Endo Surgery

Question 1

A surgical opening created in soft tissue for the purpose of releasing purulent or hemorrhagic exudate.

Answer 1

Incision and Drainage

Question 2

Done to provide relief of pressure.

Answer 2

Incision and Drainage

Question 3

Done when you can’t drain through the tooth.

Answer 3

Incision and drainage

Question 4

Don’t do this with anesthesia in incision and drainage.

Answer 4

Inject directly into the swelling.

Instead do a block, or infiltrate anterior and posterior to the swelling.

Question 5

Surgical retreatment is AKA this.

Answer 5

Periapical surgery

Question 6

t/f:

Periapical surgery is performed AFTER non-surgical RCT when post-tx disease persists.

Answer 6

True

Question 7

The following are what?:

• Non-negotiable canals
• Complex anatomy
• Procedural errors
• Irretrievable canal obstructions (posts, etc).

Answer 7

Indications for periapical surgery.

Question 8

Surgical retreatment ________:

• Anatomic considerations (IAN, mental foramen, maxillary sinus, etc).
• med complications.
• Unidentified cause of failure

Answer 8

Contraindications

Question 9

Surgical retreatment procedure:

Answer 9

• Flap design (wide base contraindicated) and incision (parallel with blood vessels and collagen).
• Flap reflection and retraction.
• Osteotomy
• Apical curettage
• Root end resection (apicoectomy)
• Root-end preparation (retroprep).
• Root-end filling (retrofill)
• Flap decompression
• Suture flap

Question 10

This flap base is contraindicated in surgical retreatment.

Answer 10

Wide base

Question 11

Two types of flap design

Answer 11

1) Submarginal

2) Full mucoperiosteal (intrasulcular)

Question 12

Another name for submarginal flap

Answer 12

Ochsenbein-Luebke

Question 13

Which flap is this?

• Requires 4mm attached gingiva
• Scalloped incision parallels the free gingival margin
• Minimizes post-op gingival recession.
• Possible scarring

Answer 13

Submucosal (Ochsenbein) flap

Question 14

What flap is this?

• Intrasulcular horizontal incision
• Provides maximum visibility and access
• Possible gingival recession

Answer 14

Intrasulcular/full mucoperiosteal

Question 15

This removes inflamed tissue
Reduces hemorrhage
Provides visibility and access to apex
Provides a biopsy specimen

Answer 15

Apical curettage

Question 16

Surgical removal of the apical portion of the root.

Answer 16

Apicoectomy

Question 17

Use this bur to do an apicoectomy.

Answer 17

Tapered fissure

Question 18

How much root is removed in an apicoectomy?

Answer 18

3 mm

Question 19

Why remove 3 mm in apicoectomy?

Answer 19

Removes 98% of apical ramifications.

Removes 93% of lateral canals.

Question 20

What kind of bevel is placed in an apicoectomy?

Answer 20

0-10 degree bevel in the bucco-lingual plane

Question 21

Why a 0-10 degree bevel in an apicoectomy?

Answer 21

Parallels the dentinal tubules so there’s less open for bacteria to escape (apical leakage).

Question 22

A cavity created to receive a root-end filling during periradicular surgery or intentional replantation.

Answer 22

Retroprep (root-end filling)

Question 23

Ultrasonic tips are used to make a 3 mm Class I prep in the canal

Answer 23

Retroprep

Question 24

Materials used for retrofill

Answer 24

MTA and SuperEBA

Question 25

Only this retrofill material allows for regeneration of periradicular tissues.

Answer 25

MTA

Question 26

Restorative material placed in the root-end preparation during periradicular surgery to enhance the seal of the root canal where orthograde obturatio hasbeen not great.

Answer 26

Retrofill

Question 27

Monofilament suture preferred for periapical surgery?

Answer 27

Monofilament= reduces wicking PTFE

Question 28

Where do you NOT tie the knot for the suture?

Answer 28

On the incision line

Question 29

Initial success rates are higher for surgical or non-surgical?

Answer 29

Surgical

Question 30

T/F: With time, the non-surgical success rates roughly equate surgical.

Answer 30

True

Question 31

Slower healing in ___________; Late failures in ______________.

Answer 31

Non-surgical; Surgical

Question 32

Surgical removal of all of the root and ahderent soft tissues, leaving the crown of the tooth intact and supported by the remaining roots.

Answer 32

Root amputation

Question 33

Indicated when one root has severe PD, is untreatable thru RCT, or fractured.

Answer 33

Root amputation

Question 34

Most commonly amputated root.

Answer 34

DB of maxillary molar

Question 35

Surgical division of a multirooted tooth thru the furcation that involves removing the defective or periodontally involved root and crown portion.

Answer 35

Hemisection

Question 36

How are mandibular molars hemisected?

Answer 36

BL

Question 37

How are maxillary molars hemisected?

Answer 37

MD

Question 38

Surgical division of a mandibular molar through the furcation in which both halves are retained and restored.

Answer 38

Bicuspidization

Question 39

Indicated when there's severe furcation involvement in periodontal disease, or severe furcation perforation.

Answer 39

Bicuspidization