Very Dental Student: How to Do a Root Canal with Zach and Kevin

In this episode of the Very Dental Student Podcast, Mo talks with Kevin and Zach to discuss endodontic procedures, comparing dental school protocols with real-world practices. They delve into a step-by-step walkthrough of an endo procedure on a premolar, highlighting key differences and offering valuable insights for dental students and new dentists.

Key Takeaways:

• CBCT is Your Friend: While PAs and bitewings are helpful, a CBCT scan provides a 3D view of the canal system, acting as a "GPS" for navigation. This is especially crucial for molars and complex premolars.
• Begin with the End in Mind: Always consider the final restoration (likely a crown). Take a pre-op impression before starting the endo to simplify temporary crown fabrication.
• Quadrant Isolation: Isolate more than just the tooth being treated with your rubber dam. This provides better orientation and access for both endo and crown prep.
• Flat Top that Tooth: Reduce the occlusion and flatten the tooth before accessing the canals. This improves visibility, access, and post-op comfort.
• Lubricate Early and Often: Use RC Prep on your files before entering the canals to prevent pushing debris apically and to aid in lubrication and chelation.
• Hypochlorite Timing: Introduce sodium hypochlorite after establishing working length to avoid pushing debris and potentially blocking the canal.
• Secondary Rinses: Use EDTA or a similar product (like Smear Off) to remove the smear layer created by sodium hypochlorite before obturation.
• Sealer Coating Technique: Coat the canal walls with sealer by running your files in reverse. This ensures a more thorough and even distribution.
• Post-Op Comfort: Even if a crown is planned, taking the tooth out of occlusion can improve patient comfort and reduce post-op complications.
• Posts - Controversial but Sometimes Necessary: While posts are less common today, they can be valuable in certain situations, particularly for premolars and anterior teeth.
• Crown Prep Under Rubber Dam: While unconventional, prepping crowns under a rubber dam can be done effectively with practice and proper technique.

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