Endodontic Guidelines

Question 1

What are the endododntic guidelines?

Answer 1

AEE
BSE
ESE

Question 2

What are the diff dx?

Answer 2

Normal pulpal tissue

Reversible Pulpitis

Symptomatic Irrever pulp

Asymptomatic Irrever Pulp

Pulp necrosis

Pre-Tx

Prev initiated tx

Normal apical tissues

Symptomatic apical periodontitis

Asymptomatic apical periodonitits

Acute apical abscess

Chronic apical abscess

Condensing osteitis

Question 3

What is dentine hypersensitivity?

Answer 3

This is where there is exposed dentinal tubules resulting in pulpal hyperalgesia - lasts few seoncda after stimulus removed (no more than this) and is never spontaneous

Question 4

How do we manage dentine hypersensitivity?

Answer 4

DBA
Fluoride varnish
Diet and OH

Question 5

What is cracked tooth syndrome?

Answer 5

This is where pt has sharp pain on bite or dull ache on release of bite

Question 6

How do we dx cracked tooth syndrome?

Answer 6

Tooth sleuth
Percussion testing
Pocket assessment
Transillumination
Occlusal assessment
Sensibility test

Question 7

What is gold standard in posterior teeth with lost cusp?

Answer 7

cuspal coverage –> dissipates forces, provides seal

Question 8

What is a gold standard PA?

Answer 8

Has the tooth in q
Cusp to apex +3mm bone apically
free from any artefacts

Question 9

What do we known about cusp coverage v direct restoration in endo tx tooth?

Answer 9

Cuspal coverage 6x increased lchange of success than direct resto

Question 10

What are success rates of primary RCT?

Answer 10

85-90%

Question 11

What are success rates of re-RCt

Answer 11

80% success rate 2-4 years post original RCT

Question 12

Risks of endo?

Answer 12

Pain, bleeding, swelling, infection
RCT failure requiring future tx
Perforation
Fracture
Sodium hypochlorite accident

Question 13

What do we use for irrigation in endo?

Answer 13

Sodium hypochlorite - 3% = bactericidal

EDTA - 17% = removes smear layer

Question 14

How do we assess success of endo?

Answer 14

Apical fill - is GP within 2mm of apex

Is obturation well tapered, well condensed?

Is GP at ACJ

Are there any overhangs

Question 15

xWhat are the outcomes at endo follow up?

Answer 15

Favourable - absence of symptoms, PA tissue healed, PDL noramal, no follow up

Unceratin = PA pathology remains or smaller in size, evidence of some healing, no symptoms, continue to follow up yearly for 4 years unless symptomatic

Unfavourable = pt symptomatic or after 5 years not healed

Question 16

Indications for surgical endo? retrograde?

Answer 16

Extruded apical mateial
Persisting pathology following RCT and re-RCT not appropriate
Perforation
Apical pathology accessed coronary