The second type of endodontic condenser is called a
spreader. The root canal spreader (fig. 7-13) has a contra-angled working end that tapers to a point (compared to the flat tip of a plugger). This instrument is single ended. Spreaders are designed to condense root canal filling materials horizontally against the wall of the prepared root canal. plugger. The finger spreader has a pointed end, the finger plugger has a flat end.
Finger spreaders and finger pluggers have a handle like a file and a smooth working end like a spreader or
Endodontic Measuring Gauges
Precise measurements of the length of a root canal are vital to the success of root canal therapy. The dentist uses a measuring gauge to measure the working length of files, reamers, and broaches. Two styles of measuring gauges are commonly used. The first type is shown in figure 7-14. The finger or thumb ruler is the other type used. The exact working distance can be set on the bar and is confirmed when the end of the instrument reaches the metal plate. The example in fig. 7-14 shows the working distance of a file set at 21 mm.
Stops (fig. 7-15) are small, round or square pieces of rubber, plastic, or silicone placed on the files, reamers, or broaches to mark the length of the canal. This prevents injury to the apex of the root and periapical tissues.
A local anesthetic must be administered by the dentist before endodontic therapy if the tooth is vital. If
Figure 7-13. - Root canal spreader.
Figure 7-14. - Measuring gauge.
Figure 7-15. - Stop attachments.
the tooth is hypersensitive, it may require injection of additional solution directly into the pulp. When a tooth is nonvital, the use of local anesthetic solution is not mandatory. At subsequent visits, after the pulp has been removed, local anesthesia may not be necessary. The dentist may give the patient a prescription for medication to control any anticipated postoperative discomfort or infection.
Endodontic therapy involving the removal of the pulp and sealing the empty canal requires debridement, irrigation, and sterilization of the pulp chamber and canals as part of the procedure. These steps of the procedure are necessary to ensure against future infection by eliminating bacteria before the canal is sealed. An absolutely dry field, free from bacteria-laden saliva is required to achieve such sanitation of a root canal. Additionally, the rubber dam prevents patients from swallowing or aspirating the very small instruments used in endodontic treatment. This dry field is maintained best with a rubber dam isolation. The rubber darn usually is prepared to expose only the tooth to be treated endodontically, thereby providing isolation of the tooth with the rubber dam. A radiolucent rubber dam frame made of plastic is
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