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EndodonticS – Vol. 2

Volume II

CHAPTER 13 – ENDODONTIC INSTRUMENTS
Brief History

Standardization of Endodontic Instruments

Hand Instruments with a Conventional. 02 Taper

Files

Reamers

Hedstroem Files

Barbed Broach

Hand Instruments with Greater Taper

Profiles. 04 Hand Files

Hand GT Files

Micro-Openers

Steel Rotary Instruments

Gates-Glidden Drills

Largo Drills

LA Axxess Burs

Endo-Eze A. E. T. Files

Mechanical Instruments in Nickel Titanium

ProFiles

ProFile Orifice Shapers

Quantec

LightSpeed

Rotary GT Files

Hero

Sybron Endo K3

Protapers

FlexMaster

RaCe

CHAPTER 14 – CLEANING AND SHAPING THE ROOT CANAL SYSTEM

Cleaning

The Removal of Vital Pulp Tissue

The Removal of Necrotic Pulp Tissue and Microorganisms

Irrigating Solutions

Chelating Agents

Shaping

Mechanical Objectives

Biological Objectives

CHAPTER 15 – SCHILDER’S TECHNIQUE FOR SHAPING THE ROOT CANAL SYSTEM

Introduction

Precurvature

Rubber Stops

Negotiation of the Root Canal and Determination of the Instrument’s Working Length

Negotiation of the Root Canal

Determining the Working Length

Electronic Apex Locators

New Generation Electronic Apex Locators

Maintaining the Patency of the Apical Foramen

Enlargement of the Body of the Canal

Radiographic Evaluations

Cleaning and Shaping of Confluent Root Canals

Ten Rules to Follow

Bibliography

 

CHAPTER 16 – A CONTEMPORARY APPROACH TO CLEANING AND SHAPING OF THE ROOT CANAL SYSTEM EMPHATIZING “EARLY CORONAL ENLARGEMENT”

Introduction

Requirements

Complete Access

The Cavity is Continuously Tapering

Maintenance of the Original Anatomy

Conservation of Tooth Structure

Instruments & Materials

Instruments

Irrigating Agents

Lubricating and Chelating Agents

Intracanal Medicaments

Concepts

Broaching – Gross Removal of Debris

Working Length Instrumentation to the Radiographic Terminus and Patency

Precurvature of Instruments

Recapitulation

Reaming

Filing

Step-back

Crown-Down

Balanced Force

Method of DeDeus

Blending

Signature

Technique

Strategy

Initial Access and Gross Debridement

Preliminary Enlargement

Establishment of Patency

Enlargement

Blending

Apical Finishing and Refinements

CHAPTER 17 – CURVED CANALS

Curves of the Apical Third

Curves of the Middle Third

Curves of the Coronal Third

Anticurvature Filing Method

 

CHAPTER 18 – ROTARY INSTRUMENTS IN NICKEL TITANIUM
Characteristics of NiTi Alloy

Shape Memory

Superelasticity

Strength

Metallurgy of Nickel-Titanium Alloys

Advantages

Functioning of the NiTi Rotary Instruments

Torsional Stress

Bending Stresses

Importance of the Section of the NiTi Rotary Instrument

Endodontic Motors

Characteristics

Formulation

Life of the NiTi Rotary Instrument

Original Anatomy of the Canal

Mechanical Characteristics of the Selected Instruments

Rotational Speed and Maximum Torque Values for NiTi Rotary Instruments

Characteristics of the Work Carried Out

Operator Ability

CHAPTER 19 – THE PROTAPER TECHNIQUE. SHAPING THE FUTURE OF ENDODONTICS

Protaper Geometries

The Shaping Files

The Finishing Files

Convex Triangular Cross-Section

Helical Angle & Pitch

Modified Guiding Tip

Protaper Concepts & Guidelines

Straightline Access

Irrigation & Lubrication

Reproducible Glide Path

Working Length & Patency

Directions for Use

Multiple vs. Single Use

Motors

The Protaper Technique

Scout the Coronal Two-Thirds

Shape the Coronal Two-Thirds

Scout the Apical One-Third

Shape the Apical One-Third

ProTaper Finishing Criteria

Finishing Larger Systems

Expanding the Deep Shape

Evidence for Clinical Success

CHAPTER 20 – PROSYSTEM GT

File Design

Basic Technique

Initial Shaping

Apical Gauging

Final Shaping

Tough Cases

Tortuous Canals

Hidden Curves

Impediments

Choosing and Using GT System Materials

Gutta-Percha

GT Paper Points

GT Obturators

GT Posts

CHAPTER 21 – THE K3 ROTARY NICKEL TITANIUM INSTRUMENT SYSTEM
The K3 System Features

Literature Review

Enhancing K3 Performance

Clinical K3 Technique

K3 Technique Summary

Additional Considearations

K3LS Hybrid Technique

 

CHAPTER 22 – THE QUANTEC™ ROTARY NiTi INSTRUMENTATION SYSTEM
Why Nickel-Titanium?

Why Rotary Instrumentation?

What Causes Breakage? What is Torsion?

What is Fatigue?

What are the Smallest File Diameters that can be Used to Meet the Torque Requirements that we are Likely to Encounter in Canals?

What Causes Fatigue?

What is the Largest File Diameter or Taper that can be Used in Curvatures that we are Likely to Encounter?

How can Files of the Same Diameter have Different Flexibilities?

What Tactile Sensations are there with Rotary Instrumentation?

How does File Engagement Affect Breakage?

How do I Determine the Optimum Rotation Speed?

The Quantec File™

Cutting Angle

Flute Design

Helical Angle

Blade Support (Radial Lands)

Balanced Forces of the Working Surface

Non-Cutting “Safe Tip” vs. Cutting Tip

The Quantec™ Series by Analytic

The Working Surface Taper

Crown Down vs. Step Back Technique

Does the Location of a Curvature Make a Difference with either Technique?

Access

Initial Preparation

Canal Length Determination

Deep Preparation – Crown-Down

The Zone Technique for Canal Preparation

Does Irrigation Reduce Torque Requirements?

Apical Patency

Irrigant Delivery

Sodium Hypochlorite

Thermo-Acceleration

Antimicrobial Effect of Irrigant Combinations within Dentinal Tubules

Efficacy of the Crown Down Approach in Reservoir Creation

Chlorhexidine

Time

Ultrasonic Instrumentation

Optimizing Clinical Success

CHAPTER 23 – OBTURATION OF THE ROOT CANAL SYSTEM:
BIOLOGICAL PRINCIPLES, MATERIALS, AND TECHNIQUES
Biological Considerations on Root Canal Obturation

Properties of the Obturating Materials

Requirements for the Ideal Root Canal Filling Material

Endodontic Pastes and Cements

Solid Materials

Semi-Solid Materials

Techniques for Root Canal Obturation with Gutta-Percha

Lateral Condensation of Gutta-Percha

Thermoplastic Gutta-Percha

Chemical Softening of Gutta-Percha

Technique of Warm Lateral Condensation

The EndoTwinn

Adhesive Endodontics: Resilon (RichardE. Mounce, Gary D. Classman)

Clinical Technique

CHAPTER 24 – THE SCHILDER TECHNIQUE OF VERTICAL COMPACTION OF WARM GUTTA-PERCHA

Armamentarium

Gutta-Percha Cones

Sealer

Selecting the Right Time for the Obturation

Preparation of the Tray

Phases of Obturation

Cone Fit

Sealer and Master Cone Placement

Down-Packing

Reverse Filling or “Back-Packing”

“Back-Packing” with Thermoplastic Gutta-Percha

Vertical Extent of the Three-Dimensional Obturation

Cemento-dentinal Junction

Radiographic Terminus of the Canal

Overfilling and Overextension

Obturation of Communicating and Confluent Root Canals

CHAPTER 25 – THE CONTINUOUS WAVE OF CONDENSATION OBTURATION TECHNIQUE

The Predecessors

The Touch’n Heat Electric Heat Carrier

The Obtura III Gutta-Percha Gun

The One-Shot Birth of the Continuous Wave of Condensation Technique

The Conceptual Basis for the Continuous Wave of Condensation Technique

Instruments and Devices

The System-B Heat Source

The System-B/Elements Obturation Device

Procedures

Conefitting

Plugger Fitting

Downpacking

Backfilling with a Warm Gutta-Percha Syringe

Obtura Gun Backfilling

System-B/Elements Extruder Backfilling

CHAPTER 26 – THE THERMAFIL SYSTEM

Components of the Thermafil Obturation System

Thermafil Obturators

The Thermafil Gutta-Percha

Size Verifiers

ThermaPrep Plus Over

Therma-Cut Burs

Post Space Burs

Operative Sequence for a Thermafil Obturation

Canal Preparation

Obturator Selection and Preparation

Pre-obturation Irrigation

Sealer Placement

Obturation

Post Endodontic Restoration

Post Operative Sequelae

Hermetic Seal and Quality of Thermafil Canal Obturation

Flow and Filling Capacity

Adaptation to the Canal Walls

Checking Coronal Infiltration

Hermetic Apical Seal

Preparation for Post Space in a Thermafil Obturation

Retreatment of Thermanl Treated Teeth

Advantages of the Thermafil System

Rapid Learning Curve

Conservative Canal Preparation

Obturation of Curved Canals

Quality of the Results

Disadvantages of the Thermafil System

Complex Use in Cases with Particular Endodontic Anatomy

The Risk of Overfilling

How to Achieve the Best Results Using the Thermafil Technique

 

CHAPTER 27 – MICROSEAL TECHNIQUE

The Microseal Technique

Phase 1

Phase 2

Experimental Evaluation of the Microseal Technique

Materials and Methods

Results

Radiographic Evaluation

Observation Using Stereo Microscope

Diaphanization

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