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ENDO > Seminar 7: RCT FAILURE > Flashcards

Seminar 7: RCT FAILURE Flashcards

1
Q

In apical lesions the cells are organised into what zones?

A

Zones of FISH

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2
Q

What are the zones of fish starting from closest to furthest from the root apex?

A

Zone of infection
Zone of contamination
Zone of irritation
Zone of stimulation

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3
Q

What cells are found in FISH zone of infection?

A

Microorganisms

PMN cells

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4
Q

What cells are found in FISH zone of contamination?

A

Leukocytes
Dead bone cells
Bacterial toxins seeping from infection zone

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5
Q

What cells are found in FISH zone of irritation?

A

Macrophages
Osteoclasts

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6
Q

What cells are found in FISH zone of stimulation?

A

Fibroblasts and Osteoblasts
Collagen is secreted by these cells and they are stimulated as toxins are mild enough in this area but not too strong to cause destruction

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7
Q

What happens to zones of FISH during acute exacerbation episodes?

A

They become disrupted

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8
Q

Describe model of periapical disease

A

Bacterial invasion in root canal
Non specific acute inflam
Phagocytosis of bacteria
Delayed immune response

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9
Q

When does condensing osteitis arise?

A

Aka periapical osteosclerosis

Occurs when long standing mild chronic irritation

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10
Q

What is the pathophysiology behind condensing osteitis?

A

Eg if the coronal pulp is necrotic and radicular pulp is vital this can dampen the noxious effect so immune system responds by laying down bone rather than resorbing

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11
Q

What is the average number of species per root canal?

A

10^5 CFU/ml

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12
Q

Which species are more dominant in acute exacerbations?

A

Fusobacteria

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13
Q

As time goes on the bacterial species in apical lesions become more what?

A

Gram negative

Anaerobic

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14
Q

How do facultative anaerobes make ATP?

A

Oxygen as well as fermentation when oxygen is low

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15
Q

What is special about e faecalis?

A
  1. Has a proton pump inhibitor acting against calcium by deactivating it from CaOH
  2. Can survive as a mono species
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16
Q

According to ESE when should RCTs be reviewed ?

A

One year
Or until lesion healed
At least 4 years following trauma

17
Q

What are the causes of RCT failure ?

A

Infection
Foreign body reaction
Cyst

18
Q

What are the two types of infections to cause failure ?

A

Intraradicular

Extraradicular

19
Q

What is the success rate for conventional retreatment ?

A

75-85%

20
Q

What are some common causes of RCT failure?

A 
Cracks
Leaking restorations 
Untreated canals
Inadequately cleaned canal
Operative errors
21
Q

What are the options after RCT failure ?

A

Re endo
Surgery
Xla

22
Q

What are the types of endo surgery ?

A

Periradiular surgery
Corrective surgery
Fistulatative

23
Q

What is an example of periradicular surgery

A

Apicectomy

Periradicular curettage

24
Q

What is an example of corrective surgery ?

A

Hemisection

25
Q

What is an example of fistulatative surgery?

A

Decompression

26
Q

What is a class 1 instrument fracture ?

A

An instrument that protrudes into the chamber

27
Q

What is a class 2 instrument fracture ?

A

A fracture file within the straight part of canal

28
Q

What technique can be used to remove broken instrument ?

A

Braiding technique

29
Q

What is a class 3 fracture instrument?

A

Beyond the curvature

30
Q

What is special about E feacalis

A
  1. Live and persist in poor nutrient environment-Survive in extreme environments with low pH, high salinity and high temperatures

Endure prolonged periods of starvation and utilize tissue fluid that flows from the periodontal ligament

  1. Survive in the presence of several medications (e.g., calcium hydroxide) and irrigants (e.g., sodium hypochlorite)
  2. Form biofilms in medicated canals
    Invade and metabolize fluids within the dentinal tubules and adhere to collagen
  3. Acquire antibiotic resistance

ENDO (22 decks)

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