Disease; Working Length; Canal Preparation Flashcards
Types & aetiology of endodontic disease; importance of establishing working length & methods; limitations of these methods; instrumentation & their biological role.
2 branches of endo disease
- of the pulp 2. of the periapical tissues
example of periapical disease and classification types
Apical Periodontitis. translucent area on x-ray. acute/chronic/abscess etc.
abscess vs granuloma
abscess: presence of puss
granuloma: chronic inflammation of tissue
two types of pulpal disease
reversible + irreversible pulpitis
overall cause of pulpitis
bacteria (fungi may cause APICAL periodontitis)
effect of trauma to pulp i.e. drilling partly through it in A STERILE ENVIRONMENT
will not cause pulpitis; bacteria needs be present; thus need for IPC & complete caries removal in endo
“itis” =
“inflammation of”
“ectomy” =
“removal”
what is common to both pulpal and periapical disease
the aetiological factors (irreversible pulpitis –> necrosis –> apical periodontitis)
3 categories of aetiological factors for endodontic disease
Microbial
Chemical (can only irritate pulp in absence of bacteria)
Mechanical (can only irritate pulp in absence of bacteria)
x2 microbial factors
caries.
leakage around restorations.
x2 chemical factors
dental materials - irritants (composite resins are cytotoxic; eugenol may kill a pulp, but it’s only chemical capable of this).
bleaching - (Hydrogen Peroxide = irritant)
*microbial biofilm also required for these to cause irreversible pulpitis)
x3 mechanical factors
operative dentistry.
dentine exposure.
trauma.
*microbial biofilm also required for these to cause irreversible pulpitis
the presiding aetiologic factor for irrevers pulpitis
microbial infection
3 categories of endodontic procedures & one thing to note.
Vital Pulp treatment.
Non-surgical endodontics.
Surgical endodontics.
*sometimes more than one may be required
meaning of Vital Pulp Treatment
pulp capping
another term for pulp capping
Pulpotomy
meaning of Non-surgical endodontics
root canal treatment/retreatment
types of Surgical endodontics
Apicectomy (root end surgical removal & substitution w a biocompatible material).
Hemisection (removal of one un-treatable root in a multirooted tooth)
Non-surgical Root Canal Treatment - Pulpectomy
removal of the pulp. aka “first stage RCT”
indications for pulpECTOMY
irreversible pulpitis OR
pulp necrosis.
pulpECTOMY scenarios
- deep decay
- deep restoration (shallow doesn’t count)
- cracked tooth
- constant pain
- swelling
- Apical periodontitis may be present.
6 stages of RCT
- Assessment, restorABILITY and Tx plan
- Access
- Chemo-mechanical prep
- Obturation
- Restoration
- Follow up
q’s to ask in 1. Assessment
tooth saveable? pt’s desire to keep or extract? enough structure remaining?