rct / endo

Question 1

reasons for loss of RCT tx tooth

Answer 1

post tx endo disease
unrestorable caries
restorative failure
irretrievable cusp / crown #
vertical root #
perio

Question 2

main factors influencing survival of root tx teeth

Answer 2

1. quantity of residual sound tooth remaining
2. choice of restoration

Question 3

ferrule effect

Answer 3

an adequate circumferential supramarginal collar of dentine to retain extra coronal restoration

Question 4

what should tooth be assessed for when deciding restoration

Answer 4

• tooth structure remaining
• terminal or non terminal tooth & no of neighbouring contacts
• presence of cracks
• occlusal factors (excursive / protrusive guidance & presence of definitive contacts)

Question 5

endocrown

Answer 5

all ceramic full coverage crown which includes an integrated intra coronal extension which projects into pulp chamber of a root filled posterior tooth (adhesively bonded to dentine)

Question 6

disadvantages of gold / cocr cast post core

Answer 6

additional removal of peri cervical root canal dentine for post space preparation and potential risk of coronal leakage during temporisation

Question 7

in most cases where at least 1 proximal wall is missing

Answer 7

root filled premolars & molars should be restored with cuspal coverage restorations
note this should always be conservatively & onlays utilised where appropriate & aim to retain as much sound residual tooth structure as possible

Question 8

to restore cracked teeth

Answer 8

cuspal coverage restoration following endodontic treatment

Question 9

tx options

Answer 9

rct
re rct
xla
monitor
surgical i.e. periradicular

Question 10

indications for root canal re tx according to ese qa guidelines

Answer 10

1. teeth with inadequate root canal filling with radiological findings of developing or persisting apical periodontitis and / or symptoms
2. teeth with inadequate root canal filling when the coronal restoration requires replacement or the coronal dental tissue is to be bleached

Question 11

clinical assessment of root tx tooth

Answer 11

coronal seal
ferrule
is it restorable
is it able to be isolated with dam
swelling
sinus
ttp
buccal sulcus - ttp?
mobility
pocketing

Question 12

radiographic assessment of root tx tooth

Answer 12

root filling - length / quality
unfilled or missed canals
shape of canal
patency - # instruments / posts / sclerosis
bone support - mild / mod / severe
crown to root ratio - want 1:1.5
pathology

Question 13

issues following rct / re rct

Answer 13

amount of tooth tissue remaining
restoration type
lack or no ferrule
wide post holes
endo complications i.e. # instrument / perforations / short or long root fillings

Question 14

2 main reasons for cuspal coverage

Answer 14

1. better coronal seal
2. helps prevent catastrophic #

Question 15

4 methods to identify cracked tooth

Answer 15

1. tooth sleuth
2. bite test
3. transillumination
4. selective anaesthesia