Complications and Re-Treatment

Question 1

when to assess rct

Answer 1

1 year

Question 2

favourable signs following rct

Answer 2

absence pain, swelling, symptoms
no sinus tract
no loss of function
normal pdl

Question 3

unfavourable signs following rct

Answer 3

tooth associated w signs/symptoms
new radiolucency or old one increased in size
radiolucency same size/slightly diminished 4 years
continuing root resorption

Question 4

iatrogenic reasons for failure

Answer 4

ledge
perforation
poor length
poor seal
poor irrigation
failure to maintain patency

Question 5

biological reasons for failure

Answer 5

persistent infection
extra-radicular bacteria
cyst formation

Question 6

what options do you have if RCT tooth presents with symptoms etc

Answer 6

monitor
orthograde re-tx [infection, loss of coronal seal, new rest w poor rct]
periradicular surgery
xla

Question 7

how to remove GP

Answer 7

thermal, mechanical, chemical

files - hedstroem
solvents - eucalyptus oil [but plugs tubules, avoid if don’t need]
reciproc 25 - efficient, heat plug to soft coronal, solvent if needed, pecking and apical pressure

Question 8

GP removal procedure

Answer 8

• coronal 1/3 w US, GG, heat plunger
• mid 1/3 R25, slow pecking 3mm w light pressure, clean every 3 pecks
• continue till fully removed mid 1/3
• WL determination size 10/15
• complete apical 1/3 CWL R25
• enlarge apical if necessary w r40/50 or files [ensure patency first]

Question 9

what are the 2 laws of symmetry

Answer 9

1 - orifice equidistant from line m-d through pulp chamber
2 - orifice lie on perpendicular to line m-d direction across centre of pulp chamber floor

Question 10

what is the law of colour change

Answer 10

colour of pulp chamber is always darker than walls

Question 11

what are the 3 laws of orifice location

Answer 11

1 - orifice always @ junction of walls + floor
2 - orifices located @ angles of floor-wall junction
3 - orifices located @ terminus of root developmental fusion lines