Phantom Head: The Purpose of an RCT

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The purpose of a RCT is to clean out the pulp cavity of neurotic tissue and then to create a complete seal that will prevent bacteria from entering and leaving the RC. A RCT might be need because of gross caries reaching the RC or leakage of previous RCT or trauma which will lead to loss of vitality resulting in interruption of blood and/or nerve supply.

The RCT can be divided according to the following steps:

1. Preoperative Radiograph
A preoperative radiograph provides the dentist with information regarding the RC obturation and its subsequent analysis. The dentist is able to see how far the blockage of the RCT reaches, allows the dentist to identify RCs orifice and to get an idea on how to negotiate the root canals15.

An example of RC blockage is the appearance of calcification in the RC. Only in rare cases blockages are not identifiable. This location and region of RC blockage allows the dentist to choose the most effective method to remove whatever is blocking the RC so that the RCT can begin, e.g. in order to be able to treat a RC in a maxilla premolar, the access for coronal penetration starts off at the centre of occlusal surface and by following the long axis of tooth.
The orifice of the RC is identified with an explorer as it is pressed where according to the radiograph the orifice is believed to be. If there really is an orifice present, the explorer will slightly dislodge as it is pressed on the blocked orifice. In order to minimise perforation and to reconfirm the orifice’s location, a second radiograph is done with the explorer left in place15.

2. Coronal Preparation/ Access
Before the access to the RC starts, the dentist places a tuber dam – thin latex sheet – with a hole over the tooth to be treated after havi...

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...nts new microorganism from entering the RC. Afterwards, a fingerspreader (fine (F) when master file used was <25 and a less finer spreader (MF for master file 30+ in size) is placed into the RC with a downwards pressure and removed by twisting and rotating the spreader towards the wall. This allows the sealent to spread laterally towards the RC walls.

This whole process is repeated until now more GP point scan fit and the whole canal is pink in colours (pink colour of GP point). If the RC is not pink it suggests that there are still gaps left and carried, microorganism or RC might leak. In the end a hot excubator is used to cut the GP points ends that are sticking out of the RC.

But in order to completely seal off the RC a restoration is placed onto the treated RC. This will completely off the RC from the outside environment and prevent wear and abrasion of the RC

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