What's up YouTube, Dr. Sami Shahhal here & today I want to make a technique video illustrating how I approach core build ups after root canal therapy. I absolutely love the rubber dam when working on root canal treated teeth because it ensures the canal is free of oral bacteria during our procedure. I also believe it makes it safer for our patients as I don’t have to worry about the tongue or cheek getting too close to my diamond bur.
Currently, you can see me carefully removing the temporary filling or IRM from the canal. I do my best to stay away from natural tooth structure until recovering the cotton pellet that is placed immediately over the canal orifices. As you can see, the decay was pretty expansive & the endodontist did his best to clean out the tooth during root canal therapy. However, I prefer to go over some of the compromised areas with a round carbide bur on slow speed to ensure that the tooth is completely free of decay. I typically place posts If I have 2 or more compromised walls; however, in this case we have adequate tooth structure to go ahead with a simple core paste build up procedure.
Air abrasion therapy, helps me enhance the dentin surface roughness & establish a higher bonding strength to my filling material. I then place a Phosphoric Acid Etchant in the canal for 15 seconds followed by a thorough wash & dry. You can definitely see a frosty look to the enamel if done correctly. The dual cure bonding agent saturates the canal & is thinned to once again increase bond strength. I slowly place core paste starting from the base of the canal to the cavosurface margin in order to minimize the creation of voids. After the build up is set, we can proceed to our crown preparation.
So, I hope this video helps patients better understand the build up procedure. If you have any questions or requests please let me know in the comment section below. I love sharing cases with this community.
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