Endodontics Basics – PS017
Description
How can you tell if a root canal treatment is truly successful?
Do you always need cuspal coverage after a root canal?
Are hand files still relevant, or has rotary completely taken over?
And does GP pumping really improve the effectiveness of irrigants like hypochlorite?
Emma returns for another Protrusive Student Series episode as she heads into her final year of dental school. Together, we explore the fundamentals of endodontics – covering restoration choices, success criteria, instrumentation, and irrigation protocols.
This episode breaks down the basics every student and young dentist should understand, while also tackling the common debates and real-world challenges of endo.
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https://youtu.be/DK1ZAEPE_E4
Need to Read it? Check out the Full Episode Transcript below!
Key Takeaways
- Understanding the ‘why’ behind dental procedures is crucial for effective practice.
- Both hand files and rotary files have their place in endodontics, especially for beginners.
- Good irrigation techniques are essential for effective endodontic treatment.
- Rubber dam isolation is critical for safe and effective endodontic procedures.
- Learning to determine the master apical file size is a key skill in endodontics.
- The use of EDTA helps in removing the smear layer during root canal treatment.
- Endodontic specialists often use advanced techniques and tools for more efficient treatments.
- Success in endodontics is not just about radiographs, it is sometimes defined by patient comfort and healing.
- Cuspal coverage is often necessary after root canal treatment.
- Patient communication is key to managing expectations.
- Consent forms should be tailored to individual cases.
- Understanding proprioception is important for tooth preservation.
Highlights of this episode:
- 00:00 Teaser
- 00:51 Intro
- 02:50 Emma’s Final Year Reflections
- 04:34 Exploring Specialties
- 07:02 Endodontics: A Student’s Perspective
- 08:15 Rotary vs Hand Files
- 11:45 Step-by-Step Notes for Students
- 14:24 Patency and Recapitulation
- 14:55 Determining Master Apical File Size
- 16:58 Irrigation Protocols and Techniques
- 21:22 Typical Irrigation Protocol
- 23:51 Rubber Dam Importance
- 27:25 Rubber Dam Importance
- 28:21 Role of 17% EDTA
- 28:59 Success Factors in Endodontics
- 29:46 Success Factors in Endodontics
- 30:46 Real-World Endodontic Practices
- and Challenges
- 32:11 Understanding Success and Survival in Root Canal
- 34:26 Successful Outcomes
- 36:24 Success vs Survival
- 38:12 The Debate on Cuspal Coverage and Timing
- 40:48 Proprioception
- 41:54 Pre-Endodontic Build-Up
- 42:29 Direct Cuspal Coverage
- 44:03 Consent and Communication in Endodontic
- 47:25 Conclusion and Future Topics
- 49:02 Outro
Resources mentioned:
- Outcome of primary root canal treatment: systematic review of the literature – Part 1
- Outcome of primary root canal treatment: systematic review of the literature – Part 2. Influence of clinical factors
- Radiographic Assessment of the Quality of Root Canal Fillings
Check out Simple Re-RCT Cases – ‘How To’ Guide – PDP233 for more Endodontic insights
#BreadandButterDentistry #EndoRestorative
This episode is eligible for 0.75 CE credit via the quiz on Protrusive Guidance.
This episode meets GDC Outcome C.
AGD Subject Code: 070 – Endodontics (Endodontic infections, microbiology, and treatment)
Aim: To provide dental students and early-career dentists with a structured understanding of endodontic fundamentals, including instrumentation, irrigation protocols, success factors, and restorative considerations.
Dentists will be able to:
- Differentiate between hand and rotary file systems and identify their advantages and risks.
- Evaluate the factors influencing the success and survival of root canal treatment.
- Recognize when cuspal coverage or pre-endodontic build-ups are required.
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Click below for full episode transcript:
Teaser: You go to dental school, you're going to be using hand files. You're gonna get taught with hand files, everything's gonna be hand files, and that's how you're taught in dental school.
Teaser:
As long as you understand when you’re doing, you’re trying to like determine tug back and you’re trying to determine the master apical file size, for example, right? Those skills you do with hand files and they’re universal.
The most important thing is more important than the final system – Root canal without rubber dam is like doing heart surgery in the toilet. The thrill of the fill. Okay. You put your GP in and it looks as though it is to length and it doesn’t have any voids in it.
And we think, wow, this is success. Right? But the thing is, when you see a radiograph, the radiograph cannot tell you. Whether rubber dam was used, whether hypochlorite was used, whether the coronal seal was really that good, and what protocols were used in terms of this disinfection.
Jaz’s Introduction:
Basics of Endodontics. Welcome back to another Protrusive Student Series. This arm of the podcast is for students, young practitioners, those returning back to practice, or you just love listening to the podcast and you want validation. Welcome new listeners and welcome back to the returning Protruserati. We were joined with our Protrusive Student, Emma.
As she transitions into her final year of dental school, she asked all the right questions. Do you always need cuspal coverage after root canal? What kind of cuspal coverage should we go for? What determines if your root canal has actually been successful? Like we’ve all seen root canal treatments that been there for 30 years and they look questionable on the radiograph.
But there’s no pathology. Does that still count as a success? How about hand files versus rotary? Are hand files obsolete? And lastly, how significant is GP pumping to agitate your arrogance such as hypochlorite? All these questions are much more discussed in this episode.
And as of a few episodes ago, these episodes are also eligible for CPD. So if you want some easy CPD for those who are paying subscribers on the Protrusive Guidance app, don’t forget to answer the quiz. You would’ve done all the hard work of listening. You might as well get the CPD saying so by time December comes, you’re absolutely laughing. Let’s join the main interview and I’ll catch you in the outro.
Main Episode:
Emma, welcome back to the podcast, a Protrusive Student. How is your summer going? You know, I mean, I remember specifically this transition from fourth year to fifth year. And it’s really strange because like for you, it is different in a way ’cause you’ve finished your finals, right? You’ve passed.
So congratulations, congratulations once again. But it’s like you’re about to enter the final chapter. It’s a bit emotional the next round when you finish finals and then you have like, you enter the rat race. That’s an even bigger, weirder scenario. But tell us about where your headspace is at the moment.
[Emma]
I think for my final year, now that I have my exams over, I’m actually kind of excited. I think a lot of people are finding the same. I find a lot of people at Glasgow say that final year is their favorite year, because you don’t have that stress of exams. You’re more just working as a wee dentist and getting put into different outreach placements and you’re just clinical all day, every day, pretty much. So it’s just purely building on your clinical skills and getting more knowledge. So no more lectures. So I’m actually kind of excited for it.
[Jaz]
I think th