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BDS 3 Sem 2 > Endo > Flashcards

Endo Flashcards

1
Q

What is endodontology?

A

It is a study that is concerned with the study of the form, function and health of, injuries to and diseases of the pulp and periradicular region, their prevention and treatment: the principle disease being apical periodontitis, caused by infection

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2
Q

What are the basic outcomes of endodontic treatment?

A
  1. Maintain the health of all or part of the dental pulp
  2. Preserve the normal periradicular tissues
  3. Restore the periradicular tissues health
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3
Q

What is the most common cause of endodontic problems?

A
  1. Caries
  2. Trauma
  3. Others
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4
Q

What is tertiary dentine?

A

Tertiary dentine represents the more or less irregular dentine formed focally in response to noxious stimuli such as tooth wear, dental caries, cavity preparation and restorative procedures.

It is also known as reactionary dentine or reparative dentine - depending on the type of stimulus.

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5
Q

What is reactionary dentine?

A

Reactionary dentine is defined as a tertiary dntine matrix secreted by surviving postmitotic odontiblast cells in response to an appropriate stimulus, Typically, such a response will be made to milder stimuli and represents up-regulation of the secretoy activity of the existing odontoblat responsible for primary dentine secretion.

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6
Q

What stimulates tertiary dentine formation?

A

Angiogenic growth factors stimulate tertiary dentine formation.

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7
Q

How can you describe dentine according to Dr. Rossi?

A

Dentine is like Swiss cheese - it is pour-us - the closer you are to the pulp the bigger the holes.

The permeability properties of dentine regulate the rate of diffusion of irritants that initiate pulpal inflammation.

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8
Q

What are the indication of indirect pulp capping?

A
  1. Deep lesions likely to result in pulp exposure
  2. No history of subjective pretreatment symptoms such as spontaneous pain or provoked pulpal pain
  3. Pulp should test vital
  4. Pre-treatment radiographs should exclude apical pathosis
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9
Q

What are some of cumulative damages that can occur during a routine filling procedure that effect the pulp?

A
  1. Damage from LA
  2. Damage from drilling/preparation
  3. Damage from the filling material
  4. Damage from an incompetent filling

ANYTHING THAT INCREASES BACTERIA IN THE PULP

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10
Q

What are the three treatments for endodontic problems?

A
  1. Extraction
  2. Root canal treatment
  3. Vital pulp therapy
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11
Q

What are the requirements for successful vital pulp therapy?

A
  1. Pulp is not inflamed
  2. Haemorrhage is controlled
  3. Non-toxic caping material is applied
  4. Good seal provided by capping material and restoration to prevent influx of bacteria - MOST CRITICAL FACTOR
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12
Q

What material is used in vital pulp therapy?

A

MTA or Calcium Hydroxide but MTA is better

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13
Q

What are the three different types of vital pulp therapy?

A
  1. Direct pulp capping - no pulp is removed as pulp is not inflamed during mechanical pulp exposure
  2. Partial pulpotomy - a little pulp removal to stop the bleeding in inflamed pulps
  3. Full pulpotomy - removal of the entire pulp in the pulp chamber
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14
Q

How often do you wanna recall your patient after vital pulp therapy?

A

1, 3, 6 and 12 months

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15
Q

What is apexogenesis?

A

It is a process of creating an environment for the pulp to allow to continue the formation of the root. Don’t kill the pulp in an immature pulp because it will allow the root to grow to a certain extent. Thus, calcium hydroxite is perfect.

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16
Q

What is endodontics?

A

Endodontics is the branch of dentistry that deals with the morphology, physiology and pathology of the dental pulp and the periradicular tissues.

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17
Q

How to write a diagnosis for endodontic diagnosis?

A
  1. Pulpal and root canal condition - aka irreversible pulpitis, necrotic pulp, reversible pulpitis
  2. Periapical status - clear periapical radiolucency with a corresponding draining sinus or no periapical radiolucency
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18
Q

What factors should you consider before endodontic treatment?

A
  1. Strategic value of the tooth
  2. Periodontic factors
  3. Patient factors - MHx, age, compliance
  4. Restorability options - consider oral hygine - and consider teeth that are not restorable
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19
Q

What system is used for case selection in endodontics?

A

American Association of Endodontists Endodontic Case Difficulty Assessment Guidlines

The following considerations are used:

  1. Patient considerations
  2. Diagnostic & treatment considerations
  3. Other considerations

Tally the numbers:
1. Easy - less than 20
2. Moderate - 20-40
3. Hard (refer) - above 40

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20
Q

When accessing a tooth - what is a good guide for access cavity location?

A

A good guide - bitewings!

They will show you that the pulp chamber is situated in the middle thus by drilling in the middle of the tooth - less tooth structure is destroyed comparing to the traditional shape outline method. Remember - long axis of the tooth is an important guide

Remember - traditional shape method does not consider a lot of factors such as the shape of the tooth, caries condition and restorations.

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21
Q

What is the objective of initial access?

A

Just to reach the roof of the pulp chamber.

If you do not sense the “pin drop” of the bur - stop and re-assess - you don’t want a perforation

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22
Q

What bur should you do after initial access?

A

A non end-cutting bur in order to extend the pulp chamber access without removing extra tooth structure from the pulpal floor.

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23
Q

How many canal does upper first premolar have?

A

2 usually

24
Q

How many canals does upper first and second molar have?

A

Usually 4 - remember MB2

25
Q

What is the purpose of an endoprobe?

A

Endoprobe is used to assist in identification of root canals

26
Q

What is a good radiographic hint pointing that a lower incisor might have 2 different canals?

A

If in the radiograph - pulp chamber suddenly thins out or becomes smaller (suddenly) - that means that the tooth might have 2 canals

27
Q

What is the aim of chemo-mechanical debridement?

A

Aim is to gradually increase the size of the canal to allow for adequate penetration of irrigants/medicaments and to facilitate obturation

28
Q

What are the types of irrigants used in chemo-mechanical debridement?

A
  1. EDTAC - 15% commonly used as a removal of smear later and to increase permeability of dentinal tubules
  2. Sodium hypochlorite - 1% commonly used, dissolves organic matter - DANGEROUS
29
Q
A
30
Q
A
31
Q
A
32
Q
A
33
Q

What is a good way to ensure you dont push sodium hypochloride through the root apex?

A

Bend the needle but not at the hub and measure it - so it is far from the apex!!!!

34
Q

What are the number on the file represent?

A

The diameter of the file

35
Q

Why files need to be curved?

A

Real canals are never straight - a curved file means it follows the natural anatomy of the file.

36
Q

What bur can be used for coronal preparation?

A

Gates-Glidden burs - they are used coronaly in order to make the canal access easier

You distinguish them by number of slots - 2 slots is size 2, 3 slots is size 3

37
Q

How do you determine root canal lengths?

A
  1. Know average lengths
  2. Measure from pre-operative radiographs
  • Estimate working length
  1. Use electronic apex locator
  2. Confirm with radiograph
  • Correct working length established
38
Q

How to use dentaport ZX?

A
  1. Moisture in canals but not too much
  2. Attach the lip clip
  3. Attach the file clip
  4. Advanced the file until the read is “Past apex” withc careful watch-winding movement
  5. Come back to “Apex” reading
  6. Measure the file
39
Q

What is important for file size increase?

A
  1. First - make sure that the smaller file goes to length and is LOOSE - remember circumventional filing (going on all border of the root canal)
  2. Irrigate
  3. GO to next file
40
Q

What is the master apical file?

A

It is the largest file that goes to the correct working length

41
Q

Why going above a size 25 may complicate thing during root canal preparation?

A

Files above size 25 may be too stiff and create iotriogenic errors due to it’s straightness.

Ledges might form or strip perfirations.

42
Q

Why is ledermix bad?

A

It stains teeth because it is a tetracyclin derivative

43
Q

What material would you use in routine endodontics?

A

Calcium hydroxide

44
Q

What naterial would you use in irreversible pulpitis?

A

Odontopaste if you can not complete debridement to length at that appoitment

45
Q

What is the aim for interim restoration?

A
  1. To prevent bacterial ingress
  2. Maintain function of the tooth
46
Q

What material are available for interim restorations?

A
  1. Cavit for initial layer
  2. GIC/RMGIC on top
47
Q

What are the reasons for obturation?

A
  1. Remove remaining bacteria
  2. Stop nutrients from apical tissues getting into root canal system
  3. Stop bacterial from coronal aspect getting into root canal
48
Q

What is the objective of a lateral spreader?

A

To condense the master GP and create space for accessory GPs - it has one end unlike endo probe

49
Q

What is the most common root canal sealer?

A

AH Plus

50
Q

What is the objective of an endodontic plugger?

A

It has a stopper to go to appropriate length - it is used to heat the GP point and burn them off

51
Q

What is working length?

A

It is the distance from a coronal reference point to the point at which canal preparation and obturation should terminate.

52
Q

What are some of the complication could occur if the correct working length is not calculated?

A
  1. Iatrogenic perforation
  2. Patency at apical terminus
  3. Extrusion of root fillings
53
Q

What are some of the technique that can be used to determine working length?

A
  1. Software
  2. Radiographic
  3. Electronic
  4. Paper point
54
Q

Why is the desired working length is 1-2 mm away from radiographic apex?

A

Because we looking at a 2D representation of a 3D object and the natural anatomy of the root may have a curvature thus if the working length taken for the entirety of root length - it may create a perforation

55
Q

What is the rule of tube shift in endodontics?

A

SLOB - (Same lingual opposite buccal) - usually the tube shift goes lingual

56
Q
A

BDS 3 Sem 2 (16 decks)

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