Case Selection And Difficulty Assessment

Question 1

What MH may indicate more complex RCT?

Answer 1

ASA class 3/4

Question 2

What things would complexity RCT?

Answer 2

MH severity

Anaesthesia issues

Pt anxiety

Oral opening

Gag reflex

Emergency condition

Tooth itself - arch position, inclination, remaining structure, curvature of canals, difficult to obtain radiograph, superimposed roots, unfavourable canal morphology

Proximity to vital structures

Resorption

Trauma history

Perio-endo condition

Question 3

How might the tooth itself affect endo treatment in terms of complexity

Answer 3

Tooth in arch:
- abnormal inclination
- abnormal canal curvature / number of
Canals
- rotation
- requires pre-treatment modification for isolation by rubber dam

Question 4

Radiographically, what might indicate more complex rct?

Answer 4

Pulp stones

Superimposition of roots

Indistinct canal path

Canals and pulp chamber not visible

Question 5

What MHs contra indicate endodontic therapy?

Answer 5

First trimester pregnancy - only emergency intervention

MI within 6 months - emergency only in liaison with cardiologist

Cancer / H+N Radiotherapy - consult oncologist

Question 6

How ensure valid consent is gained for endo?

Answer 6

• thorough pre treatment assessment
• inform pt of all other options
• inform pt of all risks associated with the tx
• inform pt of prognosis of tooth