Endodontics
Lec.2 سندس حسين.د
Basic instrumentation in Endodontics:-
It is now widely accepted that success in root canal treatment
depends upon the thorough cleaning & shaping of the root canal system
& the placement of a three- dimensional root canal filling of gutta-percha
& inert sealer. To fulfill these objectives, many different instruments each
with a specific purpose, must be available. Some of these instruments
have been used for many years, whilst others are newer & highly
technical.
❖ Endodontic Explorer:-
The straight end of the explorer is designed to aid in location of
root canal orifices, its tip is sharp & able to negotiate a small opening, the
instrument has sufficient rigidity to explore with controlled force. The L-
shaped end aids in detection unremoved portions of the pulp chamber
root.
❖ Plastic Instrument:-
The blade like end of this instrument is used to carry & place the
temporary filling materials. The opposite end is used as a plugger to
condense filling materials in the pulp chamber.
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❖ Endodontic excavator:-
The shape of this instrument allows curettage of the pulp chamber
when conventional excavator will not reach the floor of the chamber (had
long shank). It’s also part of the surgery kit and is used to curette
periapical lesion.
❖ Endodontic locking plier:-
It has a latch that permits materials to be held without continuous
finger pressure. The grooved tips facilitate holding absorbent points and
gutta-percha cones, which tend to loosen in ungrooved tips.
❖ Endodontic ruler:-
The 0.5 mm ruler is a convenient instrument with which to
measure files, gutta-percha cones, and also we have a measuring blocks
and special millimeter thumb rulers.
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❖ Endodontic syringe:-
It’s used to carry the irrigants into the root canal. The needle tip is
flat to prevent penetration into smaller canal diameter and grooved to
allow irrigants that may be under pressure to flow coronolly rather than
be forced through the apical foramen. When drying canals, most of the
irrigant may be aspirated from the canal by pulling back on the plunger.
❖ Instrument organizer:-
A means of organizing endodontic files according to size and
length is a necessity. The organizer provides holes for the files, which are
held vertically in a sponge allowing them to be grasped easily. The
sponge is saturated with disinfectant solutions that maintain instrument
sterility.
❖ Transfer sponge:-
A banker’s sponge is a convenient aid to
hold files during root canal preparation. As an
assistant or the dentist adjusts the elastic stops
on each file. The instruments are placed in the
sponge according to size. Each file is then easily
grasped, used and replaced in the sponge. The
sponge, which is saturated with disinfectant
solution, also is useful to debride the instrument.
If, during canal preparation, debris and dentin
shaving accumulate on the file, they are easily
removed by inserting the file into the sponge a
few minutes.
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❖ Instrument stop:-
After the canal length is determined, it’s necessary to mark that
length on the file. This is accomplished by placing an elastic stop on the
instrument shaft. Silicone stops are available commercially, or instrument
stops can be made easily by cutting a rubber band into 2 mm squares,
which are then centered on the instrument shaft.
When placing the stop on the instrument, it’s important to avoid
angulation which may measure different lengths as the file is rotated.
❖ Burs:-
Several types of bur will be required to accomplish good access
preparation.
1. Round bur: - round burs, normal and extra-long, size 2, 4,
and 6, are used to lift the roof off the pulp chamber and
eliminate over-hanging dentin. The longer and smaller sizes
can be used to find calcified canals.
2. Safe-ended burs:- A safe-ended diamond or tungsten-
carbide bur, the Endo-Z bur, both with a non-cutting tip, is
used to taper & smooth the access cavity preparation. The
non-cutting tip prevents gouging on the floor of the pulp
chamber, where important landmarks could be lost in
pinpointing the location of root canals.
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❖ Hand Spreader:-
Manufactured from stainless steel, land spreaders are designed to
facilitate the placement of accessory gutta-percha points around a well-
fitting master gutta-percha point during the lateral condensation method.
Their diameter & shape are not standardized making it difficult to match
spreaders with accessory gutta-percha points.
❖ Finger spreaders:-
These instruments are color-coded to match either standardized or
accessory gutta-percha points. Their short length affords a high degree of
tactile sense & allows them to rotate freely around their axis, thus freeing
the instrument for easy removal.
The depth of spreader penetration is important for the quality of the
find apical seal; spreaders should be capable of reaching to within 1-2
mm of the apical stop alongside its master gutta-percha point.
Endodontic Pluggers:-
Endodontic pluggers consist of long-handled instruments which are
of larger diameter than spreaders & have a blunt end; they are used to
pack thermally softened gutta-percha into the root canal. The different-
diameter pluggers have reference lines on the tips to allow the assessment
of plugger depth. It’s very important to realize when the plugger is
engaging a cushion of softened gutta-percha, rather than the resistance of
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the canal wall. These pluggers may also be used to pack calcium
hydroxide into root canals.