Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

1 - BDS4 finals - big topics > Endodontics > Flashcards

Endodontics Flashcards

(84 cards)

Start Studying
1
Q

Normal pulp - define

A

pulp is symptom free and normally responsive to pulp testing
pulp may not be histologically normal
mild or transient response to thermal cold testing, lasting no more than 1 or 2 seconds after stimulus is removed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

reversible pulpitis - define

A

discomfort experienced when stimulus (such as cold or sweet foods) applied
- goes away within a couple seconds following removal of stimulus
no significant radiographic changes in periapical region of suspect tooth
should return to normal following appropriate management of aetiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

reversible pulpitis - common causes

A

caries
deep restorations
exposed dentine (dentinal sensitivity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

symptomatic irreversible pulpitis - define

A

vital inflamed pulp
incapable of healing
sharp pain upon thermal stimulus
- lingering for 30 seconds or more
spontaneous pain
referred pain
pain may be accentuated by postural changed e.g. lying down or bending over
over the counter medications typically ineffective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

symptomatic irreversible pulpitis - common causes

A

deep caries
extensive restorations
fractures exposing pulpal tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

asymptomatic irreversible pulpitis - define

A

vital inflamed pulp
- incapable of healing
no clinical symptoms
usually normal response to thermal testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

pulp necrosis - define

A

death of dental pulp
pulp non responsive to pulp testing and is asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

previously treated - define

A

tooth has been endodontically treated and the canals are obdurated with various filling materials
- tooth does not respond to thermal or electric pulp testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

previously initiated therapy - define

A

tooth has been previously treated by partial endodontic therapy such as pulpotomy or pulpectomy
- may or may not respond to pulp testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

normal apical tissues - define

A

not sensitive to percussion or palpation
radiographically:
- lamina dura surrounding root is intact
- PDL space is uniform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

symptomatic apical periodontitis - define

A

represents inflammation, usually of the apical periodontium
produces clinical symptoms
- painful response to biting and/or percussion or palpation
may or may not be accompanies by radiographic changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

asymptomatic apical periodontitis - define

A

inflammation and destruction of apical periodontium that is of pulpal origin
appears as apical radiolucency
does not present with clinical symptoms (no pain on percussion or palpation)c

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

chronic apical abscess - define

A

inflammatory reaction to pulpal infection and necrosis
characterised by:
- gradual onset
- little or no discomfort
- intermittent discharge of pus through associated sinus tract
typically radiographic signs of osseous destruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how to identify the source of an associated sinus tract

A

place a gutta percha cone through the opening until it stops and take a radiograph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

acute apical abscess - define

A

inflammatory reaction to pulpal infection and necrosis
characterised by
- rapid onset
- spontaneous pain
- extreme tenderness of the tooth to pressure
- pus formation
- swelling of associated tissues
may be no radiographic signs of destruction
patient often experiences malaise, fever and lymphadenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

condensing osteitis - define

A

diffuse radiopaque lesion representing a localised bony reaction to a low-grade inflammatory stimulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

You assess a root canal treatment after 1 year - what factors would constitute to a successful outcome?

A

absence of pain, swelling and other patient symptoms
no sinus tract
no loss of function
radiographic evidence of a normal PDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

possible complications that can occur while instrumenting a canal with handfiles

A

blockage
ledges
apical zipping/transportation
perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What causes blockage of a canal?

A

dentine debris getting packed into the apical portion of the root

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

attempts to remove a blockage in a canal can result in…

A

false canal being cut and possible perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is a ledge, in reference to Endodontics? When does it occur?

A

internal transportation of the canal
occurs when working short of length
- can occur if curved canals are instrumented as if they were straight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How can a ledge be by-passed?

A

by placing a curve at the tip of a small file, with a rubber stop with marker to show direction of the curve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how does apical transportation occur?

A

occurs as a result of the tendency of the instrument to straighten inside a curved canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

apical transportation - consequences

A

transportation of apical foramen = fails to provide resistance for packing of gutta-percha
cases tend to be overextended and poorly filled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
apical transportation - management
in minor cases - canal can be reshaped to new level just above foramen more severe cases: - attempts to reshape can result in weakening or perforation of root
26
how to avoid apical transportation?
pre-curve the initial small sized hand instruments do not skip instruments in the sequence never rotate the instruments in curved canals
27
Perforation - how can it be diagnosed?
persistent bleeding into the canal multiple radiographs electronic apex locators dental operating microscope
28
2 ways an orthodontic instrument can separate?
torsional fatigue cyclic fatigue
29
how does torsional fatigue occur?
extensive instrument surface encounters excessive friction on canal walls - instrument tip larger than canal section to be shaped - tip may lock, torque exceeds critical level
30
reasons why an obturation might be too short
error in working length determination error in preparation - ledge formation - incomplete preparation error in obturation
31
how to avoid fractured files during endodontic treatment
know limits of instruments use a recognised technique pay attention to degrees of rotation lubricate canals
32
what are the objectives of a RCT?
- to eliminate infection - to remove the contents of the canal
33
How many roots do incisor teeth have?
1
34
how many roots do Canines typically have?
1
35
how many roots to maxillary first premolars usually have?
2
36
how many roots do maxillary second premolars usually have?
1
37
how many roots do mandibular premolars typically have?
1
38
how many roots do maxillary molars typically have?
3
39
how many roots do mandibular molars usually have?
2
40
Why is sodium hypochlorite used in endodontic treatment?
potent antimicrobial activity dissolves pulp remnants and collagen dissolves necrotic and vital tissue
41
downsides of sodium hypochlorite
Possible effect on dentine properties -may penetrate into it inability to remove smear layer effect on organic material
42
What is the smear layer and why does it need to be removed?
organic pulpal material and inorganic dentinal debris - formed during preparation must be removed due to: - bacterial contamination - interferes with disinfection - prevents sealer penetration
43
Sodium hypochlorite complications
discolouration of fabrics ophthalmic injuries due to eye contact apical extrusion leading to tissue necrosis allergic reaction
44
components of GP
gutta percha zinc oxide radiopacifiers plasticisers
45
define working length
the distance from a coronal reference point to the point at which canal preparation and obturation should terminate
46
reasons for carrying out obturation
- prevent coronal leakage - prevent ingress of nutrients from periapical tissue reaching inter canal bacteria - prevent bacteria entering peri apical tissues via apical foramen
47
How could you restore an endodontically treated anterior tooth with intact marginal ridges?
- composite restoration OR - veneer
48
How would you restore an endodontically treated tooth with destroyed marginal ridges?
- core build up with crown OR - post crown
49
What is the function of a post and core
Core = retention for crown Post = retains core
50
What are the features of an ideal post?
parallel sided: - more retentive than tapered - avoids wedging non-threaded (Passive) - smooth surface incorporates less stress to remaining tooth than treated (active) cement retained - less retentive than threaded post BUT - cement acts as buffer between masticatory forces and post/tooth
51
What materials can be used for posts?
- metal: gold, stainless steel, brass, titanium - ceramics: alumina, zirconia - fibre: glass, quartz, carbon
52
What are the downsides of metal posts?
- poor aesthetics - corrosion - vulnerable to root fracture - nickel sensitivity - radiopaque
53
What are the advantages of ceramic posts?
- favourable aesthetics - high flexural strength - high fracture toughness
54
what are the disadvantages of ceramic posts?
- difficult retrievability - root fracture common
55
What are the advantages of fibre posts?
- flexible - similar properties to dentine - good aesthetics - retrievable - radiolucent on radiographs
56
What materials can be used for a core?
- composite - amalgam - glass ionomer
57
What is the most commonly used core material and why?
Composite - tooth coloured - aesthetics - bonds to tooth structure - used with fibre posts
58
What are the potential probems with posts?
- perforation - root fracture or crack - core fracture - post fracture
59
outline the procedure for using an electric pulp tester
dry tooth isolate conducting medium added to tip of EPT probe probe placed on incisal edge or cusp tip adjacent to pulp horn circuit completed (by patient holding handle of EPT) current slowly increased patient indicates when tingling/heat sensation is felt
60
give examples of materials that can be used for vital pulp therapy
zinc phosphate zinc oxide eugenol calcium hydroxide e.g. decal tricalcium phosphate resins RMGI bioceramics e.g MTA, biodentine
61
Calcium hydroxide - effects on pulp in vital pulp therapy
- bacteriostatic - high pH (12.5) stimulates fibroblasts - reparative dentine formation - stimulates re-calcification of demineralised dentine - neutralises low pH from acidic restorative materials
62
calcium hydroxide disadvantages
weak very soluble if not protected
63
MTA properties
high pH creates bacterial-tight seal biocompatible sets hard enough to act as a base for restorative material
64
difference between white and grey MTA
grey MTA contains iron
65
disadvantages of MTA
prolonged setting time (over an hour) discolouration of crown
66
advantages of biodentine
similar to MTA but - quicker setting - no discolouration
67
CVEK pulpotomy steps (assume anaesthesia has already been achieved and dam has been placed)
1-2mm coronal pulp remove initially (with high speed) additional pulp removed if bleeding excessive stop once vital pulp reached rinse with 5% sodium hypochlorite place Calcium hydroxide, MTA or biodentine over pulp tissue place sealing restoration e.g. GIC place restoration e.g. composite
68
types of endodontic complications
complications with access complications of instrumentation post operative complications
69
Give 2 reasons why it is important the the roof of he pulp chamber is completely removed when carrying out RCT
allows you to gain access to all canals provides a reservoir for irritants during instrumentation
70
What factors could affect the accuracy of an apex locator?
conductive material in the canal e.g. blood, irritagants immature apex root canal perforation abscess or purulent discharge
71
how to determine working length
electric apex locator pre-operative radiograph - subtract 0.5-1mm combination
72
questions to ask patient prior to carrying out re-root treatment
when was initial RCT? why was it required? did treatment improve symptoms? dental dam hypochlorite use procedural problems
73
Features of an endodontic examination
extra oral exam intra oral exam soft tissue exam intra oral swelling sinus tract palpation percussion mobility periodontal exam
74
other special tests in endo (other than radiographs)
bite test - frac finder - tooth sleuth staining and transillumination test cavity selective anaesthesia
75
factors to consider before root canal retreatmnet
diagnosis risk/benefit analysis good reason to treat? consent? is tooth restorable?
76
endodontic re-treatmnet; features to asses in radiographic assessment
root filling - length - quality of obturation - voids unfilled/missed canals shape of canal potency - posts - sclerosis bone support crown to root ratio. (1:1.5) pathology - resorption - periapical radiolucency - perforation
77
principles for restoring root treated teeth
normally massive loss of coronal tooth structure consider cuspal protection (onlay/crown) - coronal seal - prevention of fracture
78
what is a core build up?
restorative material used to replace the lost tooth tissue in the internal part of the tooth - provides retention and resistance for definitive restorations
79
features of a Nayyar core
amalgam core extended into the pulp chamber and coronal third of root canal system gutta percha removed - typically 2-4mm from orrifice
80
When preparing to fit a post, how much gutta percha should be left in the apical portion of the canal?
3-5mm
81
advantages of a fibre post
biocompatible reduced risk of root fracture - similar elastic modulus to dentine aesthetics - tooth coloured improved bonding corrosion resistance stress distribution easier procedure - reduced chair side time
82
disadvantages of fibre posts
hard in retreateatments technique sensitive can debond
83
Root canal treatment design objevtives
create a continuously tapering funnel maintain apical foramen in original position keep apical opening as small as possible
84
how does reciproc blue differ from regular reciproc?
traditional NiTi alloy heat treated = blue better centering in the canal higher flexibility can be pre bent for better flexibility or bypassing ledges suitable for strongly curved canals

1 - BDS4 finals - big topics (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions