Restoration of the Endodontically Restored Tooth

Question 1

what do you assess for on the endodontically restored tooth

Answer 1

coronal seal
amount of remaining tooth structure
is tooth restorable
swelling
sinus
TTP
buccal sulcus - tender?
mobility
increased pocketing

Question 2

what do you look for on a radiograph

Answer 2

root filling
unfilled/missed root canals
shape of canal
patency
bone support
crown to root ratio
pathology

Question 3

what are the problems faced after RCT

Answer 3

amount of remaining tooth structure
restoration type
lack or no ferrule
wide post holes
endo complications - fractured instruments

Question 4

are teeth brittle after endodontic treatment

Answer 4

no

Question 5

are root treated teeth more prone to fracture

Answer 5

no

Question 6

is dentine hardness affected after RCT

Answer 6

no

Question 7

does dehydration affect the hardness of a RCT tooth

Answer 7

no

Question 8

what is coronal microleakage

Answer 8

ingress of microorganisms into root canal system

Question 9

what can coronal microleakage cause

Answer 9

failure of RCT

Question 10

how do you create a good coronal seal

Answer 10

trim GP to the ACJ and place RMGI over pulp floor and root canal openings

Question 11

what restorations could you give for an anterior tooth with intact marginal ridges

Answer 11

composite
veneer

Question 12

what restoration could you give for anterior teeth with intact marginal ridges and discoloured crown

Answer 12

bleaching or veneer
crown

Question 13

what restoration could you give for anterior tooth with marginal ridges destroyed

Answer 13

core build up for crown
post crown

Question 14

what is required for a direct post

Answer 14

ferrule

Question 15

what does a post/core do

Answer 15

gain intraradicular support for definitive restoration
provide retention for crown
retains the core

Question 16

what are the components of a post and core

Answer 16

post placed in root canal
core is supragingival and is what the prosthesis is cemented to

Question 17

when do you avoid placing a post/core

Answer 17

if sufficient coronal dentine present
mandibular incisors (thin roots)
curved canals (avoid perforations)

Question 18

how long should the root filling length be

Answer 18

4-5mm apically

Question 19

how wide should the post be

Answer 19

no more than 1/3 of root width at narrowest point and 1mm of remaining circumferential coronal dentine

Question 20

what should the minimum post length to crown ratio be

Answer 20

1:1

Question 21

how much ferrule do you need for a post/core

Answer 21

1.5mm height and width

Question 22

what is a ferrule

Answer 22

dentine collar - encirclement of 1-2mm of vertical axial tooth structure within walls of a crown

Question 23

what does a ferrule prevent

Answer 23

tooth fracture

Question 24

when is root fracture significantly increased

Answer 24

if a crown margin is not placed onto solid tooth

Question 25

how can you achieve a ferrule if one is not already present

Answer 25

orthodontic extrusion or crown lengthening

Question 26

how deep should a post go

Answer 26

at least halfway down the root to ensure good alveolar bone support

Question 27

what is the ideal post

Answer 27

parallel sided non-threaded cement retained

Question 28

what does a parallel sided post avoid

Answer 28

wedging

Question 29

what does a non-threaded post allow

Answer 29

less stress to remaining tooth

Question 30

what categories are post crowns classified into

Answer 30

manufacture material shape

Question 31

what are the different types of manufactured post crowns

Answer 31

pre-formed or custom made

Question 32

what are the materials available for post crowns

Answer 32

metal - cast gold/stainless steel/titanium ceramics - alumina/zirconia fibre - glass/quartz/carbon

Question 33

what are the shapes that a post crown can have

Answer 33

parallel sided or tapered

Question 34

what are the advantages of prefabricated posts

Answer 34

only 1 visit required no impressions or lab needed chairside core build up immediate preparation of core large selection of designs and materials

Question 35

how are custom posts made

Answer 35

cast from patients mouth

Question 36

how many visits are needed for custom posts

Answer 36

2

Question 37

what material are cast posts made in

Answer 37

type 4 heat hardened gold

Question 38

what are the properties of metal posts

Answer 38

poor aesthetics, root fracture, corrosion, nickel sensitivity, radiopaque

Question 39

what are the properties of ceramic posts

Answer 39

high flexural strength and fracture toughness. favourable aesthetics, difficult retrievability and root fracture common

Question 40

what are the properties of fibre posts

Answer 40

flexible, similar to dentine, aesthetic, retrievable, bone to dentine with DBAs radiolucent

Question 41

what is a core build up

Answer 41

internal part of tooth built up with restorative material to replace lost tooth tissue

Question 42

what does the core of a core build up provide

Answer 42

retention and resistance for definitive restorations

Question 43

what materials are used for core build ups

Answer 43

composite amalgam glass ionomer

Question 44

what is a nayyar core

Answer 44

RCT removed from canals amalgam packed into canals and tooth built up

Question 45

what considerations do you need to think of when deciding what restoration to choose

Answer 45

how long post is is there a ferrule how wide 3-5mm remaining GP is canal straight how much space for core

Question 46

how much taper is needed for a core

Answer 46

6 degree

Question 47

how much GP is left in apical third of canal

Answer 47

3-5mm

Question 48

how do you remove GP

Answer 48

dental dam gates gliddens size 3 working length and rubber stop

Question 49

how much space is left in occlusion for a crown

Answer 49

2mm

Question 50

what do you do when trying in a post

Answer 50

irrigate with chlorhexidine dry paper points ensure fits around prep enough occlusal clearance?

Question 51

what are the problems with posts

Answer 51

perforation core fracture root fracture or crack post fracture

Question 52

how do you manage a post perforation

Answer 52

repair internally or externally extract

Question 53

what is used to remove a post

Answer 53

ultrasonics masseran kit eggler moskito forceps

Question 54

what are the reasons for post failure

Answer 54

restorative reasons periodontal problems endodontic reasons