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BDS - Module 9 > 7. Endodontics > Flashcards

7. Endodontics Flashcards

1
Q

What should you use before filling a deep cavity?

A

A lining material

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2
Q

List 3 types of liners:

A

Dycal
Vitrebond
Ionoseal

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3
Q

What type of material is dycal?

A

Calcium hydroxide

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4
Q

What type of material is vitrebond?

A

Resin modified glass ionomer

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5
Q

What is pulp capping?

A

Covering over an exposed pulp with material. Aims to form a dentine bridge by inducing the formation of tertiary dentine.

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6
Q

What two materials can you use for pulp capping?

A

MTA - mineral trioxide aggregate
Bio dentine

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7
Q

What is sensibility testing?

A

A type of test used to confirm diagnosis by reproducing the symptoms reported by the patient.

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8
Q

Give two examples of sensibility tests:

A

Thermal test
Electric pulp test

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9
Q

What does a normal response to sensibility testing suggest?

A

Vital tooth or reversible pulpitis

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10
Q

What does an intense, prolonged respond to sensibility test suggest?

A

Irreversible pulpitis

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11
Q

What does no response to sensibility test suggest?

A

Pulpal necrosis

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12
Q

What are the possible pulpal diagnosises?

A
  1. Normal
  2. Reversible pulpitis
  3. Irreversible pulpitis
  4. Pulpal necrosis
  5. Previous RCT
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13
Q

Reversible Pulpitis:
Signs
Tx

A

Short, sharp pain that is triggered
No radiogrpahic changes apically
Tx: removal of cause of pulpal irritation

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14
Q

Symptomatic Irreversbile Pulpitis

A

Sharp, lingering pain
Spontaneous or triggered by normal stimulus
TX: RCT or XLA

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15
Q

Asymptomatic Irreverbile Pulpitis

A

No symptoms
Normal response to sensibility tests
TX: RCT or XLA

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16
Q

Pulpal Necrosis

A

Asymptomatic until inflammation reaches periapical tissues
No response to sensibility tests
TX: RCT or XLA

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17
Q

List the 5 periapical diagnosises:

A
  1. Normal
  2. Symptomatic periapcial periodontitis
  3. Asymptomatic periapical periodontitis
  4. Acute periapical abscess
  5. Chronic periapical abscess
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18
Q

Symptomatic Periapical Periodntitis

A

Pain on biting
TTP
tender to paltpation
PDL widening/PA pathology present radiographically

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19
Q

Asymptomatic Periapical Periodontitis

A

Asymptomatic
Not TTP
Non sensitive to palpation
PA pathology radiographically

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20
Q

Acute Periapical Abscess

A

Rapid onset
Localised pain
Pus
Mobility
Systemic involvement
Swelling

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21
Q

Chronic Periapical Abscess

A

Asymptomatic
Not TTP
Sinus present
No response to sensibility tests
Radiolucency present

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22
Q

Dentine hypersensitivity

A

Exaggerated sharp pain of no other cause

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23
Q

Tooth fractures

A

Pain on biting

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24
Q

File Sequence for RCT and colours of each:

A

SX- gold short file
Cleaning and Shaping:
S1 - purple
S2 - grey
Finishing:
F1 - yellow
F2 - red
F3 - blue
F4 - black
F5 - black and gold

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25
Q

Final irrigation sequence:

A

3ml sodium hypochlorite
3ml citric acid
3ml sodium hypochlorite

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26
Q

Endo Dressing sequence:

A

Non setting calcium hydroxide
Cotton wool + coltosol
GI restoration

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27
Q

List 2 ways you can determine working length?

A

Radiographically
Electronic apex locator

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28
Q

Obturation Sequence (cold lateral compaction)

A
  1. Remove dressing
  2. Irrigate
  3. Trail Radiogrpah with master cone to length
  4. Insert main cone + sealer
  5. Insert finger spreader
  6. Remove finger spreader
  7. Insert multiple accessory cones until full
  8. Remove excess GP and compact
  9. Restore
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29
Q

Indications for RCT:

A

If the dental pulp is irreversibly damaged
E.g
irreversible pulpiitis
Pulpal necrosis
Periapical disease

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30
Q

Contraindications for RCT:

A

Insufficient periodontal support
Non restorable teeth
Vertical root fractures
Non functional teeth

31
Q

What can cause pulpal inflammation?

A

Presence of micro organisms
Mechanical trauma
Chemical irritation

32
Q

Common route of root cancel infection:

A

Caries
Mechanical injury
Trauma

33
Q

How many roots do incisors have?

34
Q

How can roots do canine s have?

35
Q

What many roots do first premolars have?

A

Upper = two
Lower = one

36
Q

How many roots do second premolars have?

37
Q

How many roots do upper molars have?

A

Three (medial, distal,palatal)

38
Q

How many roots do lower molars have?

A

Two (medial and distal)

39
Q

What shape is the access cavity for incisors and canines?

A

Triangular

40
Q

What shape is the access cavity for premolars ?

41
Q

What shape is the access cavity for molars?

A

Square (ish)

42
Q

What are the two types of endodontic files?

A

Stainless Steel: hand
Nickel titanium: rotary

43
Q

List the two irrigants used for anti microbial purposes:

A

3% sodium hypochlorite
Or
2% chlorohexidine

44
Q

List the two irrigants used to remove the smear layer:

A

Citric acid
Or
EDTA

45
Q

What is the purpose of non setting calcium hydroxide in endodontics?

A

Antibacterial action
Reduces inflammation

46
Q

What are the two materials used when obturating?

A

Gutta Percha
Sealer

47
Q

List 3 different types of Endodontic sealer:

A

Zinc oxide Eugenol
Calcium hydroxide
Glass ionomer

48
Q

List 4 restorative options following RCT:

A

Onlays
Crowns
Core and crown
Post crowns

49
Q

List the 3 common causes of inter appintment pain during RCT:

A
  1. Endodontic flare up
  2. Pain following cleaning and shaping
  3. Extrusion of irrigant
50
Q

List the 6 causes of pain following obturation:

A

High restoration
Over instrumentation
Over filling with GP
loss of apical constriction
Toxicity of sealer for 24-48 hours
Root fracture

51
Q

List the 4 causes of pain following RCT:

A

Incomplete apical seal
Traumatic occlusion
Tooth fracture
Inadequate coronal seal

52
Q

List the 3 stages of endodontic re treatment:

A
  1. Access the root canal system
  2. Remove root canal filling materials
  3. RCT retreatment
53
Q

List the 4 principles for Removing direct restorations for endodontic retreatment:

A
  1. Remove all caries
  2. Reduce supported cusps
  3. Assess restorability
  4. Assess isolation
54
Q

List the two options for endondtic retreatment if an indirect restoration is present:

A
  1. Access through restoration if restoration quality is good
  2. Remove the crown completely if restoration quality is poor
55
Q

What is the process of removing a crown?

A
  1. Take sectional putty impression - to allow temporary to be made
  2. Section crown in two and remove
56
Q

What burs would you use to section a crown?

A

Diamond fissure - porecelain
Tungsten carbide - metal

57
Q

List 3 methods of removing post crowns:

A

Ultrasonic energy
Post pulling devices
Specific kits

58
Q

List 5 methods of removing root canal filling materials in preparation for retreatment:

A

Pro taper retreatment files
Pro taper gold files
Headstrong files
Solvents
Ultrasonics

59
Q

What are the stages involved in surgical endodontics?

A
  1. Pre op medications: antiinflmmaotries and antibacterial rinse
  2. Anaesthesia
  3. Flap cut
  4. Osteotomy: removal of bone to expose root
  5. Root end resection
  6. Root End Filling
  7. Flap sutured
60
Q

List the 5 types of Resorption:

A
  1. External Root Resorption
  2. Cervical Resoprotion
  3. Internal Root Resorption
  4. Pressure Root Resorption
  5. Ankylosis Root Resorption
61
Q

External Root Resorption:
Definition and Tx

A

Resorption effecting the external root surface
TX: RCT as soon as noticed

62
Q

Cervical Resorption:
definition and Tx

A

Asymptomatic
Pink tooth
+ve sensibility
TX: restore or RCT if communication with pulp

63
Q

Internal Root Resorption:
Definition and Tx

A

Resorption effecting the root canal walls
Pink crown
Radiolucency oval in root canal
TX: RCT

64
Q

Pressure Root Resprotion:
Definition and Tx

A

Apical root resorption due to pressure applied during tooth movement
Asymptomatic
Vital
Shortened roots

65
Q

Ankylosis Root Resorption:
Definition and Tx

A

Lack of mobility
Metallic percussion sound
TX: ? unpredictably asscoiated

66
Q

List 4 common complications of endodontics:

A

Fractured instruments
Ledges
Canal blockages
Canal transportations

67
Q

What should you do if you fracture a file in a root canal?

A

If can be bypassed - continue
If not and it is placed in apical 1/3 - leave file alone
If not and it is placed in middle or coronal 1/3 - remove if straight line access is possible

68
Q

List 6 methods of removing a fractured file:

A

H files
Gripping devices
Excavators
Ultrasonics
Tube system
BTR pen

69
Q

How to manage a ledge formation in endodontics:

A
  1. Locate ledge
  2. Preprare canal 1-2mm short of ledge
  3. Irrigate with chelater and sodium hypochlorite
  4. Probe with hand files
  5. Complete preparation
70
Q

How would you manage a canal blockage in endodontics?

A
  1. Locate blockage
  2. Prepare canal 1-2mm short of blockage
  3. Irrigate with chelater and NaOCl
  4. Use hand file and chelater paste and rotate file
  5. Irrigate
  6. Repeat until removed
71
Q

List the 3 indications for RCT retreatment:

A

Persitant PA pathology following RCT
New PA pathology associated with a RCT tooth
Inadequate root canal filling

72
Q

List the 4 indications for surgical endodontics:

A

Failure of previous endodontic tx and retreatment not an option
Anatomical deviations preventing normal Endo Tx
Previous Procedural errors caused by previous operator
Exploration to find fractures

73
Q

List the 8 contraindications for surgical Endo:

A

Proximity to neurovascular bundles
Thick bone
Difficult access
Inadequate periodontal support
Non restorable teeth
Blood disorders
Recent heart attack
Cancer Tx patients

74
Q

List 3 causes of resorption:

A

Injury
Idiopathic
Systemic diseases

BDS - Module 9 (16 decks)

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