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the procedure for rct , detail.
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Cleaning and Shaping of the Root Canal System. Part IIEdit by Hou Tiezhou02988088507
Root Canal InstrumentationEstimate working lengthVerify canal patencyEstimate canal sizeEstablish actual working length
Root Canal InstrumentationCrown down preparationCoronal thirdMiddle thirdApical third
Armamentarium
Armamentarium
ArmamentariumStainless steel size 10 K-filesUsed to explore canal patencyFiling or quarter turn pull motion Do not rotate through 360 degrees
ArmamentariumStainless steel size 15 and 20 K filesUsed to establish actual working length
Armamentarium
ArmamentariumProfile orifice shapersUsed to prepare the coronal one third of the root canal
Profile Orifice Shapers
ArmamentariumProfile 0.06 taper rotary filesUsed to prepare the middle third
Armamentarium
ArmamentariumProfile 0.04 taper hand NiTi filesUsed to prepare the apical third of the root canal
Armamentarium
Estimated Working LengthEstimated working length is the distance from the reference point to the radiographic apex, as measured on a parallel preoperative radiograph
Estimated working lengthTake a pre-operative parallel radiographClinically, use a XCP film holder
Estimated working length Length from incisal edge to radiographic apexOnly an estimate because of radiograph distortion
Estimate canal sizeRadiographic appearanceCrown/root morphologyStandardized sizes (See table in manual)
Estimate canal size
Explore Canal PatencyEnsure that canal can be negotiated to radiographic apexSelect #10 K filePrecurve file if necessary
Explore Canal Patency
Explore Canal Patency
Establish Actual Working lengthInstrumentation should terminate at:The apical constriction1 mm short of radiographic apexActual WL = Estimated WL 1 mm
Establish actual working lengthWL can be established using:RadiographsApex locator
Establish Actual Working Length
Establish Actual Working Length
Establish Actual Working Length
Establish Actual Working Length
Crown Down Preparation
Crown Down Preparation
Crown-down preparationPlastic incisor with transparent root
Crown-down preparationPlace SS K file into canal until the tip is just visible at the apex
Actual Working LengthRemove file from canalSubtract 1 mmThis is the actual working lengthIn this case the WL is 20 mm
Actual Working Length
Preparation of Coronal Third
Preparation of Coronal ThirdThe coronal third measurement is WL minus 8 mm, that is 12 mmProfile OS do not have rubber stops however the cutting flutes measure 10 mmThe goal is to work the largest OS to 12 mm
Preparation of coronal third
Preparation of coronal third
Preparation of the coronal thirdRotate OS at 300 rpmNote: Orifice shaper should be rotating at 300 rpm before it is placed in the canalAdvance the OS in 1 mm incrementsWhen resistance is encountered retract OS while still rotating Never force any instrument apically
Preparation of coronal thirdBlue (#60) OS extends to approx. 9 mm
Preparation of coronal third
Preparation of coronal third
Preparation of coronal thirdGold (#50) OS reaches 12 mm
Preparation of coronal thirdProgress from larger to smaller orifice shaperEach smaller OS will extend further into canalRepeat the sequence until the largest OS extends to 12 mm
Preparation of coronal thirdBlue (#60) OS extend to WL 8 mm = 12 mm
Preparation of Middle ThirdProfile 0.06 taper series 29 rotary files
Preparation of Middle ThirdProfile 0.06 taper series 29 rotary filesThe middle third measurement is WL minus 4 mm, that is 16 mmThe aim is to work the brown (#7) file to 16 mm
Preparation of Middle ThirdProceed from larger to smaller fileEach smaller file will extend further into the canalRepeat the sequence until the largest file extends to 16 mm
Preparation of middle third
Preparation of middle third
Preparation of middle third
Preparation of middle third
Preparation of middle third
Preparation of middle third
Preparation of middle third
Preparation of middle third
Preparation of middle third
Preparation of middle third
Preparation of apical thirdProfile 0.04 taper nickel titanium hand files
Preparation of apical thirdProfile 0.04 taper nickel titanium hand filesThe measurement is the full working length, that is 20 mm
Preparation of apical thirdMeasure working length on #15 fileSet rubber stop at that lengthLubricate the canal with Prolube
Preparation of apical thirdAdvance size 15 file to working lengthRotate file through 360 degreesIrrigate copiously with NaOCl after each file
Preparation of the apical thirdAdvance size 20 file to working lengthContinue through sequence, seating each file to working length
Preparation of apical thirdProgress from smaller to larger filesEach file is fully seated at working lengthSmall canals prepared to a minimum of ISO 35 or 40Large canals prepared to a minimum of ISO 40 50
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
Preparation of apical third
File kit on completion of instrumentation
Master Apical File (MAF)The largest file that extends to working lengthMAF film is exposed to confirm length and placement
Master Apical FileFor large canals minimum MAF #40 - 50For small canals minimum MAF #35 - 40
Master Apical FileTake a radiograph with MAF in place. This confirms:LengthPlacement
Mission Accomplished