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ETT 1 Flashcards

1
Q

When is Endodontic Treatment indicated?

A
  1. Deep caries
  2. Trauma
  3. Primary periodontal infection
  4. Elective endodontic treatment to facilitate prosthodontic rehabilitation
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2
Q

Reasons for fracture in ETT

A
  1. Loss of tooth structure
  2. Endodontic irrigants and medicaments
  3. Bacteria-dentine interactions
  4. Age-related changes in dentine
  5. Reduced protective response to loading (Loss of pressoreception or elevated pain threshold)
  6. Restorative factors
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3
Q

Differences between ETT and vital tooth?

A
  1. ETT abutments had higher failure rate
  2. ETT more likely to fracture
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4
Q

Is a crown needed after endo treatment?

A

Anterior teeth: No significant improvement in success of ETT

Posterior teeth: Significant improvement in success of ETT

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5
Q

Why do posterior teeth need crown after ETT?

A

Cuspal coverage prevent fracture when occlusal forces attempt to separate the cusp tips

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6
Q

When should we crown posterior ETT?

A
  1. Large magnitude of force
  2. Proximity to terminal hinge axis (Class III lever)
  3. Vertical path of loading
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7
Q

When do we not need to crown posterior ETT?

A

1.No opposing dentition
2. Tooth is out of occlusion
3. Enough remaining tooth structure (Dens evaginatus)

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8
Q

When should we crown anterior ETT?

A
  1. Plastic restorative materials have limited prognosis
  2. Extensive loss of tooth structure
  3. Aesthetic requirement
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9
Q

Definition of Anchorage

A

Securing of restoration by supporting abutment

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10
Q

Anchorage can be achieved by

A
  1. Mechanical (Preferred): Reciprocal locking of 2 opposing surfaces of abutments
  2. Adhesive means: Bonding between restoration and enamel/dentine

Quality of enamel/dentine is critical

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11
Q

For mechanical anchorage, there should be

A

3-4 mm of tooth structure available interproximally

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12
Q

What should you do if there is insufficient tooth structure available?

A

Foundation restoration: Core build-up portion of a tooth that is prepared for an artificial crown (Post+Core)

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13
Q

How should you restore intact and vital teeth?

A

Direct restorations (TCR)

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14
Q

How should you restore vital teeth with the lingual cusp partly destroyed?

A

Reconstruct a conical abutment with CR

CR increment should be limited to 1-1.5 mm only

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15
Q

How should you restore vital teeth with buccal and lingual cusps partly destroyed?

A

More than 1.5mm CR build-up needed to get conical abutment

Elective endodontic treatment is required
1. Core bonded to pulp chamber
2. Post + Core

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16
Q

What is the Nayer’s technique?

A

Amalgam coronal-radicular dowel(post) and core technique

  1. 2-4mm of GP removed
  2. Fast-setting amalgam condensed into canals, pulp chamber, coronal portion of tooth
  3. Crown preparation
  4. Cast restoration cemented over amalgam core
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17
Q

How should you restore non-vital teeth with extensive damage + ferrule?

A
  1. Endodontic treatment
  2. Post + Core
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18
Q

How should you restore non-vital teeth with extensive damage + NO ferrule?

A
  1. Endodontic treatment
  2. Crown lengthening
  3. Post + Core
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19
Q

Function of a Core

A

The foundation restoration which restores sufficient coronal anatomy of a vital tooth or ETT

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20
Q

Function of Post+Core

A

Provides retention and resistance for artificial crown

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21
Q

Post and core systems strengthen the root. True or false?

A

False

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22
Q

Ideal properties for foundation restorations?

A

Post
1. Distribute occlusal loads to entire surface of post space
2. Adequately retained within root
3. Well-contrasted on radiographs
4. Retrievable whenever needed
5. Light in colour if root/planned restoration is translucent
6. No health hazard

Core
1. Stable relative to root
2. Resist occlusal loads
3. No health-hazard

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23
Q

What is a ferrule?

A

1.5mm-2mm of dentine protrudes above gingival level

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24
Q

What is the ferrule effect?

A

Small cone of dentine protects the root against splitting

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25
Q

What is the most-important feature of a post-core design

A

Ferrule bracing

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26
Q

Criteria for successful Endodontic Treatment

A
  1. No pathologic signs and symptoms
  2. Normal periapical tissue (via radiograph)
  3. Signs of decreasing radiographic PA lesion
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27
Q

How much GP is needed to maintain apical seal?

A

As much as possible.

Study shows 5mm of GP can achieve a balance between adequate apical seal of canal and sufficient length of post for retention and resistance

28
Q

Advantages of immediate post placement?

A
  1. Greater familiarity with root canal morphology (less risk of perforation)
  2. More precise working length determination
29
Q

Immediate post space preparation via hot pluggers does not seem to different from delayed preparation with drills. True or False?

A

True

30
Q

Why should we decrease time interval between post space preparation and cementation of post?

A

Temporary restorations and provisional crowns do not provide a tight coronal seal

31
Q

Function of Post

A

Retain core and Minimise stress concentration

32
Q

Considerations when selecting a post

A
  1. Custom-cast post-cores (CPC) vs Prefabricated posts
  2. Shape (Tapered vs parallel-sided
  3. Material
  4. Passive vs Active
  5. Surface texture
  6. Post length and diameter
33
Q

What are the ADVANTAGES of CPC (Indirect technique)?

A
  1. Optimally conforms to existing canal (More critical for severely-damaged teeth)
  2. Appropriate for slender roots with small root diameters and small diameter teeth
34
Q

What are the DISADVANTAGES of CPC (Indirect technique)?

A
  1. Increased no. of appointments needed (At least 2 visits)
  2. More expensive to fabricate
35
Q

What are the ADVANTAGES of Pre-fabricated post+core (Direct technique)?

A
  1. Convenient and straightforward (Only 1 visit required)
  2. Less expensive
36
Q

What are the DISADVANTAGES of Pre-fabricated post+core (Direct technique)?

A
  1. May not be appropriate for slender roots with small root diameters

(Cannot maintain minimum dentinal thickness of 1mm)

  1. May not be suitable for small diameter teeth

(Insufficient space for core material to adequately surround the post

37
Q

Advantages of Tapered/Conical posts?

A

Better conform to overall contour of root

38
Q

Disdvantages of Tapered/Conical posts?

A
  1. Greater stress concentrations in apical zones of root
  2. Poorer pull-out strength
39
Q

Advantages of Parallel-sided/Cylindical posts?

A
  1. Less stress concentration in apical zones of root
  2. Better pull-out strength
40
Q

Disdvantages of Parallel-sided/Cylindical posts?

A

Does not conform to overall contour of root, especially slender roots

41
Q

Which post material is custom-made?

A
  1. Noble alloy
  2. Zirconiun oxide
42
Q

Which post material is pre-fabricated?

A
  1. Stainless steel
  2. Co-Cr or Co-Ni alloy
  3. Titanium
  4. Zirconium oxide
  5. Fibre-based
43
Q

Which post material has high strength?

A
  1. Noble alloy
  2. Stainless steel
  3. Co-Cr or Co-Ni alloy
44
Q

Which post material is highly biocompatible?

A

Titanium

45
Q

Which post material has low toughness and brittle?

A

Zirconium oxide (Avoid using as post)

45
Q

Which post material has a mode of failure of debonding?

A

Fibre-based (resin composite structures)

46
Q

Which post material is soft and mechanically inferior?

A

Titanium

47
Q

Differences between Fibre posts and Metal Posts

A
  1. Resins can bond to roots
  2. Fibre’s post modulus of elasticity is lower, less stress concentration in root
  3. Fibre posts will not corrode
  4. Fibre posts are more conveniently removed during re-treatment
48
Q

Differences between passive and active posts?

A

Passive posts merely adapt to the inner walls of post space

Active posts have threads that are either self-threading or tapped

49
Q

Self-threading vs Tapped posts

A

Self threading: The post cuts its thread during placement

Tapped: Screw thread is formed with special tool before post placement

50
Q

Advantages of Passive Post

A

Does not generate stress concentration in dentine walls

51
Q

Advantages of Active Post

A

Tremendous pull-out strength

52
Q

Disadvantages of Active Post

A

Generate local tensile stresses, magnified when post is loaded during function

53
Q

Purpose of Serrations on Post

A

Increase retention

54
Q

Serrated posts are passive posts. True or False?

A

True

55
Q

Considerations for post length?

A
  1. At least equal but preferably exceed the clinical crown height
  2. As long as possible without disturbing apical seal
  3. > 4mm apical to bone crest or at least 1/2 root length in alveolar bone
56
Q

Considerations for post diameter?

A
  1. Preserve as much root substance as possible
  2. Does not exceed 1/3 of root width at its apical end
  3. At least 1mm root dentine around entire post length
57
Q

What is the core material for amalgam?

A

Dispersalloy

58
Q

What is the core material for composite resin?

A

3M ESPE FIitek Supreme Ultra

LuxaCore Z Dual

59
Q

What is the Prefabricated Metal Post called?

A

ParaPost (Titanium alloy or stainless steel)

60
Q

What is the Prefabricated Fibre Post called?

A

D.T. Light-post

61
Q

What is the Metal Custom Cast-Post-Core called

A

ParaPost system + Noble metal alloy

62
Q

Prefabricated Metal/Fibre Post + CR core are cemented with?

A

Resin cement

63
Q
A
64
Q
A

FP (6 decks)

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