Handbook

Question 1

When should pulp capping be considered?

Answer 1

Only in vital, symptomatic free teeth with no history of pulpitis

Question 2

What is used as a pulp capping agent?

Answer 2

Calcium hydroxide (Dycal)
MTA
Biodentine

Question 3

What can be used to provide an appropriate peripheral seal around the tooth?

Answer 3

Opal dam

Question 4

What are the suggested clamps to use for anterior teeth?

Answer 4

C or E

Question 5

What are the suggested clamps to use for premolars?

Answer 5

E or EW

Question 6

What are the suggested clamps to use for molars?

Answer 6

A, AW, FW or K

Question 7

What is the shape of the access cavity for incisors?

Answer 7

Rounded triangle shape

Question 8

What is the shape of the access cavity for canines?

Answer 8

Oval shape

Question 9

What does mechanical shaping of the root canals allow?

Answer 9

Creates a space that allows the irrigation needle to deliver irrigant into the apical third of the canal

Question 10

What is the preferred irrigant?
What are the main properties of this?
What is it used for?

Answer 10

Sodium hypochlorite 2.5-5.25%
Dissolves organic material and is bactericidal
Disinfection

Question 11

What is used as the penultimate irrigant?
How long for?
What does this do?

Answer 11

EDTA 17% placed into the canal for 1 minute
Removes the smear later

Question 12

In the final irrigation prior to obturation what is recommended?

Answer 12

A 10 minute soak with sodium hypochlorite

Question 13

What is the % of chlorhexidine digluconate used for at the start of a RCT treatment?

Answer 13

0.2%
Used to check dam integrity/disinfect tooth surface

Question 14

What movement should be performed with K files?
Why?
What must be performed in between each K file use?

Answer 14

Watch winding
Limits the risk of unwinding and fracture
Irrigation with sodium hypochlorite - to prevent blocking the canal with organic or inorganic debris

Question 15

When should the working length calculation be carried out?

Answer 15

One the estimated working length has been reached with a size 10 K file - attach the apex locator to the apical contriction/patency

Question 16

What is the minimum size K file that can be used for a radiographic working length?

Answer 16

Size 15 to ensure visibility

Question 17

What does the modified double flare technique do?

Answer 17

Allows production of a continuously tapering funnel-shaped preparation
Involves development of an initial coronal flare followed by an apical flare

Question 18

What is used in the modified double flare technique?

Answer 18

Gates glidden drills and stainless-steel K files

Question 19

How is a coronal flare created?

Answer 19

Using a gates glidden bur
Each bur advances slightly further into the root canal
Largest gates-glidden is used first and then the smaller size 1-2mm further until you reach gates glidden 2

Question 20

What movements are involved in modified reciprocation? (RECIPROC)

Answer 20

Modified reciprocation is a reciprocating movement of the file with 2 different angles of rotation
–150 degrees counterclockwise
–30 degrees clockwise
This creates a step-wise rotary motion

Question 21

At what length would you use a reciproc to initially?

Answer 21

2/3 of the estimated working length

Question 22

What additional step is performed for non-vital teeth with symptoms or mucosal swelling?
(inter-visit)

Answer 22

Intracanal medicament to complete disinfection
Non setting calcium hydroxide paste in the prepared root canal with a temporary coronal seal of cotton wool + GIC should then be placed

Question 23

What is cold lateral compaction?

Answer 23

Obturation technique
Placing a single cone of gutta-percha (GP) with a sealer in the prepared root canal and adding secondary GP cones that are compacted together with the use of a spreader

Question 24

What are the treatment options for a previously root treated tooth?

Answer 24

Root canal treatment
Extraction
Monitor (annually with a radiograph and 6 months clinically)

Question 25

What is the indication for internal bleaching?

Answer 25

Tooth has been root canal treated and discoloured The obturation should be of appropriate clinical quality and the tooth asymptomatic

Question 26

What bleaching agent is used for internal bleaching?

Answer 26

Carbamide peroxide- 16%

Question 27

What is the technique for internal bleaching?

Answer 27

Record shade Prophylaxis- clean/scale and polish tooth Dental dam Remove restoration from access cavity Remove GP from pulp chamber and 1mm below the ACJ Place 1mm RMGIC over GP to seal canal Remove any very dark dentine Etch surface with 37% phosphoric acid Place 16% carbamide peroxide gel in cavity Cotton wool pellet over this Seal with GIC Review and repeat as required at weekly intervals

Question 28

What is ledermix used for?

Answer 28

Placed over an inflamed or hyperaemic pulp to reduce inflammation in a tooth to be root treated

Question 29

What is used as the root canal obturation sealer?

Answer 29

AH plus

Question 30

How much apical obturation material should remain after post preparation?

Answer 30

3-5mm

Question 31

How do you protect the root canal filling from coronal leakage?

Answer 31

Removal of all gutta-percha from the pulp chamber and placement of a resin-modified glass ionomer lining over the obturated root canal entrances and pulp chamber floor

Question 32

What is critical to long term success of root filled tooth?

Answer 32

Cuspal coverage onlays should be considered as the first choice for the definitive restoration The coronal/crown preparation should always be undertaken first. This helps to establish the quality and quantity of remaining dentine, the presence or absence of a suitable ferrule and the necessity for post placement

Question 33

What is considered a sufficient ferrule?

Answer 33

1-2mm of remaining sound dentine on more than 75% of the tooth circumference

Question 34

What choice of post should be used when no ferrule can be achieved?

Answer 34

A cast/prefabricated metal post and core should be used

Question 35

What is the preferred choice of post when a sufficient ferrule is present?

Answer 35

A fibre post

Question 36

Name 3 constituents of GP other than GP.

Answer 36

Zinc oxide Plasticisers Waxes Radio-pacifiers