Definition of "Root canal therapy"

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Root canal therapy (aka endodontic therapy) is a sequence of Tx for the infected pulp of a tooth, which results in the elimination of infection and the protection of the decnominated tooth from future microbial invasion.

Method
  • Root canals and their associated pulp chamber are the physical hollows within a tooth, that are naturally inhabited by nerve tissue, blood vessels, and other cellular entities, which together constitute the dental pulp
  • Root canal therapy involves removal of these structures, the subsequent shaping, cleaning, and decontamination of the hollows with small files and irrigating solutions, and the obturation/filling of the decontaminated canals with an inert filling e.g. gutta-percha and typically an eugenol-based cement
  • Epoxy resin is employed to bind gutta-percha in some root canal procedures
  • Canal placement includes:
    • Mx dentition:
      • 1, which is ordinarily 23mm long, w/ 1 root, and 1 canal. Triangular access cavity, starting at the cingulum and widening towards incisal edge
      • 2, which is ordinarily 22mm long, w/ 1 root, and 1 canal
      • 3, which is ordinarily 26mm long, w/ 1 root, and 1 canal
      • 4, which is ordinarily 21mm long, w/ 2 roots, and in 90% of cases 2 canals (B, P), 5% of cases 1 canal, and 5% of cases 3 canals (MB, DB, P)
      • 5, which is ordinarily 21mm long, w/ 1 root, and in 75% of cases 1 canal, and in 75% of cases 2 canals (B, P)
      • 6, which is ordinarily 22mm long, w/ 3 roots, and in 60% of cases 4 canals (MB1, MB2, DB, P) and 40% of cases 3 canals (MB, DB, P)
      • 7, which is ordinarily 20mm long, w/ 3 roots, and in 60% of cases 3 canals (P that is longer, and MB, DB), and in 40% of cases 4 canals (MB1, MB2, DB, P)
    • Md dentition:
      • 1, which is ordinarily 21mm long, w/ 1 root, and in 60% of cases 1 canal, and 40% of cases 2 canals (B, L)
      • 2, which is ordinarily 21mm long, w/ 1 root, and in 90% of cases 1 canal, and 10% of cases 2 canals (B, L)
      • 3, which is ordinarily 24mm long, w/ 1 root, and in 90% of cases 1 canal, and 10% of cases 2 canals (B, L)
      • 4, which is ordinarily 22mm long, w/ 1 root, and in 75% of cases 1 canal, and 25% of cases 2 canals (B, L)
      • 5, which is ordinarily 22mm long, w/ 1 root, and in 90% of cases 1 canal, and 10% of cases 2 canals (B, L)
      • 6, which is ordinarily 21mm long, w/ 2 roots, and in 65% of cases 3 canals (ML, MB, D) and 35% of cases 4 canals (ML, MB, DL, DB)
      • 7, which is ordinarily 20mm long, w/ 2 roots, and in 90% of cases 3 canals (MB, ML, D) and 10% of cases 2 canals (M, D)
Equipment
  • Barb broach, which removes pulp during a RCT, where the round wires are nothced w/ barbs
  • Gates Glidden (GG), usd for shaping the coronal 1/3rd of the root canal
    • X-Gates, replaces GG 1-4 and is ideal for radicular access
  • X-Smart Plus, an endodontic motor used for reciprocating, single file technique, or traditional continuous rotation file systems
  • Types of files:
    • ProTaper Next, which has an off-centered, rectangular cross section for increased file strength
  • Apex locator
  • Spreader, metal instruments used for packing root canal fill material to the sides of canal to make room for additional material
Materials
  • Chemomechanical preparation (CMP):
    • Na hypochlorite, which is used as an endo irrigant as it is an effective antimicrobial and has tissue dissolving capabilities, including Hypochlor 1%
    • EDTA (Ethylenediaminetetraacetic acid), which is a chelating agent that can aid in mechanical enlargement of difficult root canals by softening teh root canal dentin walls e.g. HALAS Canal Prep (15% EDTA), or RC PREP Cream (i.e. glycol, urea peroxide, and EDTA), and EDTA-C (which contains 15% EDTA w/ Cetrimide)
  • Dressing:
    • Odontopaste is a ZnO based root canal paste w/ 5% clindamycin (antibiotic) and 1% triamcinolone acetonide (corticosteroid)
    • CaOH (calcium hydroxide) neutralizes low pH of acids, has antibacterial properties, and promotes pulp tissue defence mechanisms and repair. It can however cause resorption in primary teeth
      • Calcimol is 26% CaOH
      • Odontocide is 20% CaOH and 7% ibuprofen (NSAID)
      • Calmix
      • Dycal, is a self-set rigid dental cement based on Radiopaque CaOH
  • Cavit G (gray) or Cavit W (white), is a temporary filling material, containing zinc oxide and zinc sulfate in different []
  • Sealer, including AH Plus, which provides permanent sealing based on epoxide-amine resins
  • Removing GP:
    • Chloroform, is used for plasticising GP points, to facilitate removal of GP root canal fillings in need of retreatment
    • Eucalyptus oil, can dissolve GP after 2 mins of immersion
  • Perforation repair:
    • MTA (mineral trioxide aggregate), used for dental root repair, formulated from commercial Portland cement, combined w/ bismuth oxide powder for radiopacity
    • Tricalcium silicate is the main phase of Portland cement, and Biodentine is a tricalcium silicate based material designed to be a permanent dentin substitute

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Definition of Root canal therapy | Autoprac


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