UMKC Spreadsheet Random Part 3 Flashcards
(211 cards)
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
Methods Described Walking bleach, Na perborate walking bleach
Spasser, 1961
26
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
Rotstein, 1991
27
Access when cutting access, remember that pulp chamber is in center of crown, classic access is too far mesially
Wilcox, Walton, 1989
28
Tooth survival data Outcomes of 4744 teeth over 5 yrs after RETX in Delta Dental plans; 89% of teeth retained 5 yrs after RETX
Salehrabi, Rotstein, 2010
29
Canal configuration Type I = 1; Type II - 2 into 1; Type III - 2 separate; Type IV - 1 into 2
Weine
30
Preflaring canals Preflaring canals reduced rates of separation of .04 rotary files in crown-down technique
Roland, 2002
31
Bacteria in PAR? Large PAR = more bacterial species present; Small PAR = fewer species present; Average = 5.4 strains/canal
Sundqvist, 1992
32
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
Torabinejad, 1988
33
Post space Less leakage when post space prepared at time of obturation compared to one week after obturation
Solano, 2005
34
Membrane needed? Through and through lesion - 88% success with GTR, 57% without it
Taschieri, Del Fabbro, 2008
35
Types Types of resorption: transient inflammatory (surface), progressive inflammatory, internal, external (progressive, cervical, and replacement)
Tronstad, 1988
36
Where to stop obturation? Best results when fill to apical constriction which ranges from 0.5-2 mm short of radiographic apex
Ricucci, 1998
37
Post space Argues that post space preparation weakens tooth
Trope, 1998
38
Culturing Used Virginia Polytechnic Institute Anaerobic Laboratory method to culture anaerobic bacteria in necrotic RCS
Wittgow, 1975
39
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
Roane, Sabala, 1985
40
Pulpotomy Demonstrated that you should remove blood clot after partial pulpotomy procedure, since it reduces healing. With no clot, got 76% healing rate.
Schroder, 1971
41
Anachoresis - supported Anachoresis as possible way for bacteria to enter pulp, 2 requirements: bacteria, inflammation
Robinson, Boling, 1941
42
Are EALs safe? EALs and EPTs safe in 27 patients (cardiac pacemakers)
Wilson, Baumgartner, 2006
43
Sargenti Paste formaldehyde containing N2 formulation produces extensive tissue necrosis, won't be resorbed so surgery may be needed to remove
Spangberg, 1974
44
C-shaped canals 1988 2.7%, 1998 7.6% C shaped in Mand 2nd M. Asians more
Weine
45
Ca(OH)4 Ca(OH)2 inactivates LPS in vitro
Trope, Barthel, 1997
46
Strangulation theory Disproved strangulation theory, cat study that showed localized increase in pressure with no strangulation
Tonder, 1983
47
PCR Popularized use of polymerase chain reaction in endodontics
Siqueira, 2005
48
Endotoxin Symptomatic teeth and those with PAR have increased LPS than asymptomatic teeth
Schein, Schilder, 1975
49
Fracture categories 5 categories of tooth fractures: craze lines, cruspal fx, cracked tooth, split tooth, VRF
Rivera, 2003 (AAE Coll for Exc)
50
Obturation fill 94% = Short 2 mm
Sjogren (1990)
51
Extrusion Apical worm, if RCS flood with irrigant, extrusion will always occur
Vande Visse, Brilliant, 1975
52
Flap considerations recommended PBI (papilla base incision) for surgery to preclude gingival recession
Velvart, 2002, 2004
53
RETX 81% healed; 93% functional (with perforation - 42% healed)
Toronto (Friedman)
54
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
Usman, Baumgartner, 2004
55
Goal of Shaping Tapered prep permits better debridement of apical preparation, reduces over-instrumentation of foramen and improves ability to obturate
Walton, 1976
56
Caution with US retroprep First report of US and Cracks, Cracks may be due to impact of US tip against dentin and heat formation
Saunders, Gutmann, 1994
57
Coronal Seal Coronal microleakage is important cause of RCT failure
Saunders, Saunders, 1994
58
Remove smear layer? Smear layer produced during RCt may inhibit bacterial colonization of root canals
Walton, 1994 (Don't remove)
59
Calcification If cannot bypass calcification, then C&S & obturate to level of calcification and place on recall for potential surgery
Schindler, 1988
60
Calcified canals Even when no canal appears on radiograph, there will usually be a clinical canal at least the size of a #10 file.
Walton 1990
61
Pacemaker cautions? EALs and EPTs safe in 27 patients
Wilson, Baumgartner, 2006
62
Surfactants, heat, and concentration Optimizing conc, temp, flow, and surface tension can improve the tissue-dissolving effectiveness of hypochlorite 50-fold
Stojicic, Haapasalo, 2010
63
Membrane needed? GTR may be beneficial for treatment of large PA lesions (> 10 mm),through and through lesion, or endo/perio lesion
Tsesis, 2011
64
Strange morphology Den evaginatus (prevalence 1-2%): composed of enamel, dentin, and pulpal extension; usually premolars, mostly in Mongoloid people
Senia, Regezi 1974
65
Size vs. taper White dentinal shavings don't indicate fully debrided canal
Walton, 1976
66
MTA Review of MTA and all aspects of it
Torabinejad, Parirokh, 2013
67
Regendo SCAP cells viable following necrosis
Sonoyama & Huang, 2008
68
Irrigation methods Showed limitations of NaOCl to reach apical 3 mm of RCS
Senia, 1971
69
Apexification 91-94% healing with MTA (can do it in one visit)
Witherspoon
70
3rd S RCT showed that success rate of 2nd surgery performed on same tooth is 92.9% (Modern technique)
Song, 2011
71
PAR formation primary bone-resorbing cytokine in human PAR = IL-1 beta; bacterial induced IL-1 beta and prostaglandins are destructive
Want, Stashenko, 1993
72
Outcomes assessment Using scope, US and Super EBA: 94 cases w/ success of 96%; 85% granuloma, 15% cyst
Rubenstein, Kim, 1999
73
2 Visit Endo supported 74% two steps, 64% one step
Trope, 1990
74
Direct Pulp Cap <50% (caries exposure - consider IP)
Tronstad
75
Cells of pulp Cells of pulp: odontoblasts, fibroblasts, undifferentiated mesenchymal cells, macrophages, lymphocytes, dendritic cells
Ten Cate
76
Inject slowly Inject slowly (1-2 mL/min) to get better spread of LA and therefore better hemostasis
Roberts, Sowray, 1987
77
Pulp microcirculation Resin replica of microcirculation
Takahashi, Kim, 1982
78
Gutta-percha GP exists in beta-semicrystalline state, undergoes change to alpha phase upon heating (47 degrees C), compactable not compressable
Schilder, 1974
79
NiTi Description of heat treated NiTi and its improved properties
Shen, 2013
80
Landmark Articles Cleaning (irrigate) and Shape (mechanical) to facilitate placement of root canal filling
Schilder, 1967
81
PAR formation Rat model: Th1 pro-inflammatory in expansion phase of PARL, Th2 more dominant after lesion equilibrium has been established
Stashenko, 1999
82
Focal Infection Theory No clear evidence that bacteria from RC can cause disease in remote sites of body
Siqueira, 2002
83
Going long GP activates C3 complement; may explain why over-extension with GP may induce bone resorption in some patients
Serene, Vesely
84
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).
Spili, 2005
85
Hollow Tube Theory Hollow tube theory - body cannot tolerate an underfilled canal
Rickert, Dixon, 1931
86
MTA MTA very biocompatible, Cementum grows over MTA retrofill with Sharpy's fibers
Torabinejad, 1995
87
Correlation with Pain Cellular composition of PA granuloma had no relation to symptoms, treatment, morphology or duration
Stern, 1981
88
How to avoid file separation Preflarring canals reduced rates of separation of .04 rotary files in crown-down technique
Roland, 2002
89
Minimizing resorption Recommended sealing orifices with 2 mm of Cavit prior to walking bleach
Smith, Cunningham, 1992
90
Electronic apex locator Reported that PDL and oral mucosa have a constant electrical resistance of ~6.5 kOhms
Suzuki, 1942
91
Cyst formation Breakdown theory of cysts (cyst development) - osmotic pressure buildup causes expansion due to Starling's law
Toller, 1967
92
Methods of vitality testing Thermal tests with cold does not damage pulp (extracted ortho teeth)
Rickoff, Trowbridge 1988
93
VRF causes NiTi spreaders better since less force and more distributed than SS and can penetrate deeper
Schmidt, 2000
94
Optimal obturation length Systematic Review, teeth obturated 0-1 mm from radiographic apex had best success, obturation past apex had worst success
Schaeffer, Walton, 2005
95
Correlation with Pain No correlation between symptoms/diagnosis and histology
Seltzer & Bender, 1963
96
Concerns with Hemostatic agents Calcium sulfate as hemostatic agent packed in crypt
Scarano, 2012
97
VRF detection VRF not visible on radiograph unless it's in direct plane as x-ray beam which doesn't happen often
Rud, Omnell, 1970
98
Avulsion Systemic tetracycline showed decreased rates for inflammatory resorption after avulsion
Sae-Lim, Trope, 1998
99
Calcification All sections of all roots demonstrated a canal histologically, although some regions had no canal visible radiographically.
Walton, 1990
100
Flare-ups 8.4% was the average
Tsesis, 2008 (review)
101
Regendo Calcium hydroxide less toxic to SCAP than TAP and DAP
Ruparel, 2012
102
Strangulation theory Disproved strangulation theory
Van Hassel
103
RETX vs. S RCT NS RETX prior to S RCT gives higher success than S RCT alone
Taschieri, 2010
104
Why Chloroform? Best solvent for GP is chloroform
Tamse, 1986
105
Temporaries Need 3.5 mm of Cavit to prevent leakage
Webber, 1978
106
Flare-ups Causes of flareups - overinstrumentation, overmedication, extruded debris, incomplete pulp removal, over-irrigation, hyperocclusion, root fracture
Seltzer, Naidorf, 1985
107
US retroprep First to describe US use for root resection
Richman, 1957
108
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
Testori, 1999
109
Cyst formation Immunlogic theory (cyst development) - continued immune rxn to antigens (bacteria from RCS), which causes proliferation of epithelium
Torabinejad, 1983
110
Effect of file separation on prognosis 19% higher incidence of failure with separated instruments
Strindberg, 1956
111
Necrosis with calcification? Only 8.5% of teeth with canal obliteration after trauma develop necrosis, so prophylactic NS RCT not indicated
Robertson, Andreasen, 1996
112
Electronic apex locator Root ZX is 96% accurate within +/- 0.5 mm of apical foramen
Shabahang, 1996
113
Md 1P 70% - 1 canal, 25% - 2 canals
Vertucci, 1984
114
Effect of Endo on tooth Endo treated teeth aren't more brittle
Sedgley, Messer, 1992
115
MTA Described clinical indications and techniques for using MTA, pulp caps, apical barrier, root perfs, root end fillings
Torabinejad, Chivian, 1998
116
Leave tooth open? If leave tooth open, more likely to be contaminated with enterics bacteria (E. faecalis)
Siren, 1997
117
Cognitive Dissonance Cognitive dissonance in endodontics (Sometimes NS RCT fail)
Seltzer, Bender, 1965
118
Epi. contraindications Vasoconstrictors contraindicated if: taking tricyclic antidepressants, non-selective beta blockers (propranolol), halothane, cocaine
Yagiella, 1999
119
S RCT 97% healed in 3-12 mo.; 92% in 5-7 yr
Rubinstein, Kim
120
Apexification 91-94% healing with MTA
Witherspoon
121
Outcomes assessment Complete Healing, Incomplete healing (scar tissue), uncertain healing, unsatisfactory healing
Rud, Andreasen 1972
122
Spaces of infection Facial spaces of infection: canine, mental, masticator, lateral pharyngeal, sublingual, submental, submandibular
Spilka, 1966
123
Concerns with Hemostatic agents Bone wax interferes with healing, so it's contraindicated
Witherspoon, Gutmann, 1996
124
Always prep isthmus Assume isthmus is present whenever MB root of Mx 1M is resected
Weller, Kim, 1995
125
Apical barriers Dentinal chips showed little periradicular inflammation in monkeys
Tronstad, 1978
126
What apical size? Canal worked to size #35 showed adequate irrigation in apical third
Salzgeber, Brilliant, 1977
127
Focal Infection Theory Bacteremias only develop if instrumentation beyond apex, then only last for 10 minutes
Seltzer & Bender
128
Leakage Studies Problem with leakage studies: reliability questionables, variables in tracer penetration, relation between invitro and in vivo results
Wu, Wesselink, 1993
129
Formocresol pulpotomies Introduced formocresol pulpotomies
Sweet, 1930
130
Classifications Perio/Endo classifications: primary endo; primary endo w/secondary perio; primary perio; primary perio w/secondary endo; true combined lesions
Simon, Glick, Frank 1972
131
Instrumentation errors Coined terms: Canal zip, elbow; argued against reaming (before NiTi); Terms introduced by Garcia & Gutierrez
Weine, Kelly, Lio, 1975
132
Direct Pulp Cap <50% (caries exposure - consider IP)
Tronstad
133
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
Salehrabi, Rotstein, 2004
134
Value of radiographs Radiographs are valuable in determining extra roots or strange canal configurations, look for eccentricallyl located RCS to suspect extra canal
Slowey, 1974
135
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
Shavravan, 2007
136
Referred Pain With increased severity and duration of pain, patient loses ability to locate painful tooth
Van Hassel, Harrington, 1969
137
Type of post Glass fiber post is best (don't use a stiff one) and can strengthen thin walled root
Salameh, 2007
138
What apical size? All of these guys like large apical sizes contrary to Bucannan who likes small (#25) sizes
Roane, Trope, Barnett
139
E. faecalis 4% NaOCl is effective at killing E. faecalis in vitro infected RCS
Siqueira, 2002
140
Cyst or Granuloma? Can't distinguish between cyst or granuloma on CBCT
Rosenberg, 2010
141
Techniques Step back flaring
Walton, 1976
142
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
Torabinejad, 1994
143
NaOCl Solvent action of NaOCl
Senia, Marshall, Rosen
144
Where to stop obturation? Filling canals short have better success
Strindberg, 1956
145
Prognosis 20% of cracked teeth with RP and were restored with crowns developed IP or necrosis and required endo tx
Rivera and Krell, 2007
146
Mediators involved IL-1 (500x more potent than TNF), TNF alpha/beta all stimulate bone resorption
Stashenko, 1990
147
Post needed Anterior teeth don't require post and crown. But premolars and molars require cuspal protection
Sorensen, Martinoff, 1984
148
Flare-ups Incidence of flare-ups independent of IC med; Flare-up rate of 2.6%
Trope, 1990
149
Immune components involved Immunological reactions
Torabinejad, Kettering, Bakland
150
Flap considerations Mean of 0.42 mm recession at buccal sites of intrasulcular incised flaps
Von Arx, 2008
151
Arachidonic acid pathway COX 2 - prostacyclins (dilation, inhibits platelet aggretation), COX 1 - thromboxane (constriction, platelet aggregation)
Torabinejad, 1995
152
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)
Sjogren, Sundqvist 1997
153
Thin film thickness Thin film of sealer is ideal
Weiner, Schilder, 1971
154
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
Trope, 1997
155
Perforation repair Review of surgical repair
Regan, Witherspoon, 2005
156
Archaea in endo Members of the archaea domain may have a role as human pathogens, found in necrotic untreated teeth with apical periodontitis
Vianna, 2006
157
Post-treatment disease Teeth with AP: Extraradicular biofilm 6% prevalence, intraradicular biofilm 77% prevalence (Larger lesion = more likely to have biofilm)
Ricucci, Siqueira, 2010
158
Going long Small GP pieces are extremely inflammatory
Sjogren, 1995
159
Don't trust radiograph Found apical foramen 0.72 mm short of radiographic apex and width of CDJ = 0.19 mm
Stein, Corcoran, 1990
160
PAR prevention B-cells likely responsible for preventing spread of PA Abscess
Stashenko, 2000
161
Regendo EDTA irrigation releases growth factors from dentin, which could stimulate DPSC's
Roberts-Clark, Smith 2000
162
Antibiotics for pain relief? Prophylactic Abx had no effect on post-op pain levels
Walton, Chiapinelli, 1993
163
DPC on carious exposure Carious exposures have <50% success with direct pulp caps. Carious exposures should be considered irreversible pulpitis.
Tronstad, Mjor, 1972
164
Luxated teeth Trauma to primary teeth may affect permanent teeth
Torneck, 1982
165
Steroids effective? No. IC Steroids; intracanal ketorolac better than than placebo for reducing post-endo pain. Steroids did not make a difference
Rogers, 1999
166
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
Seltzer, Naidorf, 1984
167
Cyst formation Cavitation breakdown theory (cyst development) - growth or epi. cells removes central cells from nutrition, innermost cells die
Ten Cate, 1972
168
Coronal Seal Quality of coronal restoration equally important as root filling at determination of apical health
Tronstad, 2000
169
PDL Not detrimental to the health of PDL and is type of IO injection
Walton,
170
Time with NaOCl Need at least 30 Minutes: Rat tissue in direct contact with 3% NaOCl for 30 min greatly reduced volume of tissue
The, 1979
171
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)
Walia, Brantley, Gerstein, 1988
172
Flare-ups 3% incidence of flareups; prospective RCT found no benefits to prophylactic antibiotics for reducing flareups
Walton, Fouad, 1993
173
Response of EPT to necrotic teeth 72 % necrotic teeth correctly identified by EPT with negative resposne
Seltzer, Bender, et al 1963
174
NS RCT success? Success criteria
Strindberg, 1956
175
File separation Clockwise rotation has greater chance of separation than a counterclockwise rotation
Roane, Sabala, 1994
176
Electronic apex locator CLASSIC; applied Suzuki's idea to develop an apex locator
Sunada, 1962
177
Gutta-percha GP activates C3 complement; may explain why over-extension with GP may induce bone resorption in some patients
Serene, Vesely
178
Concerns with Hemostatic agents Epi-soaked CollaCote does not cause systemic issues
Vy, Baumgartner, 2004
179
Treatment Dog study - tx of external resorption: 12 wk of Ca(OH)2 more effective than short term (1 wk)
Trope
180
NS RCT success? 86% healed; 95% functional
Toronto (Friedman)
181
Correlation with Pain Examined 142 teeth with pain; no correlation between histology and clinical symptoms
Tyldesley, Mumford, 1970
182
S RCT 74% healed; 91% functional
Toronto (Friedman)
183
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
Todd, Langeland, 1987
184
Cyst formation Epithelial proliferation theory (cyst development) - epithelial cells proliferate to line abscess cavity
Seltzer, Summers, 1974
185
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
Sargenti
186
Pain relief? Prophylactic Abx had no effect on post-op pain levels
Walton, Chiapinelli, 1993
187
History of various methods Disputed Luks claim that gutta-percha is compressible
Schilder, 1974
188
Flare-ups RETX has significantly more flare-ups
Torabinejad, 1988
189
PAR in Vital Teeth? In rats, PAR visualized prior to pulp necrosis
Yamasaki, 1994
190
Adjust occlusion? Adjust occlusion helps relieve pain (especially those with percussion sensitivity)
Rosenberg, 1998
191
Ferrule effect 1 mm of ferrule needed to increase Fx resistance
Sorenson, 1990
192
Leave tooth open? Leaving teeth open can lead to foreign body reaction of material forced in PA tissue, called "oral pulse granulomas"
Simon, 1982
193
3rd surgery? showed that success rate of 2nd surgery performed on same tooth is 92.9% (Modern technique)
Song, 2011
194
Accessory canals Filled lateral canals mix of sealer, smear layer and bacteria, not necessarilly cleaned and filled
Ricucci, 2010
195
Primary anaerobic endo bacteria Porphyromonas endodontalis, P. gingivalis, Actinomyces israeli, Propionobacterium acnes, Fusobacterium nucleatum, Wolinella necta,
Siqueira, 1996
196
System-B temperature? System B at 300 degrees never raised external root surface temperature by more than 10 degrees
Sweatman, Baumgartner, 2001
197
Pathogenesis Widely accepted that PAR is inflammatory response to prevent dissemination of bacteria from infected RCS into bone
Stashenko, 1990
198
US retroprep US tips gave superior results compared to rotary handpiece for retropreps
Steiman, 1995
199
Trust the Patient? With increased severity and duration of pain, patient loses ability to locate painful tooth
Van Hassel, Harrington, 1969
200
Cat link with cervical resorption? Showed association between feline Herpes virus and invasive cervical root resorption
Von Arx, 2009
201
Perforation repair MTA useful for furcal perforation repair; No difference if covered by wet or dry cotton pellet (moisture derived from furcal tissue
Sluyk, Hartwell, 1998
202
PAR in Vital Teeth? PA inflammatory cell infiltration, increased osteoclast numbers and bone destruction seen well in advance of total pulpal necrosis
Stashenko, 1995
203
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
Sjogren, 1990
204
Gutta-percha Small GP pieces are extremely inflammatory (larger pieces not as inflammatory)
Sjogren, 1995
205
Landmark Articles Filling root canals in 3 dimensions, objective is to seal complex RCS to ensure health
Schilder, 1967
206
MB root of Mx 1M 50% - 2 canals
Weine, 1969
207
Disinfect Gutta-percha Gutta-percha can be disinfected by submerging in NaOCl 5.25% for 1 min.
Senia, 1975
208
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)
Sjogren, 1991
209
Pain to percussion Pain on biting suggests PDL inflammation that is due to either necrotic pulp or irreversibly inflamed pulp
Seltzer, Bender, 1985
210
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)
Stashenko, 1999
211
Where to stop obturation? Overfill decreased success and = persistant inflammation; underfill had no influence
Seltzer, Bender, 1963, 1967
