Lesson 1Interappointment medication and dressing (calcium hydroxide): indications and protocolsDis section explain indications for interappointment medication, focusing on calcium hydroxide. E cover placement techniques, contact time, dressing materials, temporary sealing, and protocols for retreatment or persistent exudation in local practice.
Indications for calcium hydroxide useMixing and placement techniquesDuration of intracanal medicationManagement of persistent exudationDressings in retreatment casesRemoval of calcium hydroxide before fillLesson 2Irrigation fundamentals: sodium hypochlorite concentration and activation (ultrasonic, sonic), EDTA use, irrigation safetyDis section review irrigation goals, sodium hypochlorite concentrations, and EDTA use. E explain needle selection, activation methods such as ultrasonic and sonic, irrigation sequences, and safety measures to prevent extrusion and accidents.
Biologic goals of root canal irrigationSodium hypochlorite concentration choicesEDTA timing and smear layer removalNeedle design and irrigation depthUltrasonic and sonic activation methodsPreventing irrigant extrusion accidentsLesson 3Rubber dam isolation: techniques for posterior teeth, clamps selection, and isolation troubleshootingDis section review rubber dam armamentarium, clamp selection, and isolation techniques for posterior teeth. E address common challenges such as malpositioned teeth, broken crowns, and limited opening, plus tips for patient comfort and safety in Sierra Leone.
Rubber dam components and setupClamp selection for molars and premolarsPunching and placing dam for quadrantsIsolation in broken or carious crownsManaging limited mouth openingPreventing leakage and soft tissue injuryLesson 4Working length determination: apex locator use, radiographic confirmation, handling unusual root morphologyDis section cover working length concepts, apex locator principles, and stepwise clinical use. E include radiographic confirmation, troubleshooting inconsistent readings, and adapting techniques for resorption, open apices, and complex root forms.
Apical constriction and reference pointsApex locator setup and calibrationClinical steps with apex locatorsRadiographic verification techniquesManaging open apices and resorptionTroubleshooting erratic readingsLesson 5Canal location strategies: knowledge of mesial root anatomy, groove locations, ultrasonics for troughingDis section focus on systematic canal location using knowledge of root anatomy and grooves. E highlight mesial root landmarks, use of ultrasonics for troughing, staining and magnification, and strategies to avoid perforation while searching.
Anatomic landmarks in mandibular molarsMesial root and groove orientationTroughing with ultrasonics safelyUse of dyes and magnification aidsManaging calcified chamber floorsAvoiding strip and furcation perforationLesson 6Magnification and illumination: selection and ergonomics of loupes vs operating microscope, practical benefitsDis section discuss selection and ergonomic use of loupes and operating microscopes. E cover magnification levels, illumination options, posture, and how enhanced vision improve canal location, crack detection, and overall treatment precision in clinics.
Choosing magnification levels and opticsLoupes versus operating microscopeCoaxial illumination and light settingsErgonomic positioning and postureUsing magnification for canal locationMaintenance and infection controlLesson 7Obturation techniques for molar canals: warm vertical compaction, carrier-based systems, single cone with sealer—selection criteriaDis section compare obturation techniques for molar canals, including warm vertical compaction, carrier-based systems, and single cone with bioceramic sealer. E cover case selection, armamentarium, and steps to achieve dense, three-dimensional fills.
Criteria for timing of obturationWarm vertical compaction workflowCarrier-based obturation indicationsSingle cone with bioceramic sealerRadiographic evaluation of obturationManaging voids and underfillsLesson 8Coronal seal and provisional restoration: materials and techniques to prevent reinfectionDis section explain principles of coronal sealing after endodontic therapy. E review provisional materials, access restoration techniques, strategies to prevent microleakage, and how temporary and definitive seals influence long-term outcomes.
Importance of immediate coronal sealSelection of temporary materialsTechniques for sealing access cavitiesPreventing microleakage and washoutTransition to definitive restorationsManaging lost or failed temporariesLesson 9Management of complex anatomy: locating and negotiating extra canals, isthmus cleaning techniquesDis section address recognition and management of complex root canal anatomy. E cover locating extra canals, isthmus cleaning strategies, use of CBCT and magnification, and shaping modifications to maintain patency and avoid iatrogenic damage.
Identifying teeth prone to extra canalsUse of CBCT for anatomic assessmentTroughing with ultrasonics for MB2Isthmus cleaning and activation methodsGlide path in severely curved canalsBypassing ledges and blockages safelyLesson 10Post-endodontic restorative planning: core build-up, cuspal coverage, timing of permanent restorationDis section focus on planning definitive restoration after root canal therapy. E cover core build-up materials, posts when indicated, cuspal coverage decisions, timing of crowns, and how restorative design affect long-term tooth survival.
Assessing remaining tooth structureCore build-up materials and techniquesIndications for post placementCuspal coverage versus direct restorationsTiming of permanent restorationsCommunication with restorative dentistLesson 11Shaping protocols: glide path creation, hand vs rotary vs reciprocating systems, sequencing and torque/speed settingsDis section explain glide path creation and compare hand, rotary, and reciprocating systems. E cover sequencing, torque and speed settings, and strategies to reduce procedural errors while preserving dentin and canal anatomy.
Manual glide path creation stepsRotary glide path file selectionReciprocating systems indicationsRecommended torque and speed rangesSequencing for curved canalsAvoiding ledges, zips, and transportationLesson 12Anesthesia options for mandibular molars: inferior alveolar nerve block, infiltration, intraosseous, supplemental techniquesDis section review anesthesia strategies for mandibular molars, including inferior alveolar nerve block, buccal and lingual infiltrations, intraosseous and intraligamentary injections, and supplemental techniques for hot teeth and failures.
Inferior alveolar nerve block protocolBuccal and lingual infiltration techniquesIntraosseous injection indicationsIntraligamentary and intrapulpal useManaging hot teeth and failed blocksAnesthetic selection and bufferingLesson 13Access cavity preparation: outlines, instruments, prevention of gouging and perforationDis section detail access cavity design for different tooth groups, including outline forms and depth control. E review burs and ultrasonic tips, strategies to locate canals safely, and methods to prevent gouging, perforation, and missed canals.
Occlusal and lingual outline principlesBur selection and depth orientationUltrasonic refinement of access wallsLocating canal orifices safelyPreventing gouging and perforationManaging calcified or tilted teeth
