AND
STRAIGHTENING OF WALLS
Once the roof is removed
switch to safe ended Endo- Z bur or safe- ended
diamond extend laterally
to smoothen & straighten the walls of the cavity
ACCESS CAVITY PREP IN MAX TEETH

ACCESS CAVITY PREP IN MAND TEETH

ACCESS CAVITIES
COMMON ERRORS

perforation through crown or root

wrong inclination of the bur

 Wrong angulation of bur

Tilted tooth with upright crown

Perforation into furcation
Access cavity too small / inadequate extension of roof
of chamber

can lead to
INABILITY TO HAVE STRAIGHT LINE ACCESS

thus leading to
inability to explore all orifices
deflection of instruments
pulp debris / MO remaining in the chamber
ledge formation / perforation
Incomplete removal of the roof
Overextension
weakens coronal tooth structure and
compromises the final restoration