In today’s clinical class in endodontic at AHEAD Academy, New Delhi, the topic of discussion was “ledges in Root canal Treatment (RCT)”. The students were taught ways to prevent ledges. Failure to grasp the rationale behind cleaning and shaping concepts can increase the occurrence of needless complications, such as ledges. A ledge is created when the working length can no longer be negotiated and the original pathway of the canal has been lost. Extension of the access cavity to provide unobstructed access to the root canals, precurving and not forcing instruments, using NiTi files, using passive step-back and balanced force techniques, and instrumenting the canal to its full length will all help to prevent ledge formation. Initial negotiation and bypassing the ledge can be achieved using a small file with a distinct curve at the tip, whereas a slight rotation motion of the file combined with a ''picking'' motion can often help advance the instrument.
Irrigation plays the main role in eradication of microbes from the root canal system, while root filling is important in an effort to eliminate the possibility of reinfection. Instrumentation, irrigation, locally used disinfecting agents, and root filling (sealer) all contribute to the killing and removal of microbes from the infected root canal, with irrigation regarded as the most important factor. The next topic for the new batch at AHEAD Academy, New Delhi was “irrigation in RCT”. Sodium hypochlorite and its mechanisms were explained to the students.
A 20 year old boy came to AHEAD Academy, New Delhi with a history of accident three months back. Angle fracture was seen on examination. Angle fractures occur in a triangular region between the anterior border of the masseter and the poster superior insertion of the masseter. These fractures are distal to the third molar. Angle fractures are often unfavourable because of the actions of the masseter, temporalis, and medial pterygoid muscles, which distract the proximal segment super medially.
Inter maxillary fixation (IMF) was performed and IMF screws were placed in the lower jaw. Today the patient came with pain in the lower jaw, so the screws were removed. Intermaxillary fixation (IMF) is an age old procedure which is used for treatment of fractures involving maxillomandibular complex. Conventionally various types of tooth mounted devices like arch bars, dental and interdental wiring, metallic and nonmetallic splints are used to achieve intermaxillary fixation. The use of dental arch bars and intermaxillary fixation screws are the two primary methods for achieving intermaxillary fixation.