7. Endodontics Flashcards
What should you use before filling a deep cavity?
A lining material
List 3 types of liners:
Dycal
Vitrebond
Ionoseal
What type of material is dycal?
Calcium hydroxide
What type of material is vitrebond?
Resin modified glass ionomer
What is pulp capping?
Covering over an exposed pulp with material. Aims to form a dentine bridge by inducing the formation of tertiary dentine.
What two materials can you use for pulp capping?
MTA - mineral trioxide aggregate
Bio dentine
What is sensibility testing?
A type of test used to confirm diagnosis by reproducing the symptoms reported by the patient.
Give two examples of sensibility tests:
Thermal test
Electric pulp test
What does a normal response to sensibility testing suggest?
Vital tooth or reversible pulpitis
What does an intense, prolonged respond to sensibility test suggest?
Irreversible pulpitis
What does no response to sensibility test suggest?
Pulpal necrosis
What are the possible pulpal diagnosises?
- Normal
- Reversible pulpitis
- Irreversible pulpitis
- Pulpal necrosis
- Previous RCT
Reversible Pulpitis:
Signs
Tx
Short, sharp pain that is triggered
No radiogrpahic changes apically
Tx: removal of cause of pulpal irritation
Symptomatic Irreversbile Pulpitis
Sharp, lingering pain
Spontaneous or triggered by normal stimulus
TX: RCT or XLA
Asymptomatic Irreverbile Pulpitis
No symptoms
Normal response to sensibility tests
TX: RCT or XLA
Pulpal Necrosis
Asymptomatic until inflammation reaches periapical tissues
No response to sensibility tests
TX: RCT or XLA
List the 5 periapical diagnosises:
- Normal
- Symptomatic periapcial periodontitis
- Asymptomatic periapical periodontitis
- Acute periapical abscess
- Chronic periapical abscess
Symptomatic Periapical Periodntitis
Pain on biting
TTP
tender to paltpation
PDL widening/PA pathology present radiographically
Asymptomatic Periapical Periodontitis
Asymptomatic
Not TTP
Non sensitive to palpation
PA pathology radiographically
Acute Periapical Abscess
Rapid onset
Localised pain
Pus
Mobility
Systemic involvement
Swelling
Chronic Periapical Abscess
Asymptomatic
Not TTP
Sinus present
No response to sensibility tests
Radiolucency present
Dentine hypersensitivity
Exaggerated sharp pain of no other cause
Tooth fractures
Pain on biting
File Sequence for RCT and colours of each:
SX- gold short file
Cleaning and Shaping:
S1 - purple
S2 - grey
Finishing:
F1 - yellow
F2 - red
F3 - blue
F4 - black
F5 - black and gold
Final irrigation sequence:
3ml sodium hypochlorite
3ml citric acid
3ml sodium hypochlorite
Endo Dressing sequence:
Non setting calcium hydroxide
Cotton wool + coltosol
GI restoration
List 2 ways you can determine working length?
Radiographically
Electronic apex locator
Obturation Sequence (cold lateral compaction)
- Remove dressing
- Irrigate
- Trail Radiogrpah with master cone to length
- Insert main cone + sealer
- Insert finger spreader
- Remove finger spreader
- Insert multiple accessory cones until full
- Remove excess GP and compact
- Restore
Indications for RCT:
If the dental pulp is irreversibly damaged
E.g
irreversible pulpiitis
Pulpal necrosis
Periapical disease