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Fixed Prosth Midterm (Fall) > 9. Endo Treated Teeth II > Flashcards

9. Endo Treated Teeth II Flashcards

1
Q

What are the restorative options for an endo treated tooth

A
  • Simple restoration
  • Post and core
  • Post core and crown
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2
Q

What teeth with MOD amalgams have the highest fracture rate

A

maxillary premolars

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3
Q

Reading slide 4

A

ok

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4
Q

RCT teeth without crowns lost at _ times the rate of those with crowns

A

6x

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5
Q

What teeth had the worst survival rate after RCT after 10 years

A

2nd molars (higher occlusal forces- near the fulcrum or the TMJ)

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6
Q

What effect did the presence of proximal contacts have on RCT survival rates

A

teeth with 2 proximal contacts had better survival than 1 or none

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7
Q

What are RCT teeth considered weaker than vital teeth -

A
  • Less moisture (9% less in RCT)
  • Less dentin strength (may be decreased)
  • Less flexibility (bend and return to original shape)
  • Dentin collagen changes
  • Decreased amount of dentin= less strength**
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8
Q

What are the main considerations when determining if a tooth needs a post or not

A
  • Quanity of remaining tooth structure (aka ferrule**)
  • Functional load on the tooth
  • Shape of canal(s)
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9
Q

What factor most determines the long term success of endo treated teeth

A

-Quanity of remaining tooth structure

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10
Q

Describe the ferrule effect

A
  • Apical extension of the finish line beyond the junction of the foundation and remaining tooth structure
  • Allows the crown to engage the axial tooth structure which provides better stress distribution that reduces the potential for fracture
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11
Q

The presence of adequate _ will often increase the likelihood that failures will be restorable rather than catestrophic

A

ferrule

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12
Q

For adequate ferrul the presence of healthy dentin should extend - mm _ to the margin of the crown circumferenctially

A

1.5-2mm coronal

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13
Q

Why is it that adequate ferrule decreases the likelihood of catestrophic failure

A

because ferrule distribute the load to the coronal tooth structure

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14
Q

What are the safe minimums for ferrule

A

Vertical height= 1.5- 2mm
Thickness= 1 mm
**Needs to be 360 degrees to have the ferrule effect

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15
Q

All forces on a crown are transmitted to

A

the post and root (consequences= post dislodgement and root fracture)

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16
Q

T/F it is unclear as to whether or not crown lengthening improves the prognosis of the tooth

A

T because while it increases you failure (increases chances of success) it also increases the crown:root ratio (worse prognosis)

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17
Q

When do you need a post

A

-The remaining tooth structure is not enough to retain the foundation

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18
Q

Does a post reinforce/strengthen the tooth and increase RCT longevity

A

no

19
Q

Why does a post weaken a tooth

A

-Canal prep removes more dentin

20
Q

Anterior teeth are subjected to (more/less) force than posteriors

A

less

21
Q

What is typically the restoration for an anterior RCT

A

restoration of the endo access- often do not need FCR Especially when the marginal ridges are intact and the dentin supports all enamel

22
Q

Anterior functional forces occur on a relatively _ surface

A

flat

23
Q

Is a post generally required for anterior teeth

A

no- only if there is significant loss of coronal tooth structure

24
Q

Anterior RCT is discolored what are more conservative ways to improve the esthetics

A
  • Internal bleeching

- Veneer

25
Q

T/F A cemented post offers reinforcement

A

f

26
Q

T/F Incisors can tolerate higher loads without posts than those with posts

A

t

27
Q

If 50% of the clinical crown remains for an anterior tooth what are the treatment options (rank the choices)

A
  1. Prefab post with a resin core
  2. One piece custom cast post and core
  3. Foundation only no post (unlikely)
    * *Full coverage restoration required
28
Q

In order to provide maximum support for the resin core the post should extend

A

to the incisal reduction

29
Q

When most/all of the clinical crown of an anterior tooth is missing rank the different treatment options

A
  1. One peice custom cast post and core
  2. Pre-fab post and resin core
    * *Full coverage restoration required
30
Q

Incidactions for custom cast post and cores are

A
  • Extensive loss of coronal tooth structure

- Wide flared canals

31
Q

What is the most important prognostic factor

A

ferrule effect

32
Q

Posterior forces are subject to more force because they are closer to what

A

the condyles

33
Q

Why is it that full coverage restorations are often recommended for posterior RCT teeth

A

-Functional forces in the posterior act to “wedge” the cusps apart (this is sig. increased in RCT teeth)

34
Q

Full coverage restorations are only recommended for anterior teeth when

A

They are structurally weakened by large or multiple restorations

35
Q

What is the exception to placing a full coverage restoration on posterior RCT teeth

A
  • Mandibular first PM (the lingual cusp is out of occlusion and there in no wedging effect)
  • Bicuspids with minimal loss of tooth structure (1/2 or more of the clinical crown remains)
36
Q

When 1/2 or more of a bicuspid clinical crown remains what are the ranked order of treatment options

A
  1. Pre-fab post with amalgam or resin
  2. One piece cast post and core
    * *Full coverage restoration required
37
Q

Extensive loss of tooth structure for premolars- what are the ranked options for tx

A
  1. One piece cast post and core
  2. Pre-fab post with amalgam or resin
    * *Full coverage restoration required
38
Q

What are the potential clinical failure associated with a pre-fab post and amalgam/resin core

A
  • Material separation

- Post fracture

39
Q

What is the recommended treatment for a RCT molar with minimal loss of tooth structure

A

-This is rare- all cusps present and supported by dentin with both marginal ridges intact

Foundation required (amalgam or resin) post may be required 
-Full coverage resoration suggestted
40
Q

Describe what an EndoCore is

A

-Coronoradicular amalgam
This is an alternative to post placement
-Condensation of amalgam in the available canals (2-4mm)

41
Q

What provides the retention for for the endoCore

A

The divergence of the canals

42
Q

EndoCore is indicated when

A
  • At least 3 dentin walls (> or equal to 1 mm thick) are present around the pulp chamber
  • Adequate dentin to retain the core
  • Post not needed
43
Q

What is the recommended treatment for a RCT molar with moderate loss of tooth structure (1-2 cusps missing or 1 marginal ridge missing)

A

Foundation required and pins as needed

FCR

44
Q

What is the recommended treatment for a RCT molar with extensive loss of tooth structure

A

Foundation required + pre-fab/cast post

FCR required

Fixed Prosth Midterm (Fall) (10 decks)

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