CBCT IN ENDODONTICS CBCT in endodontics 1 apical

CBCT IN ENDODONTICS

CBCT in endodontics 1 - apical morphology and suspected lesions of endodontic region 2 -root canal system morphology 3 -presurgical visualization 4 - suspected root fractures and trauma 5 - internal and external root resorption

Axial CBCT slice of same tooth revealing a strip perforation of distal root at a level coronal to separated instrument.

Periapical radiograph of tooth #20. There is an associated radiolucency at the apex of this root-filled tooth Coronal CBCT slice of the same tooth revealing a missed buccal canal and an associated apical radiolucency.

CBCT sagital view of tooth #9 revealing lateral luxation and alveolar fracture.

Digital radiograghy: CMOS and CCD PSP

Enhanced lighting and magnification � Surgical � Dental telescope (loupes) operating microscope(DOM) � orascope

pulpal Vitality test • 1 -electric pulp test(digital, analog) • 2 -pulse oximetry • 3 -laser doppler flowmetry(specialy in luxation injuries follow up)

Pulse oximeter

Bite test: tooth slooth frac finder

Component of an endodontic rotary instrument:

The flute(groove): collect soft tissue and dentin chips Leading(cutting)edge: where the flute and land intersect forms and deflects chips from wall of canal Land (marginal width): surface project axially from the central axis

land � Reduce the tendecy of file to screw into the canal � Reduce transportation of the canal � Reduce the propagation of microcrack on its circumference � Support the cutting edge � Limit the depth of cut

Helix angle �The angle the cutting edge form with the long axis of file �Determining which file technique to use

Rake angle If a file is sectioned perpendicular to its long axis, is the angle formed by the leading edge an radius of the file Negative or scraping Positive or cutting

Electric micromotor : speed, torque, fatigue

Self Adjusting File(SAF) Hollow thin Ni. Ti lattice cylinder attached to vibrating handpiece that generate in and out vibration the VATEA continuous irrigation unit Extremely adaptable longitudinally, uniform cuttin action

Apexum device �Device for periapical debridment through a root canal access �Opening 330 micron by passing a 30 file 1 mm beyond the apex �Two miniature device: coarse apexum ablator, fine ablator

Ultrasonic device

Electronic Apex Locator Resistance - based electronic apex locator: R(ohms)=V/I Constant resistance value of 6. 5 kΩ between the canal and PDL Strong electrolytes such as endodontic irrigants lead to in accurate an even unstabe result. Low – frequency apex locator: Impedance used to mark the depth of canal penetration. High – frequency apex locator: Operating with a high frequency wave 400 k. Hz

Voltage gradient apex locator: Ushiyama found the voltage gradient was greatest at the most constricted point in the canal where the current density is the highest. Dual –frequency apex locator: Determining the canal terminus as the difference between two impedance value at two different frequencies. Root ZX Bingo 1020(Raypex 4 , propex)

Multiple frequency apex locator: The sybron elements diagnostic unit Morita combine the apex locator with handpiece that have an auto-reverse features when the apex is reached: Tri-auto ZX Dentaport ZX

Elements unit

Down pack and hot tip

Irrigation system • Endo. Activator system: subsonic handpiece • Endo. Vac system: the evacuator , a microcannula extend to apical region • Irrigated with negative pressure • The safety-irrigator system: positive pressure

Heal ozone equipment