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5th ICP - Endo > Endodontic Tx Planning > Flashcards

Endodontic Tx Planning Flashcards

(54 cards)

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1
Q

What are some indications for endodontic treatment?

A 
Irreversible pulpitis
Periapical pathology
Post retained restorations
Overdenture
Teeth doubtful pulp
Periodontal disease 
Pulp sclerosis following trauma
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2
Q

What history would you get from pt with irreversible pulpits?

A

Lingering pain
Spontaneous pain
Keep away

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3
Q

What clinic signs would indicate periapical pathology?

A

Exaggerated response sensibility testing

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4
Q

What diagnosis would you give if there was periapical pathology?

A

Symptomatic or asymptomatic apical periodontitis

OR acute/ chronic apical abscess

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5
Q

What is needed to reach diagnosis?

A

Pt hx
Clinical exam
Radiograph

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6
Q

When are post used to retain restorations?

A

When too much tooth structure has been lost and is needed to retain indirect restoration

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7
Q

What is the issue by placing posts to retain restorations?

A

Can lose vitality?

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8
Q

How much structure is needed to retain restoration?

A

4-5mm - can be made from composite core

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9
Q

What is issue w/ compostite core?

A

May not withstand lateral forces of occlusion

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10
Q

How does an over denture work?

A

Teeth decoronated to provide support as over denture abutment - need to be endo tx

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11
Q

When can teeth under overdenture not be endo tx?

A

If canals are highly sclerosed with no periapical pathology - still need to warn risk of loss vitality

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12
Q

What do pt need if having over denture?

A

Good OHI, diet and motivation

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13
Q

What instance would periodontal disease indicated endo?

A

When there is a perio-endo lesion

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14
Q

What tx can be provided with perio-endo lesion?

A

Sometime do root resection - root need to be endo prior resection

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15
Q

What happens to a tooth after trauma when they remain vital?

A

respond to trauma by laying down secondary dentine resulting in narrowing of pulp space

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16
Q

Is trauma an indicated for endo?

A

No - scelrosis/ narrowing pulp chamber is not indication

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17
Q

What is the reliable tx if pt has trauma and tooth has discoloured?

A

Endodontic treatment followed internal bleaching - warn pt can take long time

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18
Q

What are the general contraindications for endo?

A

Inadequate access
Poor OH
General medical condition

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19
Q

What are local contraindications for endo?

A 
Tooth not restorable
Insufficient periodontal support
Non-strategic tooth
Root fracture
Root resorption 
Anatomy
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20
Q

What cases by inadequate access by an issue?

A

Pt limited mouth opening
Microstomia
TMD
Previous overeruption

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21
Q

What is general rule to see is adequate opening?

A

Should be able to fit 2 fingers between incisors

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22
Q

Is there any medical specific contraindications to endo?

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A

No but pt but be well enough to undergo multiple long appointments

23
Q

Why are older people more difficult to provide endo?

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A

Scelrosis of canals

24
Q

How determine if tooth is restorable?

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A

Finishing line of restoration MUST be supracrestal and ideally supra gingival

25
Can mobile teeth be endo tx?
If grade 1 mobile potentially definitely not 2+
26
When may teeth be mobile but suitable for endo?
If significance PA infection w/ loss bony tissue at apex may become mobile - hopefully resolve with RCT
27
What is a non-strategic tooth?
One which is unopposed and non-functional
28
Why may non-strategic tooth be suitable for endo?
Used as distal abutment for a partial denture
29
What root features have poor prognosis?
Sub-crestal and vertical fractures
30
What are clinical signs of root fracutre?
Isolated, narrow or deep periodontal pocket
31
What are radiographic signs of root fracture?
J shaped radiolucency or displacement of fragment
32
What are types of root fracture?
Internal and external
33
What are sub-categories of external fractures?
External cervical resorption | External replacement resorption
34
What causes external cervical root resorption?
Aetiology unknown but may be associated with trauma
35
Where does external cervical root resorption start?
Subgingivally at cervical region
36
Is external cervical root resorption symptomatic if not why?
Often asymptomatic | Pulp is vital and only becomes involved when lesion progressed extensively
37
How diagnose external cervical root resorption?
Clinical and radiographic findings | CBCT may be useful to assess extend lesion
38
How manage external cervical resorption?
Specialist treatment, referral instigated as soon as diagnosis suspected
39
What is external replacement resorption?
Where the root surface is gradually replaced with bone - ankylosis
40
Aetiology of external replacement resorption?
Often trauma
41
How diagnosis external replacement resorption?
High-pitch sound on percussion
42
How diagnosis external replacement resorption on children?
Tooth will be non-mobile and become infra-occluded
43
How treat external replacement resorption?
RCT won't stop process therefore not indicated | No tx will stop ankylosis
44
Where does internal root resorption take place?
Entirely in canal system
45
What is the classic appearance of internal resorption?
Ovoid expansion of tooth canal - inside --> out | Outline of canal will be lost
46
What see in internal resorption if lesion is close to crown of tooth?
Pink spot lesion
47
Is internal resorption symptomatic?
If current pulp usually partially vital so may have pulpits symptoms as often chronically inflamed
48
Tx of internal resoprton?
Endo, obturation can be difficult due to anatomy caused resorption
49
What type of obturation is required for internal resorption?
Thermal obturation
50
What is the effect of radiotherapy on bone tissue?
Reduced valuation - end arteritis obliterates
51
What are bisphosphoantes?
Osteoclast inhibitor - inhibit bone resorption
52
Why are those radiotherapy on bisphosphoantes better suited RCT > XLA?
Increased risk of osteoradionecrosis/ medication related osteonecrosis - therefore may try endo tx teeth usually be contraindicated
53
What is success rate of endo?
80-90%
54
Why not provide implants > RCT?
Implant not an alternative for endo - should only be considered to replace a missing tooth once it has failed/ deemed unrestorable

5th ICP - Endo (7 decks)

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