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Authors: Dr. Mandar Pimprikar

Q.1- Teeth become sensitive to percussion during & after endodontic treatment. What could be the reason & how can we take care of the situation?

There is something known as ‘secondary apical periodontitis’.

There are various reasons behind it-

  • Over instrumentation
  • Pushing of debris in periapical tissues
  • Forceful irrigation, pushing irrigant in the periapical tissues
  • Hyperocclussion.
  1. Over instrumentation: Clinicians must have control over working length., use of Apex Locator is mandatory. The working length changes as we negotiate the canal. Never stay in the canal, when the file is rotating, for more than 3 seconds.
  2. Pushing of debris: Following crown down approach will reduce the chances of debris getting pushed periapically.
  3. Irrigants in periapical tissue: Always use side vented needles, irrigation should be passive, do not force the irrigant, never lock the needle in the canal.
  4. Hyper occlusion: Always take the treating tooth undergoing treatment out of occlusion by checking lateral excursion movements.

Q.2- How to select a master cone?

Gutta percha cone can be selected for fully shaped canal depending on the type of Gutta percha used.

Gutta percha are available as:

  1. Standardized- They come with fixed tip, diameter and taper E.g. 25/0.04 or 36/0.06
  2. Non- standardized- These cones have a designated taper but do not have fixed tip, diameter. They are available as M- fine, fine, fine medium, medium and medium large.

Clinicians need to correlate the preparation of the canal with different sizes. The tip is trimmed to fit the master cone in the prepared canal.

Most importantly- irrespective of the type of the master cone used; select the cone 1 or 2 taper smaller than the preparation.

E.g. For standardized

-Master apical file 30/0.06 → master cone 30/0.04

For non- standardized

-Master apical file 25/0.06 → master cone fine 5%

(Cut the tip of master cone to 25 by using G. P. gauge).

Q.3- How to put sealer in the root canal?

There are various methods to carry sealer in the prepared canal.

One can use-

  1. Lentullo spiral- But, spiral tends to push the sealer in the peri apex; so avoid using lentullo spiral.
  2. THE master cone- According to me, this is the best way to coat the sealer optimally
  3. Bi directional spiral (EDS) also can be used to coat the sealer.

Clinical tips: No matter what obturation technique, the clinician is using- cold lateral compaction OR warm vertical compaction; we need minimal sealer.

  • Never pump the master cone.
  • Always try to insert the master cone coated with the sealer slowly to allow the distribution of the sealer and dissipation of trapped air. This will also allow movement of the sealer coronally & laterally and minimizing the sealer extrusion in the peri apex.
 
If You Have any Question Regarding Endodontics Please feel free to send at: This email address is being protected from spambots. You need JavaScript enabled to view it. or This email address is being protected from spambots. You need JavaScript enabled to view it. . We will give you the answers in any of the upcoming issues of Guident.

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