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
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.
Precise measurements of the length of a root canal
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
ANESTHESIA AND PAIN CONTROL
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