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Flashcards in UMKC Spreadsheet Random Part 3 Deck (211)
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1
Q

Non-healing endo Samples from failing NS RCT, found microorganisms in 71%, fungi in 7%,

A

Waltimo, Haapasalo, 1997

2
Q

3 Visit Endo supported 83% one step, 71% two steps (all had PAR)

A

Weiger, 2000

3
Q

PAR vs. No PAR 96% w/o PAR, 86% w/PAR (10% difference)

A

Sjogren (1990)

4
Q

DB and P root of Mx 1M 100% - 1 canal

A

Vertucci, 1984

5
Q

Bacteria needed for PAR Human:32 traumatized teeth; PAR only when bacteria present in RCS, Sterile necrotic pulp = no PAR; pain increased with # of bacterial species

A

Sundqvist, 1976

6
Q

Getting thermafills out System B at 225 degrees to insert to 10-15 mm for 6-8 sc. Then weave files and pull. Careful - melting point of plastic carrier = 300 degrees C

A

Wolcott, Himel, Hicks, 1999

7
Q

Getting thermafills out Retreating theramafills, bypass with Hedstrom and pull

A

Wilcox, 1993

8
Q

Pathogenesis 2 things necessary for resorption: 1) loss of protective layer (pre-cementum, pre-dentin); 2) inflammation

A

Trope, 1998

9
Q

Predictors of post-op pain Best predictors of post op pain is pre-op pain or swelling

A

Walton, Fouad, 1992

10
Q

Anachoresis - refuted Famous monkey study - no bacteria found in apical granuloma, inflammatory lesion prevents spread of bacteria confining them to RCS

A

Walton, 1992

11
Q

Pathogenesis Reviews

A

Torabinejad, Kettering

12
Q

Remove smear layer? Smear layer removal reduced the leakage of bacteria through the RCS

A

Walton, 2003 (Remove)

13
Q

RETX own case? Re-treating one’s own failures, unlikely to debride new areas because instrumentation would only enlarge in same direction as first preparation

A

Wilcox, 1991

14
Q

Remove smear layer? Smear layer removed best with 17% EDTA followed by 5.25% NaOCl

A

Yamada, 1983

15
Q

Coronal Seal 3 days exposure to saliva, extensive coronal leakage to a tracer dye through apparently intact root fillings

A

Swanson, 1987

16
Q

Lack of correlation of clinical testing and Histology Poor correlation of clinical testing result and actual histology of pulp

A

Seltzer, Bender, 1963

17
Q

Referred Pain Acute pain can be referred to ipsilateral opposite arch (Md left to Mx left)

A

Sharav, 1984

18
Q

Hollow Tube Theory Disputed Hollow Tube Theory - sterile empy polyethylene tubes healed in rat connective tissue

A

Torneck, 1966

19
Q

Why do some PARs not heal? Review

A

Simon

20
Q

Md 1M 64% - 3 canals, 29% - 4 canals

A

Skidmore, 1971

21
Q

Flare-ups Flareup Incidence = 3%; pre-op pain is best predictor

A

Walton, 1992

22
Q

Immune components involved Demonstrated neuropeptides in the pulp (Substance P, CGRP, NKA, NPY & VIP)

A

Stashenko, 1999

23
Q

Compact Gutta-percha as it cools As gutta-percha cools and solidifies, shrinkage of 1-2% occurs, so compact as it cools during obturation

A

Wong, 1981

24
Q

Strange morphology Of unusual or aberrant morphologies, 60% of time it was seen bilaterally

A

Sabala, 1994

25
Q

Methods Described Walking bleach, Na perborate walking bleach

A

Spasser, 1961

26
Q

Minimizing resorption Recommended placing a 2 mm base at CEJ to preclude resorption from internal bleaching, 10% of cases - cementum and enamel don’t meet

A

Rotstein, 1991

27
Q

Access when cutting access, remember that pulp chamber is in center of crown, classic access is too far mesially

A

Wilcox, Walton, 1989

28
Q

Tooth survival data Outcomes of 4744 teeth over 5 yrs after RETX in Delta Dental plans; 89% of teeth retained 5 yrs after RETX

A

Salehrabi, Rotstein, 2010

29
Q

Canal configuration Type I = 1; Type II - 2 into 1; Type III - 2 separate; Type IV - 1 into 2

A

Weine

30
Q

Preflaring canals Preflaring canals reduced rates of separation of .04 rotary files in crown-down technique

A

Roland, 2002

31
Q

Bacteria in PAR? Large PAR = more bacterial species present; Small PAR = fewer species present; Average = 5.4 strains/canal

A

Sundqvist, 1992

32
Q

Predictors of post-op pain Best predictors of post op pain is pre-op pain and anxiety, others include: female, allergies, no or small PAR, RETX, or age of 40-59

A

Torabinejad, 1988

33
Q

Post space Less leakage when post space prepared at time of obturation compared to one week after obturation

A

Solano, 2005

34
Q

Membrane needed? Through and through lesion - 88% success with GTR, 57% without it

A

Taschieri, Del Fabbro, 2008

35
Q

Types Types of resorption: transient inflammatory (surface), progressive inflammatory, internal, external (progressive, cervical, and replacement)

A

Tronstad, 1988

36
Q

Where to stop obturation? Best results when fill to apical constriction which ranges from 0.5-2 mm short of radiographic apex

A

Ricucci, 1998

37
Q

Post space Argues that post space preparation weakens tooth

A

Trope, 1998

38
Q

Culturing Used Virginia Polytechnic Institute Anaerobic Laboratory method to culture anaerobic bacteria in necrotic RCS

A

Wittgow, 1975

39
Q

Techniques Balanced Force Technique - Crown-down to establish radicular access, CW, then CCW with apical force, CW to remove, don’t go >35 on curved canals

A

Roane, Sabala, 1985

40
Q

Pulpotomy Demonstrated that you should remove blood clot after partial pulpotomy procedure, since it reduces healing. With no clot, got 76% healing rate.

A

Schroder, 1971

41
Q

Anachoresis - supported Anachoresis as possible way for bacteria to enter pulp, 2 requirements: bacteria, inflammation

A

Robinson, Boling, 1941

42
Q

Are EALs safe? EALs and EPTs safe in 27 patients (cardiac pacemakers)

A

Wilson, Baumgartner, 2006

43
Q

Sargenti Paste formaldehyde containing N2 formulation produces extensive tissue necrosis, won’t be resorbed so surgery may be needed to remove

A

Spangberg, 1974

44
Q

C-shaped canals 1988 2.7%, 1998 7.6% C shaped in Mand 2nd M. Asians more

A

Weine

45
Q

Ca(OH)4 Ca(OH)2 inactivates LPS in vitro

A

Trope, Barthel, 1997

46
Q

Strangulation theory Disproved strangulation theory, cat study that showed localized increase in pressure with no strangulation

A

Tonder, 1983

47
Q

PCR Popularized use of polymerase chain reaction in endodontics

A

Siqueira, 2005

48
Q

Endotoxin Symptomatic teeth and those with PAR have increased LPS than asymptomatic teeth

A

Schein, Schilder, 1975

49
Q

Fracture categories 5 categories of tooth fractures: craze lines, cruspal fx, cracked tooth, split tooth, VRF

A

Rivera, 2003 (AAE Coll for Exc)

50
Q

Obturation fill 94% = Short 2 mm

A

Sjogren (1990)

51
Q

Extrusion Apical worm, if RCS flood with irrigant, extrusion will always occur

A

Vande Visse, Brilliant, 1975

52
Q

Flap considerations recommended PBI (papilla base incision) for surgery to preclude gingival recession

A

Velvart, 2002, 2004

53
Q

RETX 81% healed; 93% functional (with perforation - 42% healed)

A

Toronto (Friedman)

54
Q

Size vs. taper GT 20 and 40 files were tested with 0.06/0.08/0.10 tapers; size 40 was found to better clean the canals, no diff among tapers within the size groups

A

Usman, Baumgartner, 2004

55
Q

Goal of Shaping Tapered prep permits better debridement of apical preparation, reduces over-instrumentation of foramen and improves ability to obturate

A

Walton, 1976

56
Q

Caution with US retroprep First report of US and Cracks, Cracks may be due to impact of US tip against dentin and heat formation

A

Saunders, Gutmann, 1994

57
Q

Coronal Seal Coronal microleakage is important cause of RCT failure

A

Saunders, Saunders, 1994

58
Q

Remove smear layer? Smear layer produced during RCt may inhibit bacterial colonization of root canals

A

Walton, 1994 (Don’t remove)

59
Q

Calcification If cannot bypass calcification, then C&S & obturate to level of calcification and place on recall for potential surgery

A

Schindler, 1988

60
Q

Calcified canals Even when no canal appears on radiograph, there will usually be a clinical canal at least the size of a #10 file.

A

Walton 1990

61
Q

Pacemaker cautions? EALs and EPTs safe in 27 patients

A

Wilson, Baumgartner, 2006

62
Q

Surfactants, heat, and concentration Optimizing conc, temp, flow, and surface tension can improve the tissue-dissolving effectiveness of hypochlorite 50-fold

A

Stojicic, Haapasalo, 2010

63
Q

Membrane needed? GTR may be beneficial for treatment of large PA lesions (> 10 mm),through and through lesion, or endo/perio lesion

A

Tsesis, 2011

64
Q

Strange morphology Den evaginatus (prevalence 1-2%): composed of enamel, dentin, and pulpal extension; usually premolars, mostly in Mongoloid people

A

Senia, Regezi 1974

65
Q

Size vs. taper White dentinal shavings don’t indicate fully debrided canal

A

Walton, 1976

66
Q

MTA Review of MTA and all aspects of it

A

Torabinejad, Parirokh, 2013

67
Q

Regendo SCAP cells viable following necrosis

A

Sonoyama & Huang, 2008

68
Q

Irrigation methods Showed limitations of NaOCl to reach apical 3 mm of RCS

A

Senia, 1971

69
Q

Apexification 91-94% healing with MTA (can do it in one visit)

A

Witherspoon

70
Q

3rd S RCT showed that success rate of 2nd surgery performed on same tooth is 92.9% (Modern technique)

A

Song, 2011

71
Q

PAR formation primary bone-resorbing cytokine in human PAR = IL-1 beta; bacterial induced IL-1 beta and prostaglandins are destructive

A

Want, Stashenko, 1993

72
Q

Outcomes assessment Using scope, US and Super EBA: 94 cases w/ success of 96%; 85% granuloma, 15% cyst

A

Rubenstein, Kim, 1999

73
Q

2 Visit Endo supported 74% two steps, 64% one step

A

Trope, 1990

74
Q

Direct Pulp Cap <50% (caries exposure - consider IP)

A

Tronstad

75
Q

Cells of pulp Cells of pulp: odontoblasts, fibroblasts, undifferentiated mesenchymal cells, macrophages, lymphocytes, dendritic cells

A

Ten Cate

76
Q

Inject slowly Inject slowly (1-2 mL/min) to get better spread of LA and therefore better hemostasis

A

Roberts, Sowray, 1987

77
Q

Pulp microcirculation Resin replica of microcirculation

A

Takahashi, Kim, 1982

78
Q

Gutta-percha GP exists in beta-semicrystalline state, undergoes change to alpha phase upon heating (47 degrees C), compactable not compressable

A

Schilder, 1974

79
Q

NiTi Description of heat treated NiTi and its improved properties

A

Shen, 2013

80
Q

Landmark Articles Cleaning (irrigate) and Shape (mechanical) to facilitate placement of root canal filling

A

Schilder, 1967

81
Q

PAR formation Rat model: Th1 pro-inflammatory in expansion phase of PARL, Th2 more dominant after lesion equilibrium has been established

A

Stashenko, 1999

82
Q

Focal Infection Theory No clear evidence that bacteria from RC can cause disease in remote sites of body

A

Siqueira, 2002

83
Q

Going long GP activates C3 complement; may explain why over-extension with GP may induce bone resorption in some patients

A

Serene, Vesely

84
Q

In the case-control study, overall healing rates were 91.8% for cases with a fractured instrument and 94.5% for matched controls (p > 0.05, Fisher?s exact test). Healing in both groups was lower in teeth with a preoperative periapical radiolucency (86.7% versus 92.9%, p > 0.05).

A

Spili, 2005

85
Q

Hollow Tube Theory Hollow tube theory - body cannot tolerate an underfilled canal

A

Rickert, Dixon, 1931

86
Q

MTA MTA very biocompatible, Cementum grows over MTA retrofill with Sharpy’s fibers

A

Torabinejad, 1995

87
Q

Correlation with Pain Cellular composition of PA granuloma had no relation to symptoms, treatment, morphology or duration

A

Stern, 1981

88
Q

How to avoid file separation Preflarring canals reduced rates of separation of .04 rotary files in crown-down technique

A

Roland, 2002

89
Q

Minimizing resorption Recommended sealing orifices with 2 mm of Cavit prior to walking bleach

A

Smith, Cunningham, 1992

90
Q

Electronic apex locator Reported that PDL and oral mucosa have a constant electrical resistance of ~6.5 kOhms

A

Suzuki, 1942

91
Q

Cyst formation Breakdown theory of cysts (cyst development) - osmotic pressure buildup causes expansion due to Starling’s law

A

Toller, 1967

92
Q

Methods of vitality testing Thermal tests with cold does not damage pulp (extracted ortho teeth)

A

Rickoff, Trowbridge 1988

93
Q

VRF causes NiTi spreaders better since less force and more distributed than SS and can penetrate deeper

A

Schmidt, 2000

94
Q

Optimal obturation length Systematic Review, teeth obturated 0-1 mm from radiographic apex had best success, obturation past apex had worst success

A

Schaeffer, Walton, 2005

95
Q

Correlation with Pain No correlation between symptoms/diagnosis and histology

A

Seltzer & Bender, 1963

96
Q

Concerns with Hemostatic agents Calcium sulfate as hemostatic agent packed in crypt

A

Scarano, 2012

97
Q

VRF detection VRF not visible on radiograph unless it’s in direct plane as x-ray beam which doesn’t happen often

A

Rud, Omnell, 1970

98
Q

Avulsion Systemic tetracycline showed decreased rates for inflammatory resorption after avulsion

A

Sae-Lim, Trope, 1998

99
Q

Calcification All sections of all roots demonstrated a canal histologically, although some regions had no canal visible radiographically.

A

Walton, 1990

100
Q

Flare-ups 8.4% was the average

A

Tsesis, 2008 (review)

101
Q

Regendo Calcium hydroxide less toxic to SCAP than TAP and DAP

A

Ruparel, 2012

102
Q

Strangulation theory Disproved strangulation theory

A

Van Hassel

103
Q

RETX vs. S RCT NS RETX prior to S RCT gives higher success than S RCT alone

A

Taschieri, 2010

104
Q

Why Chloroform? Best solvent for GP is chloroform

A

Tamse, 1986

105
Q

Temporaries Need 3.5 mm of Cavit to prevent leakage

A

Webber, 1978

106
Q

Flare-ups Causes of flareups - overinstrumentation, overmedication, extruded debris, incomplete pulp removal, over-irrigation, hyperocclusion, root fracture

A

Seltzer, Naidorf, 1985

107
Q

US retroprep First to describe US use for root resection

A

Richman, 1957

108
Q

Outcomes assessment 5 yr follow up of 181 teeth w/S RCT; 85% healing w/US and super-EBA vs. 68% healing with rotary handpiece and amalgam

A

Testori, 1999

109
Q

Cyst formation Immunlogic theory (cyst development) - continued immune rxn to antigens (bacteria from RCS), which causes proliferation of epithelium

A

Torabinejad, 1983

110
Q

Effect of file separation on prognosis 19% higher incidence of failure with separated instruments

A

Strindberg, 1956

111
Q

Necrosis with calcification? Only 8.5% of teeth with canal obliteration after trauma develop necrosis, so prophylactic NS RCT not indicated

A

Robertson, Andreasen, 1996

112
Q

Electronic apex locator Root ZX is 96% accurate within +/- 0.5 mm of apical foramen

A

Shabahang, 1996

113
Q

Md 1P 70% - 1 canal, 25% - 2 canals

A

Vertucci, 1984

114
Q

Effect of Endo on tooth Endo treated teeth aren’t more brittle

A

Sedgley, Messer, 1992

115
Q

MTA Described clinical indications and techniques for using MTA, pulp caps, apical barrier, root perfs, root end fillings

A

Torabinejad, Chivian, 1998

116
Q

Leave tooth open? If leave tooth open, more likely to be contaminated with enterics bacteria (E. faecalis)

A

Siren, 1997

117
Q

Cognitive Dissonance Cognitive dissonance in endodontics (Sometimes NS RCT fail)

A

Seltzer, Bender, 1965

118
Q

Epi. contraindications Vasoconstrictors contraindicated if: taking tricyclic antidepressants, non-selective beta blockers (propranolol), halothane, cocaine

A

Yagiella, 1999

119
Q

S RCT 97% healed in 3-12 mo.; 92% in 5-7 yr

A

Rubinstein, Kim

120
Q

Apexification 91-94% healing with MTA

A

Witherspoon

121
Q

Outcomes assessment Complete Healing, Incomplete healing (scar tissue), uncertain healing, unsatisfactory healing

A

Rud, Andreasen 1972

122
Q

Spaces of infection Facial spaces of infection: canine, mental, masticator, lateral pharyngeal, sublingual, submental, submandibular

A

Spilka, 1966

123
Q

Concerns with Hemostatic agents Bone wax interferes with healing, so it’s contraindicated

A

Witherspoon, Gutmann, 1996

124
Q

Always prep isthmus Assume isthmus is present whenever MB root of Mx 1M is resected

A

Weller, Kim, 1995

125
Q

Apical barriers Dentinal chips showed little periradicular inflammation in monkeys

A

Tronstad, 1978

126
Q

What apical size? Canal worked to size #35 showed adequate irrigation in apical third

A

Salzgeber, Brilliant, 1977

127
Q

Focal Infection Theory Bacteremias only develop if instrumentation beyond apex, then only last for 10 minutes

A

Seltzer & Bender

128
Q

Leakage Studies Problem with leakage studies: reliability questionables, variables in tracer penetration, relation between invitro and in vivo results

A

Wu, Wesselink, 1993

129
Q

Formocresol pulpotomies Introduced formocresol pulpotomies

A

Sweet, 1930

130
Q

Classifications Perio/Endo classifications: primary endo; primary endo w/secondary perio; primary perio; primary perio w/secondary endo; true combined lesions

A

Simon, Glick, Frank 1972

131
Q

Instrumentation errors Coined terms: Canal zip, elbow; argued against reaming (before NiTi); Terms introduced by Garcia & Gutierrez

A

Weine, Kelly, Lio, 1975

132
Q

Direct Pulp Cap <50% (caries exposure - consider IP)

A

Tronstad

133
Q

Tooth survival data Outcomes of 1,462,936 teeth from 1,126,288 PTs assessed over 8 yrs in Delta Dental plans; 97% of teeth were retained after 8 yrs; sig diff among teeth with crowns

A

Salehrabi, Rotstein, 2004

134
Q

Value of radiographs Radiographs are valuable in determining extra roots or strange canal configurations, look for eccentricallyl located RCS to suspect extra canal

A

Slowey, 1974

135
Q

Remove smear layer? Syst Rev: Smear layer removal improves fluid-tight seal of RCS whereas others factors such as obturation technique or type of sealer do not produce sig diffs

A

Shavravan, 2007

136
Q

Referred Pain With increased severity and duration of pain, patient loses ability to locate painful tooth

A

Van Hassel, Harrington, 1969

137
Q

Type of post Glass fiber post is best (don’t use a stiff one) and can strengthen thin walled root

A

Salameh, 2007

138
Q

What apical size? All of these guys like large apical sizes contrary to Bucannan who likes small (#25) sizes

A

Roane, Trope, Barnett

139
Q

E. faecalis 4% NaOCl is effective at killing E. faecalis in vitro infected RCS

A

Siqueira, 2002

140
Q

Cyst or Granuloma? Can’t distinguish between cyst or granuloma on CBCT

A

Rosenberg, 2010

141
Q

Techniques Step back flaring

A

Walton, 1976

142
Q

Techniques Passive step-back technique - patency with small K file, coronal flare GG, confirm WL, rework GG, prepare apical stop then step back to blend

A

Torabinejad, 1994

143
Q

NaOCl Solvent action of NaOCl

A

Senia, Marshall, Rosen

144
Q

Where to stop obturation? Filling canals short have better success

A

Strindberg, 1956

145
Q

Prognosis 20% of cracked teeth with RP and were restored with crowns developed IP or necrosis and required endo tx

A

Rivera and Krell, 2007

146
Q

Mediators involved IL-1 (500x more potent than TNF), TNF alpha/beta all stimulate bone resorption

A

Stashenko, 1990

147
Q

Post needed Anterior teeth don’t require post and crown. But premolars and molars require cuspal protection

A

Sorensen, Martinoff, 1984

148
Q

Flare-ups Incidence of flare-ups independent of IC med; Flare-up rate of 2.6%

A

Trope, 1990

149
Q

Immune components involved Immunological reactions

A

Torabinejad, Kettering, Bakland

150
Q

Flap considerations Mean of 0.42 mm recession at buccal sites of intrasulcular incised flaps

A

Von Arx, 2008

151
Q

Arachidonic acid pathway COX 2 - prostacyclins (dilation, inhibits platelet aggretation), COX 1 - thromboxane (constriction, platelet aggregation)

A

Torabinejad, 1995

152
Q

Reducing bacterial levels If bacteria in RCS reduced to levels not detected by culturing, then success rates are 26% higher (94% success vs. 68% success)

A

Sjogren, Sundqvist 1997

153
Q

Thin film thickness Thin film of sealer is ideal

A

Weiner, Schilder, 1971

154
Q

Methods of vitality testing Laser doppler detected vital vs. necrotic vs. empty pulp chamber, & Case report of Laser Doppler preventing NS RCT on healthy tooth secondary to trauma

A

Trope, 1997

155
Q

Perforation repair Review of surgical repair

A

Regan, Witherspoon, 2005

156
Q

Archaea in endo Members of the archaea domain may have a role as human pathogens, found in necrotic untreated teeth with apical periodontitis

A

Vianna, 2006

157
Q

Post-treatment disease Teeth with AP: Extraradicular biofilm 6% prevalence, intraradicular biofilm 77% prevalence (Larger lesion = more likely to have biofilm)

A

Ricucci, Siqueira, 2010

158
Q

Going long Small GP pieces are extremely inflammatory

A

Sjogren, 1995

159
Q

Don’t trust radiograph Found apical foramen 0.72 mm short of radiographic apex and width of CDJ = 0.19 mm

A

Stein, Corcoran, 1990

160
Q

PAR prevention B-cells likely responsible for preventing spread of PA Abscess

A

Stashenko, 2000

161
Q

Regendo EDTA irrigation releases growth factors from dentin, which could stimulate DPSC’s

A

Roberts-Clark, Smith 2000

162
Q

Antibiotics for pain relief? Prophylactic Abx had no effect on post-op pain levels

A

Walton, Chiapinelli, 1993

163
Q

DPC on carious exposure Carious exposures have <50% success with direct pulp caps. Carious exposures should be considered irreversible pulpitis.

A

Tronstad, Mjor, 1972

164
Q

Luxated teeth Trauma to primary teeth may affect permanent teeth

A

Torneck, 1982

165
Q

Steroids effective? No. IC Steroids; intracanal ketorolac better than than placebo for reducing post-endo pain. Steroids did not make a difference

A

Rogers, 1999

166
Q

Leave tooth open? Reasons to not leave teeth open: bacterial contamination, contamination with food debris or blockage of canals, unnecessary follow-up appts to close tooth

A

Seltzer, Naidorf, 1984

167
Q

Cyst formation Cavitation breakdown theory (cyst development) - growth or epi. cells removes central cells from nutrition, innermost cells die

A

Ten Cate, 1972

168
Q

Coronal Seal Quality of coronal restoration equally important as root filling at determination of apical health

A

Tronstad, 2000

169
Q

PDL Not detrimental to the health of PDL and is type of IO injection

A

Walton,

170
Q

Time with NaOCl Need at least 30 Minutes: Rat tissue in direct contact with 3% NaOCl for 30 min greatly reduced volume of tissue

A

The, 1979

171
Q

NiTi 1st description of NiTi as an endo file. 2-3x more flexible than SS, lower modulus of elasticity (Nitinol is a term that came for the Navy, just like IRM)

A

Walia, Brantley, Gerstein, 1988

172
Q

Flare-ups 3% incidence of flareups; prospective RCT found no benefits to prophylactic antibiotics for reducing flareups

A

Walton, Fouad, 1993

173
Q

Response of EPT to necrotic teeth 72 % necrotic teeth correctly identified by EPT with negative resposne

A

Seltzer, Bender, et al 1963

174
Q

NS RCT success? Success criteria

A

Strindberg, 1956

175
Q

File separation Clockwise rotation has greater chance of separation than a counterclockwise rotation

A

Roane, Sabala, 1994

176
Q

Electronic apex locator CLASSIC; applied Suzuki’s idea to develop an apex locator

A

Sunada, 1962

177
Q

Gutta-percha GP activates C3 complement; may explain why over-extension with GP may induce bone resorption in some patients

A

Serene, Vesely

178
Q

Concerns with Hemostatic agents Epi-soaked CollaCote does not cause systemic issues

A

Vy, Baumgartner, 2004

179
Q

Treatment Dog study - tx of external resorption: 12 wk of Ca(OH)2 more effective than short term (1 wk)

A

Trope

180
Q

NS RCT success? 86% healed; 95% functional

A

Toronto (Friedman)

181
Q

Correlation with Pain Examined 142 teeth with pain; no correlation between histology and clinical symptoms

A

Tyldesley, Mumford, 1970

182
Q

S RCT 74% healed; 91% functional

A

Toronto (Friedman)

183
Q

Looking for zebras Found pulp necrosis due to neoplasm that disrupted blood flow. Think of this when pt has history of cancer, and pulp necrosis has no etiology

A

Todd, Langeland, 1987

184
Q

Cyst formation Epithelial proliferation theory (cyst development) - epithelial cells proliferate to line abscess cavity

A

Seltzer, Summers, 1974

185
Q

Sargenti Paste no RD needed, RCT length somewhere near apex, objective is chemical (not C&S), try to keep N2 in canals, but “well tolerated” by PA tissues

A

Sargenti

186
Q

Pain relief? Prophylactic Abx had no effect on post-op pain levels

A

Walton, Chiapinelli, 1993

187
Q

History of various methods Disputed Luks claim that gutta-percha is compressible

A

Schilder, 1974

188
Q

Flare-ups RETX has significantly more flare-ups

A

Torabinejad, 1988

189
Q

PAR in Vital Teeth? In rats, PAR visualized prior to pulp necrosis

A

Yamasaki, 1994

190
Q

Adjust occlusion? Adjust occlusion helps relieve pain (especially those with percussion sensitivity)

A

Rosenberg, 1998

191
Q

Ferrule effect 1 mm of ferrule needed to increase Fx resistance

A

Sorenson, 1990

192
Q

Leave tooth open? Leaving teeth open can lead to foreign body reaction of material forced in PA tissue, called “oral pulse granulomas”

A

Simon, 1982

193
Q

3rd surgery? showed that success rate of 2nd surgery performed on same tooth is 92.9% (Modern technique)

A

Song, 2011

194
Q

Accessory canals Filled lateral canals mix of sealer, smear layer and bacteria, not necessarilly cleaned and filled

A

Ricucci, 2010

195
Q

Primary anaerobic endo bacteria Porphyromonas endodontalis, P. gingivalis, Actinomyces israeli, Propionobacterium acnes, Fusobacterium nucleatum, Wolinella necta,

A

Siqueira, 1996

196
Q

System-B temperature? System B at 300 degrees never raised external root surface temperature by more than 10 degrees

A

Sweatman, Baumgartner, 2001

197
Q

Pathogenesis Widely accepted that PAR is inflammatory response to prevent dissemination of bacteria from infected RCS into bone

A

Stashenko, 1990

198
Q

US retroprep US tips gave superior results compared to rotary handpiece for retropreps

A

Steiman, 1995

199
Q

Trust the Patient? With increased severity and duration of pain, patient loses ability to locate painful tooth

A

Van Hassel, Harrington, 1969

200
Q

Cat link with cervical resorption? Showed association between feline Herpes virus and invasive cervical root resorption

A

Von Arx, 2009

201
Q

Perforation repair MTA useful for furcal perforation repair; No difference if covered by wet or dry cotton pellet (moisture derived from furcal tissue

A

Sluyk, Hartwell, 1998

202
Q

PAR in Vital Teeth? PA inflammatory cell infiltration, increased osteoclast numbers and bone destruction seen well in advance of total pulpal necrosis

A

Stashenko, 1995

203
Q

Where to stop obturation? Necrotic teeth w/o PAR = 96% success; Necrotic w/PAR = 86%; Best success w/PAR is to obturate within 0-2 mm of radiographic apex

A

Sjogren, 1990

204
Q

Gutta-percha Small GP pieces are extremely inflammatory (larger pieces not as inflammatory)

A

Sjogren, 1995

205
Q

Landmark Articles Filling root canals in 3 dimensions, objective is to seal complex RCS to ensure health

A

Schilder, 1967

206
Q

MB root of Mx 1M 50% - 2 canals

A

Weine, 1969

207
Q

Disinfect Gutta-percha Gutta-percha can be disinfected by submerging in NaOCl 5.25% for 1 min.

A

Senia, 1975

208
Q

Need for IC Med? Best documented results for canal disinfection = chemomechanical debridement with Ca(OH)2 for 1 wk (1 wk disinfection = 2, 3, 4 weeks)

A

Sjogren, 1991

209
Q

Pain to percussion Pain on biting suggests PDL inflammation that is due to either necrotic pulp or irreversibly inflamed pulp

A

Seltzer, Bender, 1985

210
Q

PAR formation bone resorbing activity is due to immune cells secreting cytokines in response to LPS, including: IL-1beta, TNF-alpha, PGE2 (tooth can be vital and have PAR)

A

Stashenko, 1999

211
Q

Where to stop obturation? Overfill decreased success and = persistant inflammation; underfill had no influence

A

Seltzer, Bender, 1963, 1967