Single Visit Class

8/2/2019 Single Visit Class

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SINGLE VISITSINGLE VISITENDODONTICSENDODONTICS


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CONTENTSCONTENTS

IntroductionIntroduction

HistoryHistory

Preliminary considerationsPreliminary considerations

Operator ability and clinical experienceOperator ability and clinical experience

Time and auxillary utilizationTime and auxillary utilization

Clinical techniquesClinical techniques

Criteria for case selectionCriteria for case selectionIndications and ContraindicationsIndications and Contraindications

Advantages and DisadvantagesAdvantages and Disadvantages


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The advances which have favoredThe advances which have favored

single visit endodonticssingle visit endodontics Digital radiographyDigital radiography

MicroscopesMicroscopes

Electronic apex locatorsElectronic apex locators Ni-Ti rotary instrumentation & crown downNi-Ti rotary instrumentation & crown down

techniquetechnique

Concept of working widthConcept of working width

Newer obturation systemsNewer obturation systems

ConclusionConclusion


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Single Visit Endodontics is defined as theSingle Visit Endodontics is defined as the

conservative non surgical treatment of anconservative non surgical treatment of an

endodontically involved tooth consisting ofendodontically involved tooth consisting of

complete biomechanical cleansing,complete biomechanical cleansing,

shaping, and obturation of the root canalshaping, and obturation of the root canal

system during one visit.system during one visit.

Paul J. AshkenazPaul J. Ashkenaz


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New technology and research is helpingNew technology and research is helping

clinicians avoid multiple visits and long,clinicians avoid multiple visits and long,

drawn out endodontic treatment.drawn out endodontic treatment.

There is widespread acceptance of single-There is widespread acceptance of single-

visit endodontics forvisit endodontics forvitalvitalcases and thecases and the

trend fortrend forNonvitalNonvitalSingle VisitsSingle Visits is becomingis becoming

more widely accepted.more widely accepted.


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Historically, root canal treatment was performed in multipleHistorically, root canal treatment was performed in multiple

visits primarily to ensure sterility of the root canal systemvisits primarily to ensure sterility of the root canal system

prior to obturation.prior to obturation.

Culturing techniques were used to determine the nature ofCulturing techniques were used to determine the nature of

the root canal flora immediately upon entry to the canal,the root canal flora immediately upon entry to the canal,

during therapy and prior to obturation.during therapy and prior to obturation.

Later a wide variety of antimicrobial agents were introducedLater a wide variety of antimicrobial agents were introduced

to eliminate microbes present in the root canal system.to eliminate microbes present in the root canal system.

In addition to killing bacteria, these agents, primarilyIn addition to killing bacteria, these agents, primarily

phenolic compounds, were also highly irritating to thephenolic compounds, were also highly irritating to the

periradicular tissues.periradicular tissues.


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Overzealous use of these medicaments led to a multitude ofOverzealous use of these medicaments led to a multitude of

post operative problems that were inappropriate andpost operative problems that were inappropriate and

excessive use of antibiotics to control the so called infection.excessive use of antibiotics to control the so called infection.

Ultimately, the deleterious effects of these medicaments wereUltimately, the deleterious effects of these medicaments were

identified and their routine clinical case was discontinued.identified and their routine clinical case was discontinued.

This led to one of the two courses of treatment:This led to one of the two courses of treatment:

Either treat the root canal in one visitEither treat the root canal in one visit

oror

Seek an intracanal medicament that does not injureSeek an intracanal medicament that does not injurethe periradicular tissues.the periradicular tissues.


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PRELIMINARY CONSIDERATIONSPRELIMINARY CONSIDERATIONS


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Operator Ability and ClinicalOperator Ability and Clinical

Experience:Experience:

Highest level of Endodontic Competence requiredHighest level of Endodontic Competence required..

Technique for experienced practitioners who have madeTechnique for experienced practitioners who have made

endodontics an integral part of their clinical practices andendodontics an integral part of their clinical practices andnot for the person who only does an occasionalnot for the person who only does an occasionalendodontic case.endodontic case.

The clinician must gauge the time that is necessary toThe clinician must gauge the time that is necessary to

perform a complete treatment on any tooth in the mouthperform a complete treatment on any tooth in the mouthand can schedule his or her one-visit proceduresand can schedule his or her one-visit proceduresaccordingly.accordingly.


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Time and Auxiliary UtilizationTime and Auxiliary Utilization

In order to accomplish a one-visit procedure successfully, aIn order to accomplish a one-visit procedure successfully, arealistic treatment time must be set aside based on both therealistic treatment time must be set aside based on both theclinician's ability and the difficulty of the case.clinician's ability and the difficulty of the case.

However, as aHowever, as a RULE OF THUMBRULE OF THUMB, the overwhelming majority, the overwhelming majorityof cases should be able to be completed withinof cases should be able to be completed within 30 to 4530 to 45

minutesminutes

The ability to complete treatment within this time frame isThe ability to complete treatment within this time frame isdependent upon the clinician's ability to organize and havedependent upon the clinician's ability to organize and have

ready for immediate use, an efficient endodontic deliveryready for immediate use, an efficient endodontic delivery

system .system .


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Allows for the rapid and efficient delivery of the variousAllows for the rapid and efficient delivery of the variousendodontic procedures such as isolation, access,endodontic procedures such as isolation, access,biomechanical preparation, and obturation of the root canalbiomechanical preparation, and obturation of the root canal

system.system.

At the heart of this delivery system is theAt the heart of this delivery system is the well-trained dentalwell-trained dentalassistant.assistant.

For it is the assistant that not only prepares the tray set-ups,For it is the assistant that not only prepares the tray set-ups,but also aids in placement of the rubber dam, passes thebut also aids in placement of the rubber dam, passes theintracanal enlarging and filling instruments and materials, andintracanal enlarging and filling instruments and materials, andaids in temporization.aids in temporization.

This enables the dentist to make more efficient use of his orThis enables the dentist to make more efficient use of his orher time.her time.


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Clinical TechniquesClinical TechniquesOne-visit endodontics is dependent upon the use ofOne-visit endodontics is dependent upon the use of

fundamental endodontic operative skills.fundamental endodontic operative skills.

There are no short cuts, simply the application of theseThere are no short cuts, simply the application of theseskills in a thoughtful and organized manner.skills in a thoughtful and organized manner.

A failure to develop these basic skills to a high degree ofA failure to develop these basic skills to a high degree ofcompetence can only result in a high incidence of brokencompetence can only result in a high incidence of brokeninstruments, ledged canals, perforations, inadequatelyinstruments, ledged canals, perforations, inadequatelyprepared and incompletely filled root canals.prepared and incompletely filled root canals.

Errors in fundamental skills lead to failures of iatrogenicErrors in fundamental skills lead to failures of iatrogenicorigin in any clinical situation. Once these preliminaryorigin in any clinical situation. Once these preliminarycriteria have been met, specific clinical cases can becriteria have been met, specific clinical cases can beselected on which to perform a one-visit procedure.selected on which to perform a one-visit procedure.

Oli t it i fOli t it i f


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Oliets criteria for caseOliets criteria for case

selectionselection

Positive patients acceptancePositive patients acceptance..

Sufficient available timeSufficient available time to complete theto complete the

procedure properly.procedure properly.

Absence of any acute symptomsAbsence of any acute symptoms requiringrequiring

drainage via the canal and of persistentdrainage via the canal and of persistent

continuous flow of exudates or blood.continuous flow of exudates or blood.

Absence of anatomical obstaclesAbsence of anatomical obstacles likelikecalcification in the canals, and proceduralcalcification in the canals, and procedural

difficulties (ledge formation, blockage, perforation,difficulties (ledge formation, blockage, perforation,

inadequate fills)inadequate fills)


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INDICATIONSINDICATIONS


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Vital Pulp Exposures andVital Pulp Exposures and

Symptomatic PulpitisSymptomatic Pulpitis

Teeth withTeeth with pulp exposures caused by trauma, caries, orpulp exposures caused by trauma, caries, or

mechanical reasonsmechanical reasons and teeth that exhibit clinical symptomsand teeth that exhibit clinical symptoms

to heat or cold stimuli but not percussion.to heat or cold stimuli but not percussion.

Briefly in cases of vital pulp, a single visit treatment shouldBriefly in cases of vital pulp, a single visit treatment should

be used whenever possible.be used whenever possible. This is based on the fact thatThis is based on the fact that

the pulp is only superficially infected and the root canal isthe pulp is only superficially infected and the root canal is

free of bacteria, provided the aseptic chain is maintainedfree of bacteria, provided the aseptic chain is maintained

during the intracanal proceduresduring the intracanal procedures. Therefore, there is no. Therefore, there is noapparent reason not to treat vital pulp in single visitapparent reason not to treat vital pulp in single visit


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Restorative ConsiderationsRestorative Considerations

Teeth requiring endodontics for restorative reasonsTeeth requiring endodontics for restorative reasonsand not because they have pathologic pulp tissueand not because they have pathologic pulp tissuethat must be removed or because of pulpthat must be removed or because of pulpexposures.exposures.

In each and every instance, because treatment canIn each and every instance, because treatment canbe planned for ahead of time, completion ofbe planned for ahead of time, completion ofendodontics in one visit can be readilyendodontics in one visit can be readily

accomplished.accomplished.


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Anterior Esthetic ProblemsAnterior Esthetic Problems

Maxillary anteriors involved in trauma that have resulted

in a horizontal fracture of the crown at the gum line, pose

esthetic as well as isolation and sealing problems if

treated in the conventional multivisit manner

Isolation and sealing problemsIsolation and sealing problems

Teeth with subgingival breakdown, teeth with multipleTeeth with subgingival breakdown, teeth with multiple

coronal walls missing, and teeth with full coverage thatcoronal walls missing, and teeth with full coverage that

have decay below the margins of their finishedhave decay below the margins of their finished

restorations would all fall into this categoryrestorations would all fall into this category


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A one-visit treatment solves these problems because at theA one-visit treatment solves these problems because at the

completion of treatment, an esthetic anterior temporarycompletion of treatment, an esthetic anterior temporary

crown can be placed rapidly and retained.crown can be placed rapidly and retained.

However, a one-visit treatmentHowever, a one-visit treatment SHOULD NOTSHOULD NOT be done if thebe done if the

tooth in question presents with anyone or a combination oftooth in question presents with anyone or a combination of

the following conditions:the following conditions:

The presence of a non vital pulp open to the oral cavityThe presence of a non vital pulp open to the oral cavity

The presence of periapical symptomsThe presence of periapical symptoms

The presence of alveolar damageThe presence of alveolar damage


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CONTRAINDICATIONSCONTRAINDICATIONS

There areThere are NO ABSOLUTE CONTRAINDICATIONSNO ABSOLUTE CONTRAINDICATIONS

as such , except following;as such , except following;

CellulitisCellulitis Acute apical abscessAcute apical abscess requiring incision and drainagerequiring incision and drainage

Severe painSevere pain when the tooth is lightly touchedwhen the tooth is lightly touched

AA weeping canalweeping canal that cannot be driedthat cannot be dried

Difficult casesDifficult cases that extend beyond our allotted time andthat extend beyond our allotted time and

the patients tolerancethe patients tolerance

Patients withPatients with acute apical periodontitisacute apical periodontitis

Molars withMolars with necrotic pulps and periradicularnecrotic pulps and periradicularradiolucenciesradiolucencies

Root canalRoot canal RetreatmentRetreatment


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CONDITIONS WHERE MULTIPLE VISIT THERAPYCONDITIONS WHERE MULTIPLE VISIT THERAPY

IS PREFERRED OVER SINGLE VISIT THERAPYIS PREFERRED OVER SINGLE VISIT THERAPY

Multiple appointment therapy should beMultiple appointment therapy should beconsidered in the following situations:considered in the following situations:

Asymptomatic nonvital teeth with periapical pathologyAsymptomatic nonvital teeth with periapical pathologyand no sinus tractand no sinus tract

Teeth with anatomic anomaliesTeeth with anatomic anomalies

Infected cases with evidence of apical periodontitisInfected cases with evidence of apical periodontitis(periapical radiolucency, swelling, exudates).(periapical radiolucency, swelling, exudates).

Patients with many allergies or previous flare-ups.Patients with many allergies or previous flare-ups.


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ADVANTAGESADVANTAGESReduces patient appointment visits per toothReduces patient appointment visits per tooth

It eliminates interappointment contamination and flare upsIt eliminates interappointment contamination and flare upsdue to leakage or loss of the temporary seal in severelydue to leakage or loss of the temporary seal in severelybroken-down teeth.broken-down teeth.

It allows the practitioner to fill the canal when he or she isIt allows the practitioner to fill the canal when he or she ismost familiar with the canal anatomy, working length, andmost familiar with the canal anatomy, working length, andposition of the apical stop.position of the apical stop.

It allows the practitioner to immediately use the canal forIt allows the practitioner to immediately use the canal forretention of a post to construct an esthetic temporary inretention of a post to construct an esthetic temporary inmaxillary anterior trauma cases in which the crown has beenmaxillary anterior trauma cases in which the crown has beenfractured off to the gum linefractured off to the gum line


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EFFICIENCY:EFFICIENCY: The dentist does not have to re-familiarize himself orThe dentist does not have to re-familiarize himself orherself to the patients particular anatomy or landmarks.herself to the patients particular anatomy or landmarks.

CONVENIENCE:CONVENIENCE: The patient does not have to endure the discomfort ofThe patient does not have to endure the discomfort ofrepetitive local anesthesia, treatment procedures and postoperativerepetitive local anesthesia, treatment procedures and postoperativerecovery.recovery.

ECONOMICS:ECONOMICS: Shorter chair time and fewer materials increase theShorter chair time and fewer materials increase thedentists profitability. The patient misses less work and incurs fewerdentists profitability. The patient misses less work and incurs fewerextra costs, such as travel and parking.extra costs, such as travel and parking.

PATIENT MANAGEMENTPATIENT MANAGEMENT:: Most patients prefer to have their treatmentMost patients prefer to have their treatmentcompleted as quickly as possible, and apprehensive patients derivecompleted as quickly as possible, and apprehensive patients derivespecial benefits from single-visit treatment. In some cases, healthspecial benefits from single-visit treatment. In some cases, healthconsiderations favour single appointments (e.g., when prophylacticconsiderations favour single appointments (e.g., when prophylacticantibiotics or sedation is required)antibiotics or sedation is required)

RESTORATIVE CONSIDERATIONSRESTORATIVE CONSIDERATIONS:: Prompt completion ofPrompt completion ofendodontic treatment may be required to allow immediate placement ofendodontic treatment may be required to allow immediate placement ofa coronal restoration (immediate postcore placement contributes to thea coronal restoration (immediate postcore placement contributes to thesuccess of treatment by ensuring an effective coronal seal).success of treatment by ensuring an effective coronal seal).


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DISADVANTAGESDISADVANTAGES1.1. Patient fatigue and discomfort with extendedPatient fatigue and discomfort with extended

operating timeoperating time2.2. Clinician fatigue with extended one-appointmentClinician fatigue with extended one-appointment

operating timeoperating time

3.3. Flare-ups cannot be easily treated by opening theFlare-ups cannot be easily treated by opening thetooth for drainage.tooth for drainage.

4.4. Inability to control exudates may prevent completionInability to control exudates may prevent completionof the Procedure.of the Procedure.

5.5. Difficult cases with extremely fine, calcified, multipleDifficult cases with extremely fine, calcified, multiplecanals may not be treatable in one appointmentcanals may not be treatable in one appointmentwithout causing under stress for both the patient andwithout causing under stress for both the patient andthe clinician.the clinician.


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RECENT ADVANCES FAVOURINGRECENT ADVANCES FAVOURING

SINGLE VISIT ENDODONTICSSINGLE VISIT ENDODONTICS


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Over the past decade,Over the past decade, Nickel Titanium RotaryNickel Titanium RotaryInstrumentation, Microscopic Endodontics, DigitalInstrumentation, Microscopic Endodontics, Digital

Radiography, A Plethora Of Obturation Systems, AndRadiography, A Plethora Of Obturation Systems, And

Biocompatible Sealing MaterialsBiocompatible Sealing Materials have helpedhave helped

practitioners perform endodontic procedures morepractitioners perform endodontic procedures moreeffectively and efficiently than ever before.effectively and efficiently than ever before.

This is not implying that endodontic treatment hasThis is not implying that endodontic treatment hasbecome easier; however, better tools and technologybecome easier; however, better tools and technology

have made it more predictable and challenge us tohave made it more predictable and challenge us to

take on a wider variety of complex cases andtake on a wider variety of complex cases and

complete it succesfully.complete it succesfully.


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DIGITAL RADIOGRAPHYDIGITAL RADIOGRAPHY

Computerized imaging system that uses an electronic sensorComputerized imaging system that uses an electronic sensor

instead of X-ray filminstead of X-ray film

Is a type of digital radiologyIs a type of digital radiology

Yields sharp clear imagesYields sharp clear images

Uses 70% less radiation than conventional X-ray filmUses 70% less radiation than conventional X-ray film


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No hazardous chemicalsenvironmentallyNo hazardous chemicalsenvironmentally

friendlyfriendly

Image appears rapidly on a computer screenImage appears rapidly on a computer screen

It isIt is quick and has the added ability to zoomquick and has the added ability to zoom

in on a specific area on the the radiograph.in on a specific area on the the radiograph.

The resolution and diagnostic quality isThe resolution and diagnostic quality is

excellent , storage isexcellent , storage is easy and there are noeasy and there are nodeveloping or processing errors.developing or processing errors.


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MICROSCOPESMICROSCOPES

Ease of observing areas of interest at high magnification underEase of observing areas of interest at high magnification underconstant illumination.constant illumination.

The use of this device during root canal treatment can assist theThe use of this device during root canal treatment can assist the

clinician in locating and negotiating calcified canals, andclinician in locating and negotiating calcified canals, andperforming surgical and nonsurgical root canal treatmentsperforming surgical and nonsurgical root canal treatments

Endoscopes, orascopes and magnifying loupes with or withoutEndoscopes, orascopes and magnifying loupes with or withouta supplemental light source are also useful tools to enhancea supplemental light source are also useful tools to enhancevisualization of the operative field.visualization of the operative field.


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Endoscopes, orascopes and magnifying loupesEndoscopes, orascopes and magnifying loupes

with or without a supplemental light source arewith or without a supplemental light source are

also useful tools to enhance visualization of thealso useful tools to enhance visualization of the

operative field.operative field.

Has made the task of identifying canals fasterHas made the task of identifying canals faster

and more efficient.and more efficient.


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Electronic Apex LocatorsElectronic Apex Locators

The task of determining canal length hasThe task of determining canal length has

moved into a new and more precise eramoved into a new and more precise era

with the rapid evolution of electronicwith the rapid evolution of electronic

devices that measure the length of thedevices that measure the length of theroot canalroot canal

Assist accurately in determining canalAssist accurately in determining canal

length in the majority of cases in a muchlength in the majority of cases in a muchshorter timeshorter time


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Recent apex locatorsRecent apex locators (ROOT ZX, JUSTY, ENDEX-(ROOT ZX, JUSTY, ENDEX-

PLUS)PLUS) have been reported to be accurate to within 0.5have been reported to be accurate to within 0.5

mm in >90% of cases .mm in >90% of cases .

A combination of Apex locator and EndodonticA combination of Apex locator and Endodontic

handpiecehandpiece

Tri Auto ZX. (Third generation apex locator)Tri Auto ZX. (Third generation apex locator)


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USE OF ULTRASONICS INUSE OF ULTRASONICS IN

SINGLE VISITSINGLE VISIT

Ultrasonics is relatively new in our endodonticUltrasonics is relatively new in our endodontic

armentariumarmentarium

Recent studies have shown ultrasonics to beRecent studies have shown ultrasonics to be

superior in debriding the root canal system whensuperior in debriding the root canal system whencompared with hand instruments.compared with hand instruments.

The ultrasonics used with small file held free ofThe ultrasonics used with small file held free of

the canal walls, warms the solution in the canalthe canal walls, warms the solution in the canal

and resonant vibrations cause movement ofand resonant vibrations cause movement of

aqueous irrigants an effect calledaqueous irrigants an effect calledAcousticAcoustic

streamingstreaming

CONCEPT OF WORKING WIDTHCONCEPT OF WORKING WIDTH


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CONCEPT OF WORKING WIDTH:CONCEPT OF WORKING WIDTH:

Traditional .02 tapered hand files and rotaries withTraditional .02 tapered hand files and rotaries with

greater tapers are of little value for accurategreater tapers are of little value for accurate

determination of the correct W.W.determination of the correct W.W.

Tapered instruments cut canal walls in severalTapered instruments cut canal walls in several

places simultaneously and it is not clear what isplaces simultaneously and it is not clear what ishappening apically.happening apically.

The correctThe correct WWWW correlates closely to the largestcorrelates closely to the largestdiameter of the original size in the apical third.diameter of the original size in the apical third.


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Working WidthWorking Width is as important asis as important as

determining the working length.determining the working length.

If the apical portion of the canal is largeIf the apical portion of the canal is largebefore instrumentation, the WW should bebefore instrumentation, the WW should be

large after instrumentation, and samelarge after instrumentation, and same

applies for small canals.applies for small canals.An undersized WW, even with a correctAn undersized WW, even with a correct

WL , compromises cleanliness.WL , compromises cleanliness.

An oversized WW compromises rootAn oversized WW compromises rootstrength.strength.


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OBTURATION: NEW DELIVERY SYSTEMSOBTURATION: NEW DELIVERY SYSTEMSSuccessful single-visit treatment depends on effectiveSuccessful single-visit treatment depends on effectivemechanical debridement, chemical disinfection, and propermechanical debridement, chemical disinfection, and propersealing of the canal system.sealing of the canal system.

Obturation can only be as good as the instrumentation,Obturation can only be as good as the instrumentation,since filling material cannot occupy the same space as thesince filling material cannot occupy the same space as thedebris left by poor instrumentationdebris left by poor instrumentation

There areThere are TWO BASIC METHODSTWO BASIC METHODS of root canal obturation,of root canal obturation,with a number of permutations to these techniqueswith a number of permutations to these techniques

TheThe Lateral Condensation TechniqueLateral Condensation Technique requires lateralrequires lateralcompaction of cold gutta-percha points to fill the spacecompaction of cold gutta-percha points to fill the space

Warm gutta-percha techniques, also called verticalWarm gutta-percha techniques, also called verticalcompaction techniques,compaction techniques, use warm gutta-percha that isuse warm gutta-percha that is

made plastic and compacted apically.made plastic and compacted apically.


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OBTURA IIOBTURA II

Viscosity of softened gutta purcha can be controlledViscosity of softened gutta purcha can be controlled

High temperature not detrimental to periodontal ligamentHigh temperature not detrimental to periodontal ligament

Allows continuous heatAllows continuous heatBetter adaptation and effective in obturation of accessoryBetter adaptation and effective in obturation of accessorycanalcanal

ThermafilThermafil (Dentsply Tulsa Dental Tulsa(Dentsply Tulsa Dental Tulsa


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ThermafilThermafil (Dentsply Tulsa Dental, Tulsa,(Dentsply Tulsa Dental, Tulsa,

Okla.)Okla.)Solid-core carriersSolid-core carriers

Plastic carrier with a groove to provide back flow ofPlastic carrier with a groove to provide back flow ofguttaperchaguttapercha

Space for carrier retrieval if re-treatment necessary.Space for carrier retrieval if re-treatment necessary.

Verifiers available in Ni-Ti can be heat sterilized for reuse.Verifiers available in Ni-Ti can be heat sterilized for reuse.

Verifiers with flutes for minor apical shapingVerifiers with flutes for minor apical shaping

Used in curved canalsUsed in curved canals

Less time (17 seconds)Less time (17 seconds)

ONE STEP OBTURATORSONE STEP OBTURATORS


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ONE STEP OBTURATORSONE STEP OBTURATORS

Compatible with all rotary and non rotary instruments.Compatible with all rotary and non rotary instruments.

No handle.No handle.

No cutting shaft to remove handle.No cutting shaft to remove handle.

Better accessibility.Better accessibility.

Preset to working length each time.Preset to working length each time.


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E and Q SystemE and Q SystemEasy and Quick system for obturation . It has aEasy and Quick system for obturation . It has a

Automatic heat carrierAutomatic heat carrier

Gutta percha gunGutta percha gun

Is used during vertical compaction, heat softened guttaIs used during vertical compaction, heat softened gutta

percha injection or combination of both techniques.percha injection or combination of both techniques.

When does Single Visit Therapy turns intoWhen does Sing

le Visit Therapy turns into


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When does Single Visit Therapy turns intoWhen does Single Visit Therapy turns into

Multiple Visit Endodontics ?Multiple Visit Endodontics ?

Factors related to tooth being operated onFactors related to tooth being operated on

Calcified canals which take time to negotiateCalcified canals which take time to negotiate

Excessive uncontrolled bleedingExcessive uncontrolled bleeding

Canal blockage due to foreign bodies, glass beads, oldCanal blockage due to foreign bodies, glass beads, oldrestorationsrestorations

PerforationsPerforations

Instrument separationInstrument separation

Weeping canalsWeeping canals

b) Other factorsb) Other factors- Patient going in syncope.- Patient going in syncope.- Lack of skill of practitioner to manage the case in less time.- Lack of skill of practitioner to manage the case in less time.- Patient fatigue.- Patient fatigue.


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ConclusionConclusion

Single Visit EndodonticsSingle Visit Endodontics has been provedhas been proved

to be an effective treatment modality,to be an effective treatment modality,

when compared to multiple visitwhen compared to multiple visit

endodontics, it is more beneficial toendodontics, it is more beneficial topatients and dentists in many ways.patients and dentists in many ways. TheThe

requirementrequirementis tois to select the caseselect the case

properly and to acquire the requiredproperly and to acquire the required skillskillfor getting the better results from thefor getting the better results from the

procedure.procedure.


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Single Visit Class

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