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Endodontics 2 > CLINICAL PROCEDURES & TIPS > Flashcards

CLINICAL PROCEDURES & TIPS Flashcards

1
Q

First CASE:

A

Must be a non-
complicated anterior or
premolar tooth

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2
Q

Third CASE:

A

Must be a
non-complicated
anterior or premolar
tooth

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3
Q

Second CASE:

A

Must be a
non-complicated anterior
or premolar tooth

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4
Q

Last CASE:

A

Must be a
COMPETENCY (Mock
board examination plastic
teeth)

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5
Q

ALL COMPLICATED TEETH will be REFERRED to

A

ADVANCED ENDO.

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6
Q

– teeth are optional and will
be assigned depending on the student’s
Expertise

A

Molar

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7
Q

Two Endo Recalls
Any RCT done at UMKC yours or
other including advanced endo.
Should be about – mos. Since
completion or last check
Do Clinical Testing and Record
results and patient’s concerns
— Radiographs = No Charge
Must be checked by Endo faculty.
Complete the recall on Axium and
print out sheet for credit

A

6
1-2

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8
Q

Two Assisting in Grad.

A

Go to Advanced Endo Clinic and
volunteer to assist and observe for 2 half
days
Best to do this early in your 3rd year
You will receive a time unit credit/ 1.0
day be sure to get Signed Card & take to
the clinical dean’s office

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9
Q

It is mandatory to assist in the predoc
clinic – weeks before renderingclinic two weeks before rendering
ttreatment to your first patientreatment to your first patient

A

two

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10
Q

skipped
TRIAL (MOCK) BOARD as Y-4
in Jan.
Trial Boards requested by students as preparation for the CDCA-WREB-CITA Exam.
TRIAL BOARD is FORMAL & is designed to be as much like the actual Exam as we
can make it. You may not bring “cheat sheets”, images, or anything other than
the test materials, your Zip-Lock Bag, and the Candidate Manual.
GET YOUR CANDIDATE MANUAL ASAP and START READING IT ALL - CAREFULLY.
REMEMBER THIS IS YOUR COMPETENCY. TREAT IT AS SUCH
You will be expected to know the protocol and follow it religiously for TRIAL and Dental board. You will do
mounted sextants and manikins with heads. You will be graded as on CDCA-WREB-CITA and those NOT prepared
will likely FAIL. Don’t let it happen – be prepared.

A

skipped

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11
Q

The General Protocol for CLINICIANS
(4)

A

PROTECT:
COLLECT:
SELECT
INSPECT:

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12
Q

PROTECT

A

-Patient, Yourself, Staff:

-Med. And Dental HX
-Vital Signs & Meds.
-Other Med testing or
consultations p.r.n.
-CC (Chief Complaint)
-Expectations/Desires &
Attitude of patient

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13
Q

INSPECT:

A

-Problem Focused Exam:

-Inspection
-Clinical Testing
-Radiographs
-Other
-Document all findings
A Separate DX Form for
each tooth in Area O.S.

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14
Q

COLLECT

A

-Exam, Testing and
Radiographic Studies
Perio and Restorability

-ENGAGE BRAIN
-Try to Prove or
Disprove etiology of C.C

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15
Q

SELECT

A

-The MOST APPROPRIATE
DX & TX PLAN which
explains the CC and
symptoms IN CONCERT
with the Exams and
Testing results.
_ CAN YOU deliver the
appropriate TX?

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16
Q

ISSUES commonly seen in Clinic to be
mastered as a CLINICIAN in practice
(9)

A

consultation
clinical testing and diagnostic rx
dx and case selection
isolation via RD
temp restoration
patient handling, protocol, and records
documentation
time management
procedures and incidents

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17
Q

CONSULTATION: important &
free @ UMKC
PREPARATION: (3)

A

Complete entry interview: CC, Med/Dental HX etc.

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18
Q
  • Complete —
  • Complete & Documented —
  • Complete Diagnostic — (New if new restoration)
  • Complete Diagnostic — in AxiUm (one for EACH tooth)
  • Complete — Forms
  • Complete — Consult (if needed)
  • Be ready with your — and prepare to defend
  • Be prepared to perform — or repeat:
  • Trans-illumination ?
  • Tracing DST ?
  • EPT
A

MEDICAL & DENTAL HX
Clinical Exam and Testing
Radiographs
Forms
Restorability and Consult
Periodontal
Tentative DX
additional testing

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19
Q

You MUST fill out — DX Form including
other teeth in the quadrant and ,
Consult Form and restorability form for
— requiring an Endo
Consult

A

one
EACH TOOTH

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20
Q

IF current x-rays are:
(3)
TAKE — NEW RADIOGRAPHS

A

-Incomplete or inadequate
-More than 2 mos. old
-Any TX, restoration etc. done

2-3

Now & ONLY NOW, you are
prepared to ask your Team
Clerk to CALL for an ENDO
CONSUL

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21
Q

when not to ask for an endo consult

A

ANY TIME YOU HAVE
NOT COMPLETED THE
REQUIREMENTS which
are listed on the previous
slide

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22
Q

Restorability

A

To have reasonable
longevity following
heroic restoration

23
Q

Previous O&R

A

Periodontal or
Endodontic
outcome

24
Q

Asymptomatic Pulp Exposures

A

Strategic value of
tooth to retain

25
Q

LOOK at the TOOTH
and THINK about it.
Not EVERY tooth
needs to be saved

Do Clinical Testing and
Evaluation —
you waste time on
O&R on a hopeless or
non-strategic tooth.

A

BEFORE

26
Q

WHEN DO you call
for a
CONSULTATION?

REMEMBER: you may
ONLY do —
in E-CHAIR.
For RCT to be
COMPLETED, you MUST

A

DEBRIDEMENT

have the patient become a
patient of record and the
TEAM must approve the
RCT & restoration and
ENTER this on the
TREATMENT PLAN

27
Q

ENDO RECALL of RCT
done at UMKC
Pt in pain
A TRUE
Necrotic pulp:
w/wo symptoms
which is deemed
desirable to
retain

A

Previous RCT therapy w/wo symptoms and PARL that needs retreatment
Symptomatic teeth, radiographic pathologic findings, need for RCT due to prosthetic reasons
Create post-space before a perforation occurs

28
Q

How to Obtain an Endo.
CONSULTATION:
ONE & ONLY WAY –

A

THE PAGER

HAVE YOUR TEAM CLERK
CALL ENDODONTIST
will appear at
your UNIT ASAP
for the CONSULT.
The Person on
the BEEPER will
perform NO
TREATMENT

29
Q

NO ENDO CONSULTS are done after

A

11:30 and 3:30
Please Plan Accordingly

30
Q

What to do if pulp exposure
may occur?
Don’t PANIC!
If you TESTED tooth BEFORE starting procedure &
found it ASYMPTOMATIC & VITAL.
(5)

A
  1. Insure Dental Dam is in
    place and tooth is well
    isolated.
  2. Remove ALL remaining
    Caries.
  3. Irrigate with 8.3%
    NaOCl to gain hemostasis
    & to reduce microbial
    contamination.
  4. Place dycal over
    exposure and place a
    good
    temporary restoration.
  5. Take 2-3 radiographs of
    post-restoration tooth.
    IMMEDIATE
    PROCEDURE:
31
Q

SUBSEQUENT PROCEDURE: at a later time

A

Contact Dr. Weisleder via Email: Only write the patient’s name and chart
number in the body of the email. No need for explanations.
We will review the chart, radiographs, diagnosis
forms and consult. If any of these elements are
are missing, we will e mail you back!!!
- Get the patient referred and
- Scheduled to the appropriate clinic

32
Q

Remember to TEST teeth before
anesthesia and — O&R is
done and take radiographs
— restoration is in place.

A

before
after

33
Q

Complete CLINICAL TESTING before
calling for Endo Consult
* Students develop skills by doing their own clinical testing
–
* Often Not Done correctly
–
* Only 1 tooth tested ?
– (What does this tell us?)
–
–
* Results not documented
–

A

(Do NOT expect faculty to do it for you)
(cotton tipped applicator vs. cotton on cotton forceps)

No baseline has been established*
Need a minimum of 2-3 control teeth***

Must PROVE reasons 4 your TX

34
Q

The Axium DX & Consult Forms should state a

A

DX & justify and document the compelling
reason(s) for doing RCT on this tooth.

35
Q

Take
OWNERSHIP
of your case ***
* It is the responsibility of the Student Doctor
to arrive at a tentative — (from clinical
tests/radiographs) before presenting a case to his or
her instructor – including residents & dental faculty
at consultation and treatment planning.
* This all must be recorded in — (medico-legal)
* — should be ruled out.

A

PULPAL, P/A and
PERIODONTAL DX
AXIUM
Differential Diagnoses

36
Q

PROCEDURAL INCIDENTS
* AVOID:
(4)

A

– SEPARATED INSTRUMENTS
– PERFORATION OF ROOTS
– NaOCl ACCIDENT
– UNPROFESSIONAL TREATMENT OF PATIENT

37
Q

An OFFICIAL INCIDENT REPORT is REQUIRED from you and the faculty
overseeing No LATER THAN – Hours after the Incident to be on Chair’s Desk
and recorded in students grades.
One incident loses credit for that tooth; Incidents may affect Grade,
NO ENDO. Clinic Privileges until Remediation is Completed.

A

24

38
Q

Endo Recalls procedure:
(4)

A
  • Fill out the form on Axium
  • Do sensibility testing: Percussion,
    palpation mainly
  • Take two radiographs: Straight on and
    a shift shot (unless anterior).
  • Call the pager to get an Endo faculty
39
Q

CASE SELECTION: Extremely Important
* If you CANNOT predict a perfect outcome in YOUR hands:

A
  • Don’t attempt the RCT!
40
Q

UMKC Endo has 4 basic JOBS:
1. To offer basic guidance in ..
2. To present ..
3. To equip you to recognize and treat non-…
4. To give you the basic criteria to determine when ..

A

EXAMINATION & TESTING leading to an ACCURATE DIAGNOSIS
ONE BASIC TECHNIQUE of NS Endodontic Treatment for NON-COMPLICATED RCT CASES
complicated endodontic cases in a CLINICAL SITUATION
REFERRAL is in the BEST INTEREST of the PATIENT

41
Q

COME PREPARED to Clinic. If you don’t have a
viable PLAN for what you are to do today, you are
not prepared and the

A

patient may be taken away
from you in favor of someone who is prepared. If
you can’t describe in detail exactly what you plan
to do (in proper sequence), you have no business
treating the patient. (Your cheat sheet allowed

42
Q

BE RESPONSIBLE to collect & confirm
appropriate and accurate — to keep
the patient and yourself safe. Also to
accumulate all indicated — and studies to
determine an accurate diagnosis and be able to
prescribe appropriate treatment in an efficient
and caring manner.

A

health history
testing

43
Q

Every file that we use will be placed in the
red sharps container at completion of the
appointment We believe that — USE
FILES help to prevent —

A

SINGLE
SEPARATION

44
Q

TART RCT EARLY: Look for endo. all the time.
Frequent E-chair. Don’t shy away. Traditionally,
students accomplish –% of their endo in the 1st
20 mos. in the Clinic and –% in the last 4 mos.
Worst Possible Time to learn! Faculty is
overwhelmed with more difficult cases and less
experienced & more desperate students. The
least help on cases is available the last 4 mos

A

30
70

45
Q

TEAM APPROACH! Buddy up!

A

Volunteer to assist
your friend: You will learn the ropes and maybe your
friend will help you. Save time and Learn! Appreciate
the help of a good assistant!

46
Q

Keep your operating area sterile and clean.
Also keep it neat and organized. This will save you
valuable treatment time (instead of looking for
misplaced instruments). This habit will create
time for you to have at least — additional appoint
each day and to look professional doing i

A

1

47
Q

You may find that PERSONAL MANAGEMENT SKILLS may
become very important to you as you advance to the Clinic:

A

among your SKILLS must be Communication, Motivation,
Accommodation, Attitudes, Time Management, Patience,
Analgesia, Antisepsis, and Self Control, etc

48
Q

Don’t worry: Avoid all foreseeable failures by
alert — but some may still occur.
But don’t worry. We learn little from success
while Failure observed and corrected is the path
to improvement

A

PLANNING AHEAD

49
Q

Clinical Endodontics is DIFFICULT and requires
—. Look to your Clinical Faculty for
help. We are happy to answer questions, look at
the situation and generally help (UNLESS it is your
competency Exam)

A

CONSTANT FOCUS

50
Q

Learn to use your TIME responsibly.
One eventually learns that — is
the secret to success and prosperity. Remember:
The task will always expand to meet the time
available (whether or not you choose to recognize
it). Plan to start and finish at the given time or
sooner

A

TIME MANAGEMENT

51
Q

GET into the HABIT of — BEFORE you begin treatment to
learn to anticipate possible problems which may
occur during treatment and may be revealed at the
planning stage. Faculty will be helpful if asked.

A

searching tooth anatomy and
radiographic studies

52
Q

When you complete a case, be sure to have the
— Grade Sheet filled out and Graded by the
faculty with whom you worked. Take a photo on
your phone of the graded case and immediately
take the — Grade Sheet to the Endo Office to
have the Grade recorded so we may be aware of
your advancement toward graduation in Endo

A

Green
Green

53
Q
  • If you think about it: You have been somewhat
    successful throughout your academic years by an
    ADVERSARIAL APPROACH with faculty (arguing the
    finest details to get another point in hope for a better
    grade)
  • Now, your OBJECT is to LEARN to
A

Perfect your SKILLS:
Think of faculty more as a Mentor to help you learn.
(no need to argue; we both want a good result)

Endodontics 2 (12 decks)

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