cleaningand shaping- american associationof endodontists（美国整形协会经清洗）.docVIP

Chapter 16 Cleaning and Shaping William T. Johnson D.D.S., M.S. W. Craig Noblett D.D.S., M.S. Learning Objectives After reading this chapter, the student should be able to: 1 State reasons and describe situations for enlarging the cervical portion of the canal before performing straight-line access. 2 Define how to determine the appropriate size of the master apical file. 3 Describe objectives for both cleaning and shaping; explain how to determine when these have been achieved. 4 Diagram “perfect” shapes of flared (step-back) and standardized preparations; draw these both in longitudinal and cross-sectional diagrams. 5 Diagram probable actual shapes of flared (step-back) and standardized preparations in curved canals. 6 Describe techniques for shaping canals that are irregular, such as round, oval, hourglass, bowling-pin, kidney-bean, or ribbon-shaped. 7 Describe techniques, step-by-step, for standardized and flaring (step-back and/or crown-down) preparations. 8 Distinguish between apical stop, apical seat, and open apex and discuss how to manage obturation in each. 9 Describe the technique of pulp extirpation. 10 Characterize the difficulties of preparation in the presence of anatomic aberrations that make complete débridement difficult. 11 List properties of the “ideal” irrigant and identify which irrigant meets most of these criteria. 12 Describe the needles and techniques that provide the maximal irrigant effect. 13 Discuss the properties and role of chelating and decalcifying agents. 14 Explain how to minimize preparation errors in small curved canals. 15 Describe techniques for negotiating severely curved, “blocked,” or constricted canals. 16 Describe, in general, the principles of application of ultrasonic devices for cleaning and shaping. 17 Evaluate, in general, alternative means of cleaning and shaping and list their advantages and disadvantages. 18 Discuss nickel-titanium hand and rotary instruments and how the physical properties