Thursday 21 June 2012

Design Principle For The Access Cavity




1] The access cavity should enable root canal instruments to be introduced into the canals to their                         apical constriction without undue bending and binding coronally.

2] The access cavity must be large enough to allow complete debridement of the pulp chamber otherwise it may lead to reinfection or crown discolouration.

The roof of the pulp chamber must be removed completely.If not removed completely, access to canals is difficult.Also, infected and necrotic material will be retained within the pulp chamber which may then be transferred to root canals through instumentation. Breakdown products from such remnants may responsible for the subsequent discolouration of the crown.

3] In multirooted teeth great care must be taken not to damage the floor of the pulp chamber.Not only is there a possibility of perforation but the contour of the floor is such that the openings to the root canal tend to be funnel shaped. If  this natural anatomy is destroyed, subsequent instrumentation is more difficult.

4] The access cavity should funnel into the canal orifices.In multirooted teeth the orifice of the root canals should be at the periphery of the base of the access cavity so that instruments may be slipped down the walls of the cavity and into the root canal.

5] The occlusal projection of the access cavity should be larger than the base, to allow better visualization of the floor of the pulp chamber, especially if an operating microscope is used.

6] As part of the access preparation, the unsupported cusps of posterior teeth must be reduced by trimming with a tapered fissure carbide or diamond stone until a definite clearance in occlusal and lateral movement is obtained.

7] The objective of entry is to give direct access to the apical foramina, not merely to the canal orifice.

8] The likely interior anatomy of the tooth under treatment must be determined.Each tooth has a typical length no. and configuration of roots and canals. Prior to starting of the access, radiographs taken from  atleast 2 different angles must be studied, knowing what combinations of interior anatomy are possible and having the information given by radiograph, the operators will be able to ascertain with great accuracy the canal system present in the tooth to be treated and the possible alternative configurations. This information gained prior to initiation of preparation will greatly facilitate the entry as well as urther treatment.

Wednesday 20 June 2012

Composition Of Local Anaethesia

1] LA agent - Lignocaine HCL-21.34 mg

2] Vasoconstrictor - adrenaline - 0.05 mg

3] Reducing agent - Sodium metabisulfite - 0.05 mg
                             prevents oxidation of vasoconstrictor in LA

4] Preservative- Methyl Paraben - 1 mg
                        maintain stability of solution and give shelf life of 2 years

5] Fungicide- Thymol

6] NaCl - 5-6 mg/ml

7] Vehicle - water - 1 ml

Components Of Dental Prescription

Doctor's details


                          Letter Head
                                                                        date:
MCO
Special instructions
Investigation




                      Name and age of the patient




                    -ANTIBIOTICS
                    -ANALGESIC/ANTINFLAMMATORY
                    -ANY OTHER [ IN ORDER]




Advice:


Follow up




                                                             sign and stamp

Tuesday 19 June 2012

Principles Of Endodontic Therapy

1] Objective-The objective of endodontic therapy is restoration of the treated tooth to its proper form and function in the masticatory apparatus, in a healthy state.


2] Basic phases of therapy: three phases


first phase-diagnostic phase-in which the disease to be treated, is determined and treatment plan developed.


second phase-preparatory phase-when the contents of the root canal are removed and the canal prepared for the filling material.


third phase-involve filling or obliterating canal to gain hermetic seal with an inert material as close as possible to cementodentinal junction.




3] Importance of debridement
Endodontic is essentially a debridement procedure that require the removal of  the irritants of the canal and periapical tissue if success  is to be gained.


Debridement may be required in various ways:
1] instrumentation of the canal
2] placement of the medicament
3] irrigant
4] electrolysis
5] surgery


4] Use of rubber dam is mandatory


5] Great respect due the periapical tissue during treatment


6] Proper restoration the culmination of success


7] Postoperative observation necessary


8] Case presentation to set the stage

Movements Of Files









1] stem winding,watch winding or twiddling
the file is used with 45 degree rotational movement clockwise and anticlockwise with gentle apical force.The canal becomes enlarged and the file can be moved apically into the root canal.
use-useful when penetrating fine canals and in re-treatment cases.Files are usually precurve prior to use in this way


2] Quarter turn and pull
this causes more aggressive cutting than stem winding and tends to remove more material from the wall.


3]Apical-coronal filing
The file is applied to the wall of the root canal and moved in and out of the canal at an amplitude of 1-2mm. This movement is especially efficient with Hedstrom files.
To ensure that all the walls of the root canal are cut, circumferential filing is done.


4] Balanced force technique


The movement of the file is clockwise and anticlockise and its action is based upon Newton's third law .The file is placed into the canal till it first binds and then advanced further by clockwise rotation, usually through approximately 60 degree. The file cuts into the root canal wall and creates threads in the dentin as it moves apically.This is the powerphase.The anticlockwise rotation, through approx 120 degree is carried out with some apical pressure so that the file does not unscrew out of the canal..


During this movement the threads of the dentin formed during the power phase are cut from the wall.This is so called control phase.
Oten an audible click can be heard which resembles an instrument fracturing but is merely the dentin being cut from the wall. The file is then removed and the flutes cleaned of debris.If difficulty is encountered in removing the file then the small rotation clockwise, of about 30 degree,allows the file to be forced.In nearly all studies where this manipulations of the file has been compared with other methods.The balanced force technique has been shown to be superior in shaping the canal with less likelihood of iatrogenic damage.The reason for this is tha the file i tends to remain more centrally placed within the root canal which means that the canal can be prepared to a large size without compromising the structure of the root. This combination of a larger size and smooth, even flare follows the natural curvature of the canal probably results in a cleaner canal and certainly one that is easier to obturate with GP.

About Me

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Welcome to my blog....I am Dr Pratibha Singh and I am trying to create awareness in people so that people can have healthy and beautiful smile.Smile improves our face value and giving that wonderful smile is our[dental] profession.So keep reading and updated.

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