Direct Restoration of Endodontically Treated Teeth Flashcards

1
Q

Name 7 steps of the pre-operative assessment

A
  1. Endodontic status
  2. Anatomical factors
  3. Tooth position in the mouth
  4. Periodontal status
  5. Restorability of the tooth
  6. Occlusal factors
  7. Aesthetic concerns
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2
Q

Describe the endodontic status during a pre-operative assessment

A
  • Any previous root filling / quality?

- Presence of pathology?

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3
Q

Describe the anatomical factor during a pre-operative assessment

A
  • Number, shape and position of roots
  • Number of canals
  • Curvature
  • Patency
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4
Q

Describe the tooth position in the mouth during a pre-operative assessment

A
  • Anterior or posterior
  • Angulation
  • Over eruption
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5
Q

Describe the periodontal status during a pre-operative assessment

A
  • Pocketing
  • Localised deep narrow pocketing consider root fracture
  • Mobility
  • Perio-endo lesions
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6
Q

Describe the restorability of the teeth during a pre-operative assessment

A
  • Amount of the remaining tooth structure

- Condition of the existing restoration

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7
Q

Describe the occlusal factors during a pre-operative assessment

A
  • Occlusal contacts in ICP, RCP and lateral excursions

- Vulnerable cusps

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8
Q

Describe the aesthetic concerns during a pre-operative assessment

A
  • Involved in the aesthetic zone

- Discolouration

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9
Q

Name 3 effects of endodontic treatment on the integrity of the tooth

A
  1. Weakening of tooth structure
  2. Changes to structure and property of dentine
  3. Changes to mechanoreception of PDL
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10
Q

Name 4 ways the tooth is weakened by endodontic treatment

A
  1. Carious lesion
  2. Access cavity
  3. Changes to properties of dentine
  4. Force of cold lateral condensation
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11
Q

Name 4 ways structure and property of dentine is changed by endodontic treatment

A
  1. Collagen depletion
  2. Sodium hypochlorite / EDTA
  3. Medicaments
  4. Possible heat generated
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12
Q

Name 3 ways structure and property of mechanoreceptors of PDL is changed by endodontic treatment

A
  1. Loss of neurosensory feedback with biting forces
  2. Higher pain threshold in non-vital teeth
  3. Increased loading of non-vital teeth
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13
Q

Describe the 5 essential components of a restoration following endodontically treated teeth

A
  1. Coronal seal
  2. Restore function
  3. Improve the aesthetics
  4. Maintain gingival health
  5. Cuspal coverage
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14
Q

Describe the essential component of a restoration following endodontically treated teeth - “Coronal Seal”

A
  • Critical to prevent reinfection
  • Should be carried out as soon as possible
  • Applied either directly or indirectly
  • Isolation achieved by rubber dam, cotton wool and well-adapted matrix
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15
Q

Describe the essential component of a restoration following endodontically treated teeth - “Restore Function”

A
  • Restore tooth back into articulation
  • Provide occlusal centric stops
  • Approximal contact points
  • Prevents tilting and over eruption
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16
Q

Describe the essential component of a restoration following endodontically treated teeth - “Aesthetics”

A
  • Caries in unaesthetic
  • Treating the disease and restoring form will improve aesthetics
  • Consider bleaching non vital discoloured teeth
17
Q

Describe the essential component of a restoration following endodontically treated teeth - “Maintain Gingival Health”

A
  • Avoid positive and negative ledges at restoration margins
  • Sectional matrix system
  • Anatomical shape
  • Closed contact point
18
Q

Describe the essential component of a restoration following endodontically treated teeth - “Cuspal Coverage”

A
  • Depends on amount of tooth structure remaining and amount and direction of occlusal load
19
Q

Name 3 types of direct restorations following endodontic treatment

A
  1. Amalgam
  2. Composite
  3. Direct post
20
Q

Name 5 types of indirect restorations following endodontic treatment

A
  1. Inlay
  2. Onlay
  3. Overlay
  4. Full coverage crown
  5. Cast post crowns
21
Q

Describe restoration of anterior teeth

A
  • Small defects likely to be restored using composite
  • Larger defects may be considered for crowning
  • Retention may be achieved by post into canal space if not enough remaining tooth structure
22
Q

How are posterior teeth usually restored when both marginal ridges and cusps are lost?

A

Indirect restorations

23
Q

Discuss the use of a core in restoration of posterior teeth

A
  • Should be avoided as fractures common as all load down one root
  • Nayyar Core used instead
24
Q

Describe SDR as a material to restore posterior teeth

A
  • Self-Levelling
  • Applied in increment of up to 4mm and light cured
  • Requires composite cap
  • Low shrinkage and contraction