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Ledge by Mind Map: Ledge
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Ledge

Ledge is an iatrogenically created root canal wall irregularity that may impede placement of an intracanal instrument to the apex.

ENDODONTIC MISHAPS

Access related

Instrument related

Obturation related

Miscellaneous

CAUSES

Lack of straight line access

Anatomy of the canal

Inadequate irrigation or lubrication

Excessive enlargement of the curved canals with large files

Obstruction or the packing of debris in the apical portion of the canal

Correction

Recognition of a ledge is the first step in its management; this might be by

Canal first must be relocated and renegotiated

One technique is to use a precurved (1 to 2 mm apically) small file to re-establish correct working length

Despite all effort, correction of a ledge is difficult because instruments and obturation materials tend to be directed into the ledge.

If unable to bypass ledge, clean and shape at the "new" working length.

Prognosis

Successful treatment after ledge creation depends on the extent of debris remaining in the region past the ledge.

Inform the patient of the prognosis, and instill the importance of recall and the signs that would indicate failure.

Tips

The best approach to managing ledges is prevention

If the radiograph shows that the instrument point is directed away from the lumen of the canal, then it is highly likely that there is a ledge

the shortest file to reach working length should be chosen. Shorter instruments provide more stiffness and move the clinician’s fingers closer to the tip of the instrument

A nickel–titanium instrument should not be used to bypass ledges

Do not use (EDTA) for chelation because it tends to intensify the ledge.

Ref.

JOE — Volume 33, Number 10, October 2007

InglePDQ: Ch. 08 - Endodontic Mishaps

Ingle’s ENDODONTICS 6th Edition

Mindmap Author

Mahmoud Al-Johani

Twitter: @dr_aljohani

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