Endodontics
Course Review
Enoch Ng, DDS 2014
K3 technique
o
After achieving working length, apically enlarge to MAF
-
Initial radiographs – straight on and angled (Mx incisors only require straight on shot)
o
Parallel film optimal for working length estimation
-
Estimated working length on radiograph
-
Access chamber – irrigate with 1-2mL NaOCl
-
ID canal orifices
-
“scout” coronal 2/3 of canal with size #10 file
-
Coronal flare with Gates Gliddens burs
o
Measure chamber floor depth on GG burs
Advance #4 < depth of bur head (~2mm), irrigate 1-2mL NaOCl
Advance #3 3mm past orifice, irrigate 1-2mL NaOCl
Advance #2 6mm past orifice, irrigate 1-2mL NaOCl
o
Hand file to size #20 to create glide path, irrigate 1-2mL between files
-
Estimated working length with #20 file, get CWL
o
If >1mm change, expose new radiograph
o
Once working length is established, measure EVERYTHING placed into canal
-
Use these files to resistance, irrigate and recapitulate with #10 file after each rotary file
o
25/.10 (tip diameter/taper)
o
25/.08
o
35/.06
o
30/.04
o
25/0.6 – if does not reach CWL, repeat sequence
-
Apically enlarge canals with .04 taper (small/curved canals) or .06 taper (large/straight canals) to MAF size
-
Use all files at 300 RPM – special torque controlled motors
-
Final apical file radiograph – made with
HAND FILE
corresponding to MAP
-
Final irrigation with >3mL NaOCl per canal
-
Dry canal with paper points
-
Apical clearing – passive 1/3 turn clockwise rotation with sterile MAF at CWL to remove debris
o
No cutting, just load flutes with debris for removal
Summary
-
Straight line access and glide path necessary for successful rotary instrumentation
-
Irrigation and recapitulation provide many benefits
-
Bacteria cause disease, eliminating them gives patient’s immune system chance to heal
