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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