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Endo Pgcert > Technical > Flashcards

Technical Flashcards

1
Q

Why isolate

A

Prevent contamination ingestion of instrument / irrigant

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2
Q

What to consider when preparing the tooth

A

Sound tooth (no caries / leakage )
Remove pulp / debris
Shape for effective cleaning
Removal of bacteria

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3
Q

Why irrigate

A

Lubricate
Flush debris
Dissolve organic debris
Remove bacteria

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4
Q

Aim of rct

A

Remove bacteria / fluid
Block foremen / tubules / acc. Canals

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5
Q

Root filling material must be

A

Biocompatible
Dimensionally stable
Insoluble
Radiopaque
Seal / prevent bacterial ingress removable

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6
Q

What radiographs when performing rct and why

A

2 pre op to see additional canals
Cone fit and post op to assess taper width length
1 year to assess pa lesion

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7
Q

Cross section of k and headstrom files

A

K- Diamond non cutting tip
H- Circle

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8
Q

How do you get past a ledge

A

Pre bend file / up and down movement
USS
edta irrigation or gel

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9
Q

How do you get pap

A

It is a reaction to Infection within the tooth
Decreased blood supply decreases defence and no longer greater pressure inside and fluid not pushed out so bad can enter pulp space

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10
Q

What moves the canal laterally

A

Transportation

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11
Q

What does straight gp indicate

A

Perforation

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12
Q

Difference between ledging and zipping

A

Sudden stop as debris deflects tip vs large foremen with leakage

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13
Q

Prognosis for retx with ap and no ap?

A

70 and 90%

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14
Q

What reduces prognosis

A

Apical lesion
Sinus
No proximal contact / restorability
Quality of current rct
Bone levels
Biological width

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15
Q

What can reduce prognosis of rct by 25%

A

Uncontrolled diabetes

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16
Q

Which niti files have a reduced restoring force

A

Gold due to heat treatments

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17
Q

What virus can make root canal infection worse

A

Hpv

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18
Q

Define over extension vs over filled

A

Changing constriction (failure risk)

Constriction intact e.g sealer puff

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19
Q

Pros and cons of 1% hypochlorite

A

Need to use more to have similar anti bac effect
Less severe hypochlorite incident

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20
Q

Benefits if a smaller apical gauge

A

More conservative
Less fracture risk / more favourable fracture
Reduced extrusion
Matches continuous taper prep

BUT MORE DEBRIS

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21
Q

How to determine the MAF

A

tap on the end and it shouldn’t move

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22
Q

What creates a triangular cross section that remains central

A

Balanced force

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23
Q

How to remove a broken file

A

Braiding files
IRS
Stieglitz rorfepw
Etpr post removal

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24
Q

What fibres help localise

A

A beta (pdl propripceptive)

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25
What can prevent gp reaching length
Binding coronallh as gp 1.2mm and file max 1mm
26
What can reduce rct outcomes - mh
Cancer Thyroxine Diabetes Bisphosphonates Blood thinners if surgical
27
What can cause file breakage
No Sla Push and stay too long Tip binds / apical pressure Working dry Wrong rpm/ torque
28
Prognosis of pulp capping is improved if
Younger than 40 Mta over dycal Occlusal perf of pulp over axial Less than 100 days without symptoms / loss of vitality (Haemostasis in 6 min with naocl)
29
What is apexogensis
Pulpotemy to allow tooth to grow
30
What does edta do
Softens dentine (chelating agent) Removes smear allowing for better cleaning of LC AND DT No antibacterial effect
31
Name some reciprocating files
Reciproc Wave one gold (degressive taper 1.2mm max) One curve
32
Describe manual irrigation
Easier depth control 1mm deeper and volume control Reduced flushing action Weak flushing action (reduced biofilm disruption) Increases vapour lock
33
Using gp for irrigation is called Pros / cons
Manual dynamic Sterilises gp and reduced vapour lock Hydrodynamic effect But increased risk of extrusion
34
Active / ultra sonic
Less extrusion removes smear activates irritant Risk of fracture high Reduced amplitude increased frequency
35
Sonic pros / cons
No damage no fracture (polymer tips) Low frequency high amplitude
36
How to manage a hypochlorite accident
Irrigate with la or saline or water until bleeding stopped Place caoh2 temp infraoccluded 24 hours cold After warm Analgesics anti his abc amox and metro Self limiting rv in 3 days Swelling increases up to a week but resolves at 2
37
When looking for anatomical landmarks when locating canals
Level of cej At floor wall junction angles Colour changes Dentine map Tooth shape is pulp shape Central Distance from cej to pulp same Equidistant and perpendicular
38
Pro and con of reciprocating file
Decreased fracture and transportation as good centering Increased debris and extrusion apically
39
If paper points are bloody you should
Increase file size to improve taper
40
If your idb doesn’t work even with lip sign what % of success with supplemental la
Articaine infil 84 Repeat idb higher 32 Pdl 48 Repeated AI ONLY 2%
41
Why does inflam stop La working
Change in ph Nocioceptors change Vasodilation reduces concentration
42
What does straw colour fluid indicate
Radicular cyst
43
What type of sealer is one fill
Bioceramic which bonds to dentine and releases caoh2 and increases ph for new tissue growth
44
Name 3 sealers which dissolve
Tubiseal Sealapex Ah plus bioceramic
45
How would you carry out an aseptic technique
Rubber dam Sterile pp Disinfect gp/files Change gloves
46
When does access size increase not matter as much in terms of fracture
When a marginal ridge already lost
47
Bigger apical preparation size
Increased risk of iatrogenic damage (stiffer instruments) Not good for thermoplastic ob Increased irrigant to WL Remove infected dentine / debris
48
Smaller taper file 04 has
Increased cyclic fatigue resistance
49
What is the smear layer
Inorganic dental debris Organic pulp materials Bacteria and byproducts Blood saliva
50
Limitations of edta
Use for 1 minute to prevent erosion of tubules with longer exposure
51
Why 30/06 taper
Good irrigant exchange vs not destructive
52
What is a good irrigation protocol
Naocl throughout MAF selected then manual agitation with gp cone Smear layer removed with edta 17% for 1 minute (aspirate) Final rinse with naocl (risk of erosion) so can leave
53
What is balanced force
90 clockwise Maintain pressure 270 anti clockwise Listen X3 Clean flutes
54
What is recapitulation
Small file to working to prevent blockages
55
What is patency filing
Small file to +0.5 of working length Do not rotate when through foremen
56
Why restore with a crown
found that teeth restored with crowns more than 4 months after root canal treatment were almost 3 times more likely to be extracted when compared with those restored within 4 months
57
Difference between bioceramic putty and caoh2 when doing a pulpotemy
BC - smoother dentine bridge Ca - dentine bridge not uniform and can block canal
58
How to do a pulpotomy
HS to remove coronal pulp 5 mins NaOCl- light pressure 5 mins Rest with bioceramic putty (5mm) allow to set then RMGIC
59
How does an apex locator work
An apex locator measures the electrical impedance between an endodontic file and oral mucosa. As the file approaches the periodontal ligament past the apex, impedance changes predictably. The device interprets this to estimate the position of the apical constriction, helping determine accurate working length
60
What’s in articaine
• Articaine hydrochloride 4% — the actual local anaesthetic agent (40 mg/ml). • Adrenaline (epinephrine) — usually either 1:100,000 or 1:200,000 concentration (to cause vasoconstriction). • Sodium metabisulfite — antioxidant to preserve the adrenaline. • Sodium chloride — to make the solution isotonic with body tissues. • Water for injection — as the solvent. Extra points about articaine: • It’s the only common dental anaesthetic with a thiophene ring
61

Endo Pgcert (5 decks)

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