Root Camp Lecture 9 - Errors in Obturation Flashcards
(43 cards)
When do the following procedural accidents occur?
Severe wear of dental tissues
Fractures (coronal or root)
Loss of restorations
Cervical supragingival perf
Soft tissue injury
Damage to adjacent teeth
Access prep
When do the following procedural accidents occur?
Ledge formation
Mid-root and apical perf
Over-instrumentation
Separated instruments
Canal blockage
Cleaning and shaping
When do the following procedural accidents occur?
Overfilling/over-extension
Under-obturation
Root fracture during condensation
Over heating of PDL
Obturation
When do the following procedural accidents occur?
Perf
Improper placement depth
Post space prep
What do the following lead to?
Lack of attention to inclination of tooth
Failure to orient bur parallel to long axis of tooth
Searching for canals through underprepared access
Failure to check access orientation opening during prep
Access through a cast crown not aligned in long axis of tooth
Perf
Must be recognized early to avoid subsequent damage to perio tissues w/ hand files, rotary instruments, and irrigants
Perf during access prep
What are 5 signs of perf?
Sudden pain during WL determination
Sudden hemorrhage
X-Ray evidence of instrumentation exiting tooth
Apex locator indicating apical location far short of estimated length
Burning pain/bad taste during NaOCl
How do you prevent perfs? (5)
- Knowledge of morphology/outlines of access cavities
- Location/angulation in relation to adjacent teeth and alveolar bone to avoid misaligned access prep
- Proper reading of pre-op X-Ray
- X-Rays from different angles
- Refer complex cases
What type of perf?
Can be restored w/ usual operative material (alloy, composite, etc)
Supragingival perf
What type of perf?
Punched out defect caused by bur looking for canal orifices - immediate repair w/ MTA or bioceramic material
Direct perf
What does MTA stand for?
Mineral trioxide aggregate
What are the 2 main parts in root repair material (MTA and bioceramic cements)?
Calcium silicates
Radiopacifier
What material has the following indications?
Pulp protection
Pulpotomy apexigenesis
Furcal perf
Lateral root perf
Root-end filling
Apical plug apexification
Root reabsorption
Revascularization
MTA
Which accident during cleaning and shaping?
Straightening of the canal along outer wall of the curve
Transportation
Which accident during cleaning and shaping?
File is forced deeper into a transported canal
Ledge
What do the following cause during cleaning and shaping?
Lack of straight line access
Inadequate irrigation/lubrication
Packing debris in apical portion of canal
Excessive enlargement of curved canals w/ files
Placement of larger, less flexible files into small, calcified, acutely curved or underprepared canals
Excessive apical instrumentation pressure
Ledge
Which accident?
Instrumentation beyond apical foramen resulting in loss of an apical constriction
Over-instrumentation
If you over-instrument, establish a new ______, apical stop, and obturate canal.
If unable to create apical stop, place _______ or ___________ material
Prognosis depends on size and shape of defect
WL; MTA; bioceramic
Which type of perf?
Occurs during access prep while attempting to locate canals
Direct perf
Which type of perf?
Caused by excessive flaring of canal
Stripping perf
Which type of perf?
Located furcation side of root, results from excessive flaring w/ files, more difficult to repair, non-surgical intervention requires immediate repair w/ MTA or bioceramic material
Stripping perf
Which accident during cleaning and shaping?
Forcing files past a ledge causes file to create its own canal; file penetrates to PDL
Perf
Don’t force files. How do you bypass a ledge?
Curved #10 or #15 hand file
Which accident during cleaning and shaping?
File protrudes through foramen and filing causes canal to be transported w/ tear-dropped foramen developing
Zipped apex
