Preclinical dentistry - Endodontics Morphology: Dental pulp, pulp chamber, root canal. Endodont is a complex of dentin and dental pulp It is morphological and functional unit. Healing potential of dental pulp: Tertiar (reparative dentin) - produced by odontoblasts as reaction on irritation (dental caries) Dentinal sclerosis - intratubular dentin
Dentin bridge - new dentin formation when dental pulp is exposed (perforation
due to preparation or trauma). Vital methods - methods keeping the dental pulp vital:
Direct pulp capping Indirect pulp capping Pulpotomy
Importance of calcium hydroxide
Endodontic treatment
Diagnosis (patient)s history, inspection,
percussion, rthermal rraction, x- ray)
Treatment
Access to the pulp chamber Opening of root canals Root canal shaping Root canal celaning Rootcanal filling Final control - x- ray Postendodontic treatment
Diseases of dental pulp and apical
periodontal tissues
Pulpitis - reversible (dental pulp can be kept vital)
- irreversible (dental pulp must be removed and the rct must be done) Necrosis - dental pulp is non vital Gangraena - dental pulp is nov vital,infected Periodontitis - the apical part of periodontal ligament is affected (chronic, acute)
Li     » ■  -Um ffi
Ktavj)o trepanaci dřeňové dutiny a rozšíření vchodu
Correct access
And apical morphology:
Apical constriction Apical foramen
Apex
Access
• Prepare cavity on occlusal or oral surface
• Open the pulp chamber
• Find the root canals
• Do the root canal shaping, cleaning
• Filling.
Opening of the pulp chamber
Steel round burs
Removal of the roof of the pulp chamber
Safe ended tips , ^ ^ . ±   * Fissurbur
Batt s instruments
Peeso - Largo
Gates - Glidden: Blunt, non active tip
Programm point of breakage
Removal dental pulp from the root canal
Pulpextractor
Emoval of soft content - pulp, cotton,paper point
Wider canals only!!!
Risks: breakage of the instrument Breaking of spurs and their pushing out
> Reamers (penetration)
> Files (enlargement)
K -reamer
Triangl or square wire spun
Symbol
Blades
Space for dentin chips
Rotation - reaming achtion - panetration
Reamer
Rotation (clockwise) - penetration
Application of plastic material (contraclockwise)
K file
Wire triangl or square
Symbol is always square
K-flexofile, flexicut, flex-R
• Triangle wire always
u □
Flexibility
K- flexofile a flex - R file: non cutting tip and first blades are blunt
Like K-file
H-file
No rotation!!
Pull motion only!!
Risk of breakage in small sizes
ISO
> Diameter of the tip
> Length of the cutting part >Taper
2G 25
35
SG SS
7G
Root canal shaping
Reaming action
Filing - circumferential filing
Balanced force technique
Without any pressure in - rotation 90° (lze i 180°) clockwise 180 - 270° contrac lockwise - slightly press forward Clockwise and out
Efekt rotace a cirkumferentního pilování
Lentulo - paste carrier
> delivers pastes >1,5 -2 mm ahead
> at most for Ca (OH)2
Compactors
Spreader
Pointed
Vertical introduction
Compactors
Plugger
Not pointed
Vertical introduction
Vertical condensatuion - compaction
Filling techniques
Cold Warm
Warm lateral condensation
(compaction)
Vertical compaction
• Difficul control of the working length
• Possible extrusion of the sealer
• Warm
Injection of heated guttapercha
• Fast
• Possible extrusion
• Warm