Endodontic microbiology

Question 1

What disease do we fight in endo?

Answer 1

-Periapical periodontitis

Question 2

What are the routes of bacteria infection?

Answer 2

• Caries
• Fracture
• Restorative

Question 3

What gram stain is strep mutans?

Answer 3

-Gram positive

Question 4

What gram stain is enterococcus faecalis?

Answer 4

-Gram positive

Question 5

What two bugs do you see in endodontic disease etiology?

Answer 5

• Strep mutans

- Enterococcus faecalis

Question 6

You don’t typically see apical involvement in an endo case until when?

Answer 6

The pulp tissue is fairly necrotic

Question 7

What bugs do you see in a retreatment endo case?

Answer 7

-Enterococcus faecalis

Question 8

What causes the smear layer?

Answer 8

-Instrumentation

Question 9

T/F Vital pulp canals are usually bug free

Answer 9

-True

Question 10

T/F Non-vital pulp canals are bug infested

Answer 10

True

Question 11

What do you do to fight the bugs?

Answer 11

• Asepsis
• Disinfection
• Barrier seal

Question 12

How many root canals fail without dental dam isolation?

Answer 12

-30-40%

Question 13

What are disinfecting agents and how do you agitate them?

Answer 13

• Sodium hypochlorite
• EDTA
• Alcohol
• Endo activator to agitate the solution

Question 14

What are the properties of sodium hypochlorite?

Answer 14

• Antimicrobial
• Dissolve vital and necrotic tissues
• Free chlorine and NaOCl breaks down proteins in to amino acids
• Lubricating
• Toxicity potential

Question 15

How do you increase disinfection effectiveness with sodium hypochlorite?

Answer 15

• Increase the volume
• Increase the time used
• Agitation
• Warming the solution

Question 16

What is a good disinfectant material?

Answer 16

-Calcium Hydroxide

Question 17

What are the qualities of calcium hydroxide?

Answer 17

• Antimicrobial
• Alkaline pH
• Osteogenic capability

Question 18

What are two things to do with irrigation that increases your bug busting capability?

Answer 18

• Irrigate often

- Agitation

Question 19

How much sodium hypochlorite do you use in treating a canal?

Answer 19

-at least 2 6cc vials

Question 20

When calcium hydroxide is added after NiTi instrumentation with NaOCl irrigation how many of the canals were rendered bacteria free?

Answer 20

-93%

Question 21

If you have irreversible pulpitis and a periradicular diagnosis of normal can you treat it in one visit?

Answer 21

-Yes

Question 22

If you have irreversible pulpitis and a periradulcar diagnosis of Chronic apical periodontitis can you treat it in one visit?

Answer 22

-No

Question 23

If you have necrotic pulp with a normal periradiuclar diagnosis can you treat in a single appt?

Answer 23

-No