Endodontic Procedure (Root Canal)

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MATERIALS

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BASIC SETUP, ANESTHETIC SETUP, RUBBER DAM SETUP, SALIVA EJECTOR, HVE, AIR/WATER SYRINGE, SLOW SPEED HANDPIECE AND A #4 AND #6 ROUND BUR, ACRYLIC BURS, DISCS, MANDRELS, HIGH SPEED HANDPIECE #556 OR #557 BUR OR BURS

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MATERIALS

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BROACHES, FILES, REAMERS, ENDO SPOON EXCAVATOR, SPREADER, CONDENSOR, WOODSON, ARTICULATING PAPER, FLOSS, IRRIGATING SYRINGE, IRRIGATING SOLUTION, BEAD STERILIZER, BUTANE TORCH, OR OTHER HEAT SOURCE

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MATERIALS

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PAPER POINTS, SMALL COTTON PELLETS, MEDICATION, TEMPORARY FILLING, ENDODONTIC RULER AND STOPS, X-RAY FILM, LEAD APRON

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STEP 1

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PASS THE MIRROR AND EXPLORER THEN PASS A 2x2 GAUZE TO DRY THE MUCCOBUCCAL FOLD AND THE TOPICAL ANESTHETIC. PASS SYRINGE, THEN DENTAL ASSISTANT RINSES THE AREA W/ AIR/WATER SYRINGE AND ASPIRATES EXCESS WATER W/ HVE TIP

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STEP 2

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DENTAL ASSISTANT OR DENTIST PLACES THE RUBBER DAM ON THE AFFECTED TOOTH. DENTAL ASSISTANT SHOULD INFORM THE PATIENT OF THE PURPOSE OF THE DENTAL DAM AND THAT IF THERE ARE ANY CONCERNS TO INFORM DENTAL TEAM

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STEP 3

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DENTIST CREATES AN OPENING IN THE TOOTH W/ THE HIGH SPEED HANDPIECE AND BUR. DENTAL ASSISTANT SHOULD KEEP THE RUBBER DAM FREE OF DEBRIS BUT BE SURE TO STAY OUT OF THE DENTIST'S LINE OF VISION

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STEP 4

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DENTIST USES THE LOW SPEED HANDPIECE AND ROUND BUR TO REMOVE CARIES AND TO ACCESS THE PULP CHAMBER. THE DENTAL ASSISTANT MAY QUICKLY RINSE THE AREA TO IMPROVE THE DENTISTS FIELD OF VIEW

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STEP 5

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DENTIST MAY WANT TO USE THE ENDODONTIC SPOON EXCAVATOR TO REMOVE CARIES AND THE ENDODONTIC EXPLORER TO LOCATE THE PULP CHAMBER AND CANAL OPENINGS

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STEP 6

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DENTAL ASSISTANT PASSES A BARBED BROACH FOR THE DENTIST TO REMOVE PULPAL TISSUES FROM W/IN THE ROOT CANAL. DENTIST MAY WANT SEVERAL BROACHES, ESPECIALLY IF THE TOOTH HAS MORE THAN ONE ROOT

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STEP 7

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DENTAL ASSISTANT PASSES A #10 OR #15 REAMER W/ STOPPERS TO MEASURE THE LENGTH OF EACH CANAL. DENTAL ASSISTANT EXPOSES XRAY SO DENTIST CAN MEASURE LENGTH OF EACH CANAL W/ FILE(S) OR REAMER(S). RECORD IN PATIENTS CHART

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STEP 8

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DENTAL ASSISTANT PASSES ADDITIONAL FILES IN PROGRESSION UNTIL THE PROPER WIDTH AND LENGTH OF THE CANAL ARE ACHIEVED. THE SIZE AND LENGTH OF THE FINAL FILE USED ARE RECORDED IN THE PATIENT'S CHART

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STEP 9

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DENTAL ASSISTANT PASSES THE IRRIGATING SYRINGE W/ IRRIGATING SOLUTION TO DENTIST. DENTIST IRRIGATES THE CANAL(S). DA MUST KEEP TIP OF HVE CLOSE TO TOOTH SO SOLUTION IS ASPIRATED & NOT ALLOWED TO SPLASH PATIENT OR DENTAL TEAM

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STEP 10

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DA PASSES PAPER POINTS W/ LOCKING COTTON PLIERS AND CONTINUES TO PASS PAPER POINTS UNTIL THE CANAL OR CANALS ARE COMPLETELY DRY

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STEP 11

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DA PASSES SMALL COTTON PELLETS CONTAINING MEDICATION. (AT THISPOINT DENTIST PLACES A TEMP FILLING MATERIAL INTO THE TOOTH OR CONT. TO OBTURATE THE CANAL & COMPLETES THE ROOT CANAL TREATMENT.)

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STET 11 (CONTINUED)

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IF A TOOTH IS SEVERELY INFECTED , THE DENTIST MAY ELECT TO HAVE THE PATIENT RETURN AT A LATER DATE TO COMPLETE THE ENDO THERAPY

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STEP 12

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A MASTER GUTTA PERCHA POINT IS SELECTED THAT MATCHES THE WIDTH SIZE OF THE LAST FILE USED IN EACH CANAL. THE DA EXPOSES AN XRAY TO VERIFY THE PROPER LENGTH AND SEAL

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STEP 13

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DA MIXES THE ENDO SEALER TO A CREAMY CONSISTENCY & PASSES TO DENTIST SO THEY CAN COAT THE TIP OF THE MASTER GUTTA PERCHA POINT. THE DENTIST PLACES THE GUTTA PERCHA W/ CEMENT INTO THE CANAL

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STEP 13 (CONTINUED)

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SOME DENTISTS WILL USE A LENTULO SPIRAL TO PLACE THE ENDO SEALER DEEP INTO THE CANAL BEFORE PLACING THE GUTTA PERCHA POINT

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STEP 14

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DA PASSES THE ENDO SPREADER AND ADDITIONAL ACCESSORY GUTTA PERCHA POINTS AND CONTINUES TO PASS THE SPREADER AND AN ADDITIONAL POINT UNTIL EACH CANAL IS FULL

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STEP 15

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DA PASSES THE ENDO CONDENSOR AND PREPARES THE TORCH. THE DA HOLDS SOME 2x2 GAUZE SQUARES AND HOLDS THE HVE TIP CLOSE TO THE TOOTH

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STEP 16

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DENTIST HEATS THE TIP OF THE ENDO CONDENSOR AND MELTS OFF THE EXCESS GUTTA PERCHA MATERIAL. IT IS IMPORTANT TO ADEQUATELY HEAT THE INSTRUMENT TO AVOID REMOVAL OF THE GUTTA PERCHA FILLING FROM THE CANAL

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STEP 16 (CONTINUED)

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THE DA ENSURES THAT THE HVE TIP ASPIRATES ANY SMOKE AND RECEIVES THE MELTED GUTTA PERCHA FROM THE DENTIST W/ A 2x2 GAUZE

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STEP 17

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DA PREPARES THE TEMPORARY FILLING MATERIAL AND PASSES THE WOODSON. DENTIST PLACES THE FILLING. DA PASSES A LIGHTLY DAMPENED COTTON APPLICATOR TO DENTIST, WHO USES IT TO SMOOTH THE TEMP. RESTORATION

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STEP 18

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DA USES THE HVE AND AIR/WATER SYRINGE TO ENSURE THAT THE RUBBER DAM IS RINSED AND FREE OF DEBRIS. RUBBER DAM IS REMOVED AND THE DA FRESHENS THE PATIENTS MOUTH BY RINSING AND ASPIRATING

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STEP 19

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DA DRIES THE TOOTH & PASSES THE ARTICULATING PAPER TO DENTIST, PATIENT LIGHTLY TAPS TEETH TOGETHER. IF NECESSARY DENTIST WILL ADJUST THE OCCLUSION W/ WOODSON, COTTON APPLICATOR, OR ROUND BUR & SLOW SPEED HANDPIECE

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STEP 20

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DA EXPOSES A FINAL XRAY AND PROVIDES POSTOPERATIVE INSTRUCTIONS TO THE PATIENT

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POSTOP

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DO NOT EAT OR DRINK ANYTHING HOT UNTIL ANESTHETIC WEARS OFF. NOTHING HARD, TACKY, CHEWY, EAT SOFT FOODS UNTIL FINAL RESORATION. CAN BRUSH. TAKE MEDICATION AS PRESCRIBED. CALL OFFICE IF ANY DISCOMFORT OVER PERIOD OF TIME