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BDS Finals > Endodontics > Flashcards

Endodontics Flashcards

1
Q

Maxillary incisor access cavity

A

Triangular

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2
Q

Mandibular anterior access cavity

A

Ovoid

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3
Q

Maxillary molar access cavity

A

Trapezoid - mesial

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4
Q

Mandibular molar access cavity

A

Trapezoid - central

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5
Q

Sclerotic Canal

A

Calcification in the root canal system

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6
Q

What helps a sclerotic canal

A

EDTA chelating agent 17%

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7
Q

Which material is used in the canal between visits

A

Non setting calcium hydroxide

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8
Q

Pulpal Diagnoses (7)

A
  1. Normal pulp
  2. Reversible pulpitis
  3. Symptomatic irreversible pulpitis
  4. Asymptomatic irreversible pulpitis
  5. Pulpal necrosis
  6. Previously treated
  7. Previously untreated
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9
Q

Problems with sensibility testing multi rooted teeth

A

1 canal could be necroded while the others are fine

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10
Q

Temperature of ethyl chloride

A

-50

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11
Q

Temperature of frozen carbon dioxide

A

-78

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12
Q

EPT

A

Electric Pulp Test

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13
Q

Electric Pulp Test (2)

A
  1. Electric current used to stimulate A delta fibres
  2. Negative response reliable indicator
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14
Q

Issues with EPT (3)

A
  1. No indication of reversibility of inflammation
  2. No correlation between threshold and pulp condition
  3. Immature apices unreliable
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15
Q

Apical Diagnoses (6)

A
  1. Normal
  2. Symptomatic apical periodontitis
  3. Asymptomatic apical periodontitis
  4. Chronic apical abscess
  5. Acute apical abscess
  6. Condensing osteitis
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16
Q

Cells found in the pulp

A

Odontoblasts

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17
Q

What do odontoblasts generate

A

Tertiary dentine

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18
Q

RDT

A

Remaining Dentine Thickness

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19
Q

Dentine permeability and cavity depth

A

The deeper the cavity the greater the dentine permeability

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20
Q

Condensing osteitis (2)

A
  1. Diffuse radiopaque lesion
  2. Localised bony reaction to low grade inflammation
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21
Q

Temperature of endo ice

A

-27.2

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22
Q

Periodontitis impact on pulp

A

Prematurely ages pulp

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23
Q

Pulp ability to respond to inflammation with age

A

Less resistant to inflammation as age increases

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24
Q

Sodium Hypochlorite properties (4)

A
  1. Antimicrobial
  2. Dissolves pulp remnants and collagen
  3. Dissolves necrotic and vital tissue
  4. Disrupts smear layer
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25
Q

Concentration of sodium hypochlorite

A

0.5 - 5.25%

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26
Q

Problems with sodium hypochlorite (3)

A
  1. Possible effect on dentine properties
  2. Inability to remove smell layer by itself
  3. Effect on organic material
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27
Q

Sodium hypochlorite complications (4)

A
  1. Discolouration of fabrics
  2. Eye injury if contact
  3. Apical extrusion leading to tissue necrosis
  4. Allergic reactions
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28
Q

Antifungal activity of chlorhexidine

A

Less than NaOCl

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29
Q

Chlorhexidine impact on biofilms

A

Unable to disrupt biofilms but somewhat active against them

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30
Q

Chlorhexidine absorption

A

Prevents microbial colonisation for time beyond time of application

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31
Q

Can canal irritants be used at the same time

A

No

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32
Q

Order of canal irrigation after instrumentation (3)

A
  1. NaOCl 30ml (at least 10 mins pre obturate)
  2. EDTA 1 min
  3. NaOCl final rinse
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33
Q

Endodontics during pregnancy (3)

A
  1. Not a contraindication
  2. First trimester emergency only
  3. Pain/infection managed alongside obstetrician
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34
Q

Endodontics and CV disease (3)

A
  1. Myocardial infarction within 6 months - contraindication
  2. Emergency tx provided w/consultation from cardiologist
  3. Minimise stress
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35
Q

Endodontics and cancer (2)

A
  1. Chemo and radiotherapy can compromise healing
  2. Consult oncologist
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36
Q

Endodontics and diabetes (4)

A
  1. Pts carefully monitored
  2. Appointments don’t interfere with normal insulin/meal schedule
  3. Minmise stress
  4. Higher rate of RCT failure
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37
Q

Endodontics and Bisphosphonates (2)

A
  1. Non-surgical endo preferential to extraction
  2. Use entire health care team when developing tx plan
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38
Q

Endo - restorative considerations for restorability (4)

A
  1. Sub-osseous caries
  2. Poor crown/root ratio
  3. Misalignment of teeth
  4. Pre-existing full coverage restorations
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39
Q

Why should front surface mirrors be used

A

Rear surface mirrors increase distortion

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40
Q

Internal resorption radiographic appearance

A

Continuous with the canal

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41
Q

External resorption radiographic appearance

A

Appears superimposed on canal

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42
Q

Alternatives to non-surgical endodontic tx for difficult cases (3)

A
  1. Extraction
  2. Orthograde root canal treatment
  3. Surgical endodontics
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43
Q

How to assess endodontic case difficulty

A

AAE Endodontic Case Difficulty Assessment Form

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44
Q

Why is protaper used for re root treatment

A

Active tip allows initial penetration into material

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45
Q

Protaper D1

A

Coronal filling removal

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46
Q

Protaper D2

A

Middle filling removal

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47
Q

Protaper D3

A

Apical filling removal

48
Q

Protaper speed for retreatment (2)

A

Slowest speed that engages obturation material
500-700rpm

49
Q

How far away from the apex should you stop for retreatment

A

2-3mm

50
Q

How can you bypass ledges in endo

A

Pre curved C+ files

51
Q

Solvent for gutta percha removal (2)

A
  1. Chloroform
  2. Eucalyptus oil
52
Q

Assessment of endodontic tx (5)

A
  1. 1 year later
  2. Absence of pain, swelling etc.
  3. No sinus tract
  4. No loss of function
  5. Radiological evidence of normal PDL
53
Q

Irregularly mineralised tissue on post endodontic assessment (3)

A

Scar tissue
Not necessarily persisting apical periodontitis
Continue to monitor

54
Q

Types of success - endo (2)

A

Technical success
Biological success

55
Q

Operative factors contributing to endodontic success (4)

A
  1. Filling extended to within 2mm of radiographic apex
  2. Not extruded
  3. Well condensed root filling with no voids
  4. Good quality coronal restoration
56
Q

Law of centrality

A

Pulp chamber always in the middle
If 1 canal - in the middle
If canal off to one side - more canals

57
Q

Colour of pulp chamber floor

A

Always darker than the walls

58
Q

Where do canal orifices lie

A

At the junction of the walls and the floor

59
Q

What should be established before retreatment - endo

A

Cause of the failure

60
Q

PRD

A

Periradicular Disease

61
Q

Purpose of intra-canal medicaments (3)

A
  1. Destry microorganisms and prevent reinfection
  2. Reduce inflammation and exudate
  3. Control of root resorption
62
Q

Anti-microbial paste - endo (3)

A
  1. Mix of corticosteroid and tetracycline
  2. Used in management of hot pulps to reduce inflammation
  3. Effective for 5-7 days
63
Q

Non-setting calcium hydroxide (2)

A
  1. High pH contributes to antibacterial activity
  2. Prolonged antibacterial activity
64
Q

pH of non-setting calcium hydroxide

A

12.5

65
Q

How to use non-setting calcium hydroxide

A

Fill canal completely with disposable syringe tip

66
Q

Design objectives for RCT (3)

A
  1. Create a continuously tapering funnel shape
  2. Maintain apical foramen in original position
  3. Keep apical opening as small as possible
67
Q

Bur that has cutting sides but will not cut any deeper

A

Endo Z bur

68
Q

Hand file motions (4)

A
  1. Filing
  2. Reaming
  3. Watch-winding
  4. Balanced force
69
Q

Describe watch winding

A

Back and forward oscillation of 30-60 degrees with light apical pressure

70
Q

Describe balanced force (3)

A

1/4 turn clockwise
With continued pressure turn 1/2 turn counterclockwise
Do this 1-3 times then irrigate and repeat

71
Q

Syringe used for endo

A

Luer lock syringe

72
Q

Reason for early coronal flare (3)

A
  1. Avoids hydrostatic pressure in canal
  2. Removal of heavily contaminated contents
  3. Improved straight line access to apical 1/3
73
Q

Distance between apical constriction and radiographic apex

A

Greater in older teeth with secondary cementum

74
Q

Paper point working length determination

A

If the point touches blood or tissue fluid it will be red

75
Q

Gauging

A

Passive exploration

76
Q

How long does AH plus take to set

A

8 hours

77
Q

Purpose of obturation (4)

A
  1. Prevent microorganisms from reentering
  2. Block apical foramina
  3. Block dentinal tubules
  4. Block accessory canals
78
Q

Main obturation technique

A

Cold lateral compaction

79
Q

Other obturation techniques (3)

A
  1. Warm vertical compaction
  2. Continuous wave obturation
  3. Carrier based obturation
80
Q

RCT Sealer function (3)

A
  1. Seals space
  2. Fills voids
  3. Lubrication
81
Q

Root Resorption Definition

A

Non-bacterial destruction of the dental hard and soft tissue due to interaction of clastic cells

82
Q

What makes RANKL good at root resorption (3)

A
  1. Very motile
  2. Ruffled border
  3. In contact with dentine
83
Q

Molecules involved in root resorption (2)

A
  1. RANKL
  2. OPG
84
Q

What does OPG do to RANKL

A

Inhibits it

85
Q

RANKL stimulation (3)

A
  1. PTH, B3 and interleukin
  2. Trauma
  3. Chronic inflammation
86
Q

Largest protective element from root resorption from osteoclasts

A

Periodontal ligament

87
Q

Types of internal root resorption (2)

A
  1. Inflammatory
  2. Replacement
88
Q

Types of external root resorption (4)

A
  1. Inflammatory
  2. Replacement
  3. Cervical
  4. Surface
89
Q

How to differentiate internal/external root resorption

A

Internal resorption - lines of canal widen
External resorption - still see parallel lines of canal

90
Q

Internal Inflammatory root resorption signs (4)

A
  1. Can be unrestored
  2. +ve response to sensitivity testing
  3. Can have pocketing if lesions perforated
  4. Can have sinus if PRD
91
Q

Will internal resorption change position with parallax

A

No

92
Q

Pathogenesis of internal inflammatory root resorption (3)

A
  1. Coronal pulp necrotic
  2. Apical pulp vital
  3. Will continue to progress until apical pulp goes non vital
93
Q

Internal inflammatory resorption treatment

A

Orthograde endodontics

94
Q

Internal replacement root resorption signs (2)

A
  1. Can be unrestored
  2. +ve to sensitivity testing
95
Q

Internal replacement root resorption radiographic signs

A

Pulp radiopaque

96
Q

Treatment for internal replacement root resorption (2)

A

Leave tooth until it becomes symptomatic
RCT difficult

97
Q

External surface resorption signs (3)

A
  1. Can be unrestored
  2. Increased mobility
  3. +ve to sensitivity testing
98
Q

Radiographic signs of external surface resorption (2)

A

PDL intact
Trabecular pattern where PDL used to be

99
Q

Tx for external surface resorption (3)

A

If middle of ortho - stop ortho
If post ortho - no tx
Splint mobile teeth

100
Q

Aetiology of external surface resorption (5)

A
  1. 90% of teeth have some form
  2. 1-5% severe ESR
  3. 15% moderate
  4. Usually teeth for anchorage worst affected
  5. Can happen idiopathically during growth
101
Q

What can cause external surface resorption (4)

A
  1. Ortho
  2. Ectopic teeth
  3. Pathological lesions
  4. Idiopathic
102
Q

External inflammatory resorption signs (3)

A
  1. Usually restored
  2. -ve response to sensitivity testing
  3. Possible sinus, swelling, TTP
103
Q

External inflammatory resorption radiographic signs (2)

A

Periapical radiolucency
Restoration close to pulp

104
Q

Aetiology of external inflammatory resorption

A

Pulp is necrotic and inflammation precipitates resorption process

105
Q

Tx for external inflammatory resorption

A

Remove cause of inflammation
Usually re endodontic treatment

106
Q

Signs of external replacement resorption (4)

A
  1. Can be restored but infraoccluded
  2. No TTP but high pitched note
  3. No mobility
  4. +ve to sensitivity testing
107
Q

Radiographic signs of external replacement resorption (2)

A
  1. No obvious PDL
  2. Pulp appears normal
108
Q

Aetiology of external root resorption (2)

A

Trauma
Osteoclasts comes into contact with root dentine

109
Q

Tx for external replacement resorption (2)

A
  1. Decoronation to prevent hard and soft tissue defect
  2. Allows bone to grow over root
110
Q

External cervical resorption signs (3)

A
  1. Can be unrestored
  2. Pink spot
  3. +ve to sensitivity testing
111
Q

External cervical resorption radiographic findings (3)

A
  1. Usually spares pulp (predentine)
  2. Apple core appearance
  3. CBCT useful for visualising
112
Q

External cervical resorption class 1 (2)

A
  1. Crestal
  2. 1/4 circumference
113
Q

External cervical resorption class 2 (2)

A
  1. Coronal 1/3
  2. 1/2 circumference
114
Q

External cervical resorption class 3 (2)

A
  1. Middle 1/3
  2. 3/4 circumference
115
Q

External cervical resorption class 4 (2)

A
  1. Apical 1/3
  2. More than 3/4 circumference
116
Q

External cervical resorption potential causes (5)

A
  1. Ortho
  2. Trauma
  3. Historical heated non-vital whitening
  4. viral infection
  5. Systemic - thyroid
117
Q

Tx options external cervical resorption (3)

A
  1. Monitor
  2. Extraction
  3. Internal repair and orthograde endodontics (less likely)

BDS Finals (23 decks)

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