MODERN METHODS AND ADVANTAGES OF INSTRUMENTAL TREATMENT OF ROOT CANALS OF TEETH

Аннотация

Among the many different types of root canal system preparation, two basic ones should be distinguished: Step Back (from the English “step back”, apical-coronal, consisting of the sequential, “step by step”, use of instruments from a smaller to a larger size) and Crown Down (coronal-apical, carried out with instruments from a larger size in the mouth of the root canal and a gradual decrease in size towards the apex). All root canal preparation techniques known today are, to one degree or another, a combination of “classical” ones. Currently, there are a number of methods for root canal treatment, which is due to the emergence of new types of endodontic instruments, modern devices and equipment. Keywords: recapitulation, curved canals, endodontic instruments, K-files and H-files, gutta-percha, silicone. СОВРЕМЕННЫЕ МЕТОДЫ И ПРЕИМУЩЕСТВА ИНСТРУМЕНТАЛЬНОЙ ОБРАБОТКИ КОРНЕВЫХ КАНАЛОВ ЗУБОВ Аннотация. Среди множества различных видов подготовки системы корневых каналов следует выделить два основных: Step Back (от англ. «step back», апикально- коронковый, заключающийся в последовательном, «шаг за шагом», применении инструментов от меньшего к большему размеру) и Crown Down (коронково-апикальный, осуществляемый инструментами от большего размера в устье корневого канала и постепенным уменьшением размера по направлению к верхушке). Все известные на сегодняшний день методики подготовки корневых каналов в той или иной степени являются комбинацией «классических». В настоящее время существует ряд методов обработки корневых каналов, что обусловлено появлением новых видов эндодонтических инструментов, современных приборов и оборудования. Ключевые слова: рекапитуляция, изогнутые каналы, эндодонтические инструменты, К-файлы и Н-файлы, гуттаперча, силикон. The Step Back technique was proposed for the treatment of curved canals in 1979. After determining the working length, all attention is focused on the apical third of the root canal. The choice of the type of endodontic instruments is individual, preference is given to K-files and H- files. 456 ResearchBib IF - 11.01, ISSN: 3030-3753, Volume 2 Issue 2 The first file that fits the size of the root canal (and not the one that the dentist takes in hand), I emphasize, fits the size of the canal, is considered the initial fileThe canal expansion begins with a size 10 K-file. A silicone stopper is installed on the file at the working length mark (e.g. 20 mm). Then the next size 15 file is taken and processed to the same length – 20 mm. After the next expansion, a 10 K-file is placed in the root canal again. This stage is called recapitulation, i.e. a control pass and processing of the root canal section, which allows cleaning the working area from dentine filings, as well as identifying and eliminating preparation errors. Recapitulation must be repeated each time after moving to the next size. Root canal preparation continues with 20 and 25 K-files, followed by recapitulation with 15 and 20 files, respectively. After this, the technique changes slightly. A 19 mm rubber stopper is installed on a 30 file and the canal is processed with preliminary introduction of EDTA and canal rinsing. Then, returning to size 25, process the canal to a depth of 20 mm. The next file 35 with a rubber stopper of 18 mm is used to process the canal and again with file 25 to a depth of 20 mm. Then process the canal with file 040 with a rubber stopper of 17 mm and return to size 25. In this way, process the canal to the required instrument size, usually 40-50, maintaining the size of the apical part of the canal 25. Maintaining the diameter of the apical part 25 is due to the fact that this size allows for the necessary medicinal treatment and full obturation of this part of the canal. It is imperative to follow the sequence of using endodontic instruments. If you do not follow the sequence, then 1- the endodontic instrument may break in the canal, 2- a ledge may form in the canal, which can change the direction of the canal and lead to perforation 3- close the lumen of the canal with dentin files Another option is possible when the step of the indentation of the next size of the instrument increases, growing by 0.5; 1.0; 1.5; 2.0 mm. With this technique, regardless of the step of the indentation, steps appear on the dentin walls of the canal, which will interfere with the introduction of the gutta-percha pin when filling the canal.