Peri-radicular surgery Flashcards Preview

ACS for FINALS > Peri-radicular surgery > Flashcards

Flashcards in Peri-radicular surgery Deck (17)
Loading flashcards...
1
Q

What does surgical endodontics encompass? (7)

A

• emergency procedures (e.g. incision & drainage)
• biopsy / EUA
• peri-radicular surgery (micro-surgical endodontics)
• corrective surgery
(perforation repair / root resection / hemi-section)
• surgical re-treatment
• regenerative procedures
• decompression (large cysts)

2
Q

Aim of surgical endodontics (1)

A

Elimination of apical periodontitis where this cannot be achieved by non-surgical means

3
Q

The causes of apical periodontitis (6)

A

•persistent intra-radicular infection
•persistent extra-radicular infection
•foreign body reaction to exogenous materials in
peri-apical tissues
•cholesterol crystal accumulation leading to periapical irritation
•true cystic lesions
•scar tissue formation

4
Q

Indications for surgical endodontics (5)

A

•persistent intra-radicular infection
•persistent extra-radicular infection
•foreign body reaction to exogenous materials in
peri-apical tissues
•cholesterol crystal accumulation leading to periapical irritation
•true cystic lesions
•scar tissue formation
•As a combined approach with non-surgical treatment
or re-treatment (e.g. persistent exudate / open apex), or in conjunction with procedures such as root
amputation or hemi-section
•Where patient factors dictate that surgical treatment would be more expedient than non-surgical
treatment

5
Q

Contra-indications to surgical endodontics (6)

A

•When non-surgical endodontic treatment or retreatment is feasible
•Tooth with inadequate periodontal support
•Non-restorable tooth (including root fractures)
•Poor surgical access
•Serious underlying medical conditions (e.g. bleeding
disorders / G.A. risk) or psychological problems
•Limited ability / skill of operator

6
Q

Prognosis (4-year success rates) for non-surgical re-RCT (1)

A

86%

7
Q

5-year success rates for traditional root end surgery (1)

A

59%

8
Q

5-year success rates for modern micro-surgical techniques (1)

A

94%

9
Q

Surgical objectives of surgical endodontics? (4)

A

• remove diseased peri-radicular tissue
• debride canal system as far as possible (retro-grade
approach)
• seal the root-end cavity (prevent possible egress of
micro-organisms into the peri-radicular tissues)
• allow healing / regeneration of normal pdl
apparatus around apical portion of root

10
Q

Surgical prerequisites (6)

A

• patient’s informed consent
• skilled operator / nurse
• detailed knowledge of anatomy of surgical site
• check medical history carefully
(care with anticoagulants / bleeding disorders)
• correct equipment / materials
• light and magnification

11
Q

Surgical sequence (10)

A
  • pre-op NSAIAs / Corsodyl mouth rinse
  • local analgesia
  • incision / flap reflection
  • osteotomy / 90 degree root end resection
  • curettage of peri-radicular lesion
  • ultra-sonic preparation of root-end cavity
  • haemostasis (moisture control of bony crypt)
  • inspection, drying & filling root-end cavity
  • suturing
  • post-operative instructions & aftercare
12
Q

Incisions (6)

A
Semi-lunar
Intra-sulcular 2-sided (triangular)
Intra-sulcular 3-sided (rectangular)
-intra-sulcular incision with SM63 blade
Sub-marginal
Papilla-base
Flap reflection
13
Q

Bone removal by (4)

A

Normal air-rotor
Surgical air-rotor
Bone removal
Root-end resection

14
Q

Root-end cavity with (2)

A

Ultra-sonic handpiece

KiS micro-surgical-surgical ultra-surgical tips

15
Q

Filling materials (5)

A
  • Ethoxy Benzoic Acid cement (super EBA)
  • Intermediate Restorative Material (IRM)
  • Mineral Tri-oxide Aggregate (MTA)
  • glass ionomer cement / composite resin
  • (Biodentine)
16
Q

Sutiring materials (3)

A

4-0 Polyglactin
(resorbable)

5-0 PTFE
(non-resorbable)

6-0 Polypropylene
(non-resorbable)

17
Q

Post-op care (6)

A
  • post-operative instructions
  • ice-pack
  • NSAID’s (ibuprofen / paracetemol)
  • (antibiotics)
  • OHI - Corsodyl mouthrinses
  • review / suture-removal 48-96 hours post-op