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Endodontic treatment (Step Back Technique)
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is also known as Telescopic canal preparation or serial root canal preparation.
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Step back technique emphasizes keeping the apical preparation small
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and producing a gradual taper coronally
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This technique was first described in 1960 by Mullaney
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basically this technique involves the
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the canal preparation into two phases
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phase I involves the preparation of apical constriction
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and phase II involves the preparation of the remaining canal
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Phase I
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Evaluate the carious tooth before initiating endodontic treatment
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prepare the access cavity, and locate the canal orifices
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Establish the working length of the tooth using pathfinder
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The working length is the distance between the reference point coronally and the anatomical apex
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two ways to determine the working length
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first by x ray that taken while the file is inserted in the canal
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In this situation Apical foramen is usually found 0.5-1mm
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shorter from the radiographic apex
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so we need to decrease the length
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Second by Electronic apex locators
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That designed to determine the canal length by
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giving the reading when the file tip is at the apical foramen
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first lubricate the instrument for use in apical area
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by EDTA or other lubricant
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Now insert the first K file into the canal
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with considering the working length with gentle
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clockwise and anticlockwise rotation
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of file with minimal apical pressure is given
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Remove the instrument and irrigate the canal
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Place the next larger size files to
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to the working length in similar manner and again irrigate the canal
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Don't forget to recapitulate the canal with
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previous similar number of H file
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This breaks up apical debris
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which are washed away with the irrigant
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Repeat the process until a size 25
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or 30 H-file that reaches the working length
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that will be the master file or
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Recapitulate between the files by
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placing it into the working length
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Phase II
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Place next file in the series to a length 1 mm short of working length
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remove it , irrigate and recapitulate
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Repeat the same procedure with successively larger files
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at 1 mm more shorter from the previously used file
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Finally, refining of the root canal is
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done by master apical file with
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push-pull strokes to achieve a smooth taper form of the root canal
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