Root Canal Preparation

- Objectives of Root canal preparation:

1- Remove remaining pulp tissue

2- Eliminate microorganism

3- Remove debris

4- Shape the root canal

5- So that root canal system can be cleaned and filled

- Requirements of Root canal preparation:

1- Prepared canal should include the original canal

2- Apical constriction should be maintained

3- Canal should end in an apical narrowing

4- Canal should be tapered from crown to apex

5- Preparation should be undertaken with copious irrigation

6- The final length of the preparation should not be reduce by treatment

- Root canal preparation techniques:

According to Direction:

1- Apical to coronal

2- Coronal to apical

According to Type:

1.Standardized technique

2. Step back technique

3. Balanced forces technique

4- Step down technique

5- Double flared technique

6- Crown down pressure less technique

- Standardized technique

Can be use for straight tiny canal

Unsuitable for curve canals

Common problems:

1- Ledging

2- Zipping

3- Elbow formation

4- Perforation

5- Loss of working length

- Overcomes procedural errors of Standardized technique:

- Suitable for Slight to moderate curve canals

- Not suitable for severely curve canals

- Can be improve by: "Specific filing technique - Non-cutting tip - Flexible files"

- Steps of successful Root Canal Preparation:

1- Obtain a good pulp chamber cleaning.

2- Make sufficient deroofing for the pulp chamber area "ensure that files enter orifices in a straight manner"

3- Use GG to widen the orifices.

4- Insert the initial file which is "size 15 for centrals and premolars" and "size 10 for molars" Note: "size 8 may be useful for severely narrow canals ex: MB of the lower first molars"

5- Start to measure the full working length using the initial file and X-ray or by using the Apex Locator. Note: file size 10, 8 and 6 may not appear in the X-ray so that they may lead to misleading or interpretation for the working length, Note: It's better to have a good X-ray image with the length measured by Apex Locator to avoid false Apex Locator's readings ..

6- Start to widen canals to 3 files larger than the initial file to the full working length measured before, to create the good apical stop ... "The third file will be called the patency file".

7- Start to use the larger next file with a length 1 mm shorter than the previous one ..

8- Use 5 more larger files, every one 0.5 mm shorter the previous one.

9- Use the patency file between  files to avoid blockage of canals ...

10- Start to put the master cone and complete obturation ....

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