• Document: Pre Endodontic Build-up of a Grossly Destructed Tooth: A Case Report
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Cas e R e po r t DOI: 10.17354/ijss/2015/90 Pre Endodontic Build-up of a Grossly Destructed Tooth: A Case Report Shirin Kshirsagar1, Shalini Aggarwal2, Alia Mukhtar1, Pooja Gupta1, Vinay Rai1, Monika Chawla1 PostGraduate Student, Department of Conservative Dentistry and Endodontics Dr. D.Y.Patil Dental College and Hospital Pimpri, Pune, 1 Maharashtra, India, 2Professor, Department of Conservative Dentistry and Endodontics Dr. D.Y.Patil Dental College and Hospital Pimpri, Pune, Maharashtra, India Abstract Tooth structure loss due to caries or trauma often will hamper the required isolation with a rubber dam during root canal treatment. Improper isolation is one of the important reasons for compromised root canal therapy. The few minutes spent placing a build-up prior to the initiation of root canal therapy will help to achieve maximum positive result of treatment. The time investment will result in easy rubber dam placement, the adequate amount of achieved isolation, the reduced chance of losing the provisional restoration, and the superior quality of the end odontic treatment. Hence in this presentation, we will be reviewing the technique of restoring grossly decayed teeth prior to starting endodontic therapy. We are also showcasing cases of composite core build-up on grossly decayed teeth. Keywords: Cariously destructed teeth, Core build up, Pre endodontic build up INTRODUCTION not only efficient disinfection but also application of the rubber dam sturdily over the tooth being treated.2 One of the main principles of endodontic therapy is disinfection of the root canal space. This disinfection is The Pre-treatment Triad then consists of: achieved by a three pronged approach, viz. cleaning and 1. Removal of carious tooth structure. shaping, irrigation of the root canal space and usage of 2. Removal of old restorations. intra-canal medicaments. Achieving thorough debridement 3. Restoring contour of the tooth. of the canal space is possible only when these modalities succeed. Having an access cavity that is four walled goes a Completion of these steps fulfills the following objectives: long way in helping these goals to succeed. The dichotomy 1. It prevents contamination of the root canal space by here is that very often the very teeth that need root canal bacteria present in the carious lesions. therapy are also those that have lost a substantial amount 2. It prevents inter-appointment contamination of the of tooth structure.1 These teeth almost never have intact canal space by oral fluids and saliva. crowns and at other times could also have old leaky 3. This also allows the intracanal medicaments to restorations that need removal and hence we are faced with function to their optimum best. At the same time, a further weakened tooth that does not lend itself to the the medicaments do not leach out into the oral cavity. application of a rubber dam clamp. These teeth that require This ensures that the root canal space remains in a root canal therapy thus need to be “pre-treated” before they medicated state in between appointments. can be subjected to root canal therapy. Doing this enables 4. Having four good walls enables the tooth to sustain the forces exerted by a rubber dam clamp. Access this article online 5. Reconstruct the pulp chamber so that there is an adequate space for the irrigating solutions and Month of Submission : 12-2014 temporary medications. One must recall that, During Month of Peer Review : 01-2015 the cleaning and shaping procedure, the pulp chamber Month of Acceptance : 01-2015 must never be dry; on the contrary, it must contain Month of Publishing : 02-2015 as much irrigating solution as possible. The access www.ijss-sn.com cavity, therefore, must function as a basin, which is Corresponding Author: Dr. Shirin Kshirsagar, Dr. D.Y.Patil Dental college and Hospital, Pimpri, Pune, Maharashtra, India. Phone: +91 8411912525. E-mail: shirinkshirsagar87@gmail.com 225 International Journal of Scientific Study | February 2015 | Vol 2 | Issue 11

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