Clinical Procedures and Tips Flashcards
(25 cards)
What are the endo requirements to graduate?
- two cases
- two endo recalls
- two assisting in grad
- trial mock board
What are the three cases you must do to graduate?
- First CASE: Must be a non-complicated anterior or premolar tooth
- Second CASE: Must be a non-complicated anterior or premolar tooth
- Last CASE: Must be a COMPETENCY (Mock
board examination plastic teeth
What counts for the two endo recalls you must do?
- Any RCT done at UMKC yours or other including advanced endo
- Should be about 6 mos. Since completion or last check
- Do Clinical Testing and Record results and patient’s concerns
- 1-2 Radiographs = No Charge
- Must be checked by Endo faculty. Complete the recall on Axium and print out sheet for credit
What counts for the two assists in grad endo you must do?
- Go to Advanced Endo Clinic and volunteer to assist and observe for 2 half days
- Best to do this early in your 3rd year
- You will receive a time unit credit/ 1.0 day be sure to get Signed Card & take to the clinical dean’s office
It is mandatory to assist in the predoc clinic ___ weeks before rendering treatment to your first patient
two
What are the trial (mock) boards for endo?
- Trial Boards requested by students as preparation for the CDCA-WREB-CITA Exam.
- TRIAL BOARD is FORMAL & is designed to be as much like the actual Exam as we can make it. You may not bring “cheat sheets”, images, or anything other than the test materials, your Zip-Lock Bag, and the Candidate Manual.
- GET YOUR CANDIDATE MANUAL ASAP and START READING IT ALL -CAREFULLY. REMEMBER THIS IS YOUR COMPETENCY. TREAT IT AS SUCH
- You will be expected to know the protocol and follow it religiously for TRIAL and Dental board. You will do mounted sextants and manikins with heads. You will be graded as on CDCA-WREB-CITA and those NOT prepared will likely FAIL. Don’t let it happen –be prepared
What is the general protocal for clinicians?
PROTECT:
- Patient, Yourself, Staff:
- Med. And Dental HX
- Vital Signs & Meds.
- Other Med testing or consultations p.r.n.
- CC (Chief Complaint)
- Expectations/Desires & Attitude of patient
INSPECT:
- Problem Focused Exam:
— Inspection
— Clinical Testing
— Radiographs
— Other
- Documentall findings. A Separate DX Form for each tooth in Area O.S.
COLLECT:
- Exam, Testing and Radiographic Studies, Perio and Restorability
- ENGAGE BRAIN
- Try to Prove or Disprove etiology of C.C.
SELECT:
- The MOST APPROPRIATE DX & TX PLAN which explains the CC and symptoms IN CONCERT with the Exams and Testing results.
- CAN YOU deliver the appropriate TX?
What are the issues commonly seen in clinic to be mastered as a clinician in practice?
- consultation
- clinical testing and diagnostic radiographs
- DX and Case selection
- isolation via rubber dam
- temporary restoration
- patient handling, protocol, and records
- documentation
- time management
- procedures and incidents
How do you need to be prepared for an endo consultation at the school?
- Complete MEDICAL & DENTAL HX
- Complete & Documented Clinical Exam and Testing
- Complete Diagnostic Radiographs (New if new restoration)
- Complete Diagnostic Forms in AxiUm (one for EACH tooth)
- Complete Restorability and Consult Forms
- Complete Periodontal Consult (if needed)
- Be ready with your Tentative DX and prepare to defend
- Be prepared to perform additional testing or repeat
What forms are required for an endo consult?
- one DX Form including other teeth in the quadrant
- a Consult Form and restorability form for each tooth requiring an endo consult
If current x-rays are…
- incomplete or inadequate
- more than 6 months old
- any Tx, restorations done since
what should you do?
take 2-3 new radiographs
When should you not ask for an endo consult?
ANY TIME YOU HAVE NOT COMPLETED THE REQUIREMENTS which are listed on the previous slide
When do you need an endo consult?
- patient is in pain
- previous RCT therapy w/wo symptoms and PARL that needs retreat
- symptomatic teeth, radiographic pathologic findings, need for RCT due to prosthetic reasons
- create post-space before a perforation occurs
How do you obtain an endo consult?
ONE & ONLY WAY HAVE YOUR TEAM CLERK CALL THE PAGER
- ENDODONTIST will appear at your UNIT ASAP for the CONSULT
- The Person on the BEEPER will perform NO TREATMENT
What is the procedure to follow if a pulp exposure happens?
- Insure Dental Dam is in place and tooth is well isolated.
- Remove ALLremaining Caries.
- Irrigate with 8.3% NaOClto gain hemostasis & to reduce microbial contamination.
- Place dycal over exposure and place a good temporary restoration.
- Take 2-3 radiographs of post-restoration tooth
Don’t PANIC!
If you TESTED tooth BEFORE starting procedure &
found it asymptomatic and vital
If you have a pulp exposure how do you alert endo?
- Contact Dr. Weisleder via Email: Only write the patient’s name and chart number in the body of the email. No need for explanations.
- We will review the chart, radiographs, diagnosis forms and consult. If any of these elements are are missing, we will e mail you back!!!
- Get the patient referred and Scheduled to the appropriate clinic
It is the responsibility of the Student Doctor to arrive at a tentative ___________________ (from clinical tests/radiographs) before presenting a case to his or her instructor – including residents & dental faculty at consultation and treatment planning
PULPAL, P/A and PERIODONTAL DX
What do we expect for P/A radiographs?
– All radiographs sharp and properly oriented and showing at least 2mm beyond apices
– Quality is of outmost importance! Clear, no patient movement, well angled.
– No more than 2 months old. If any tx has been done lately, you need a new radiograph.
A minimum of ___ PA radiographs are required
2
- straight-on
- angled (shift-shot)
Why do you need a bitewing radiograph for endo?
– Determine restorability
– True level of bon
What procedural incidents should be avoided?
– SEPARATED INSTRUMENTS
– PERFORATION OF ROOTS
– NaOCl ACCIDENT
– UNPROFESSIONAL TREATMENT OF PATIENT
An OFFICIAL ________________ is REQUIRED from you and the faculty overseeing No LATER THAN 24 Hours after the Incident to be on Chair’s Desk and recorded in students grades.
INCIDENT REPORT
What is the procedure for an endo recall?
- Fill out the form on Axium
- Do sensibility testing: Percussion, palpation mainly
- Take two radiographs: Straight on and a shift shot (unless anterior)
- Call the pager to get an Endo faculty
UMKC endo has 4 basic jobs…
- To offer basic guidance in EXAMINATION & TESTING leading to an ACCURATE DIAGNOSIS
- To present ONE BASIC TECHNIQUE of NS Endodontic Treatment for NON-COMPLICATED RCT CASES
- To equip you to recognize and treat non-complicated endodontic cases in a CLINICAL SITUATION
- To give you the basic criteria to determine when REFERRAL is in the BEST INTEREST of the PATIENT
