Endodontic Procedure

The video introduces the instruments and equipment used during a root canal (endodontic) procedure. This includes the basic setup with a mirror and explorer, locking cotton pliers, endodontic explorer, and endodontic spoon excavator. The use of a dental dam with a butterfly clamp for anterior teeth is also shown.

The video details the high-speed handpiece with a round bur (friction grip) and the slow-speed handpiece, also equipped with a round friction grip bur. The irrigation syringe, filled with sodium hypochlorite (a mixture of 5% Javex and 95% water), is shown for irrigating the canal. For simulation purposes, water is used instead of sodium hypochlorite.

The video presents the barbed brooch, finger file system with a measuring device, and endodontic files ranging from size 15 (white) to size 40 (black). It also introduces the lentulo spiral and Gates Glidden drills (sizes 2-4). Gutta-percha cones (in sizes determined by the dentist) and paper points (with color-coded tips indicating size) are displayed as essential materials for filling the canal. The use of Cybron endo sealer powder in a dappen dish is also mentioned for dipping pluggers.

The video shows the Cybron endo sealer, a glass slab, and a spatula for mixing the sealer. Cavit is introduced as the temporary filling material. Other instruments include an anesthetic setup with topical anesthetic, a Glick #1 PFI for temporary fillings, endodontic pluggers, and the touch and heat instrument for warming gutta-percha. A gutta-percha gun and pellets are presented for backfilling, along with the mention of alternative hand instruments for backfill.

The video highlights the endo ease, which attaches to the high-volume suction to dry the canal. It further details the use of endodontic files (sizes 15-40) and Gates Glidden drills (sizes 2-4). Rotary instrument systems, such as endodontic flaring tools to open the canal and endodontic rotary files used with a special handpiece, are presented as alternatives to traditional files. RC prep is introduced as an aid for rotary systems to navigate the canal.

The procedure begins with assisting with local anesthetic and dental dam placement. The dentist uses a friction grip round bur followed by a latch round bur. The assistant passes the spoon excavator with a 2x2 and then the endodontic explorer for the dentist to locate the canal opening.

Once the canal is found, the dentist uses a barbed brooch. The assistant passes a cotton roll soaked in sodium hypochlorite, followed by the sodium hypochlorite syringe for rinsing. A size 15 file is then passed to the dentist with an apex locator to determine the working length. The assistant places the grounding hook on the patient's lip and clips the apex locator to the file. After removing the apex locator, the assistant measures subsequent files (20, 25, 30, 35, 40) at incrementally decreasing lengths based on the established working length.

During the shaping process, the assistant keeps sodium hypochlorite ready for irrigation between each file. The final rinse with sodium hypochlorite is performed after the largest file (size 40) is used. The dentist then utilizes the Gates Glidden drills (size 2), with the assistant holding the sodium hypochlorite for irrigation between each use.

To dry the canal, the dental assistant places the endo ease on the high-volume suction and passes it to the operator. The assistant then passes paper points, held with locking pliers, for drying the canal, collecting used points on a separate 2x2. The dentist requests a specific size gutta-percha (e.g., size 25) for try-in, which the assistant passes on a wet 2x2 using locking pliers.

The assistant helps the dentist take an endodontic image with a lead apron to verify the working length of the gutta-percha. Once confirmed, the gutta-percha is retrieved. The dentist then places the lentulo spiral into the slow-speed handpiece, and the assistant prepares the endodontic sealer on a slab for the gutta-percha.

The assistant prepares the touch and heat instrument and endodontic pluggers (from largest to smallest) to condense the gutta-percha. The high-volume suction is used to catch the plume. After removing excess gutta-percha, backfilling is performed, either with cut pieces of gutta-percha heated by the touch and heat or with a gutta-percha pellet gun (as demonstrated).

The temporary filling (Cavit) is placed using the Glick #1 PFI. The assistant then passes a wet cotton pellet to clean the area and articulating paper to check for occlusion. A final image is taken to confirm the success of the root canal and proper sealing. Finally, the assistant provides post-operative instructions to the patient, including care for the anesthetized area, whom to call for swelling, and scheduling the final restorative procedure.