Root Canal (Endo) Setup/Pictures

General

Dr. Bryant Specific

Dr. Mark specific

1. Seat patient & introduce yourself.
2. Place the bib on patient. Set up hand pieces, place air/water tip, take bur block out of package, then place mirror, explorer, & one cotton plier on the bracket table. Open endo kit and lay instruments out on tray, set up suctions & air/water tip. Have radiographs pulled up & Gendex/Tuxedo (digital sensor) ready
3. Place topical for anesthetic 
4. Notify the Doctor that the patient is seated, of the patients concerns and any other pertinent information.

Note: Remember to suction with the tip as close as possible to the tooth to remove as much of the aerosol as possible.

5. Doctor comes in to anesthetize the patient.  Then lets the anesthetic soak in so they are numb for the procedure.  After a few minutes ask the patient if they are feeling numb and let the dr. know more is needed, if necessary
6. Chart appointment in patient’s chart. Make any changes or adjustments to the patient’s appointment. in the computer and add your name in the assistant field if not already there, then complete the appt. in the computer.
7. Inform the patient of what their next appointment will be. Ask if the patient has any questions, & escort the patient to the front desk so they can check out.

Root Canal Charting (Start to Finish)

Endo Diagnosis: (SIP, AID, PN, PT, PIT) – Ask doctor which one
Periapical Diagnosis (WNL, SAP, AAP, CAA, AAA) – Ask doctor which one 

Discussed risks and complications with patient, including file breakage, the decision to refer to a specialist mid-way through appointment, multiple visits to compete RCT, possible permanent paresthesia, tooth possibly being non-restorable & the need to extract. Patient understands risks, possible complications.

Accessed canals using #10 & #15 handfiles with rotary SX file
Removed all decay. Accessed pulp chamber. Verified tooth still restorable.
Obtained patency for canals and with apex locator and size #15 hand file established WL for the canals:
Took a verification PA for WL (MB – , DB – , P – , ML – ) (List out the working lengths)
Shaped canals with rotary file XP-Shaper to the WL with EndoSync handpiece
Recapitulated between each file and iteration by checking patency and copious irrigation of NaOCl
Finished cleaning canals with XP-Finisher to 1 mm short of WL with EndoSync handpiece
Tried in GP master cones to length of WL, verified tugback
Took a verification PA to confirm master cone fit
Dried canals with paper points
Placed BC Sealer into canals before inserting GP master cones to the WL. Burned off excess GP with Endo270.
Placed BC liner to seal off the GP
Took a PA to verify obturation
Finished, polished, checked bite. Reminded patient that root canal treated posterior teeth should receive a crown & anterior teeth are by case-by-case basis
Patient informed to expect some discomfort that gradually improves. Cautioned patient about flare ups, patient is to call if any sudden intense pain

Root Canal Charting (Pulpal debridement)

Endo Diagnosis: (SIP, AID, PN, PT, PIT) – Ask doctor which one
Periapical Diagnosis (WNL, SAP, AAP, CAA, AAA) – Ask doctor which one 

Discussed risks and complications with patient, including file breakage, the decision to refer to a specialist mid-way through appointment, multiple visits to compete RCT, possible permanent paresthesia, tooth possibly being non-restorable & the need to extract. Patient understands risks, possible complications. Accessed canals using #10 & #15 handfiles with rotary SX file
Removed all decay. Accessed pulp chamber. Verified tooth still restorable.
Obtained patency for canals and with apex locator and size #15 hand file established WL for the canals:
Took a verification PA for WL (MB – , DB – , P – , ML – ) (List out the working lengths)
Shaped canals with rotary file XP-Shaper to the WL with EndoSync handpiece
Recapitulated between each file and iteration by checking patency and copious irrigation of NaOCl
Filled canals with Vitapex, placed cotton rolls in pulp chamber and temporized with IRM
Patient informed to expect some discomfort that gradually improves. Cautioned patient about flare ups, patient is to call if any sudden intense pain