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Module 5 - Endodontics > Disinfection > Flashcards

Disinfection Flashcards

1
Q

3 organisms that are primarily present in root filled teeth?

A
  • Enterococci (29-77%)
  • Candida
  • Actinomyces
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2
Q

What are the two “main” functions of root canal irrigants? Give named examples.

A
  1. Antimicrobial (sodium hypochlorite, 2% chlorhexidine -historical).
  2. Remove smear layer (citric acid, 17% EDTA)
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3
Q

Which root canal irrigants are antimicrobial?

A
  • Sodium hypochlorite
  • 2% chlorhexidine.
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4
Q

Which root canal irrigants remove the smear layer?

A
  • Citric acid
  • 17% EDTA
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5
Q

EDTA?

A

Ethyldiaminetetraacetic acid

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6
Q

What organisms does sodium hypochlorite act against?

A
  • BROAD SPECTRUM: bacteria, fungi, spores, viruses.
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7
Q

What give sodium hypochlorite its antimicrobial properties?

A
  • Antimicrobial properties rely on FREE CHLORINE.
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8
Q

What is a MAJOR ADVANTAGE of sodium hypochlorite?

A

DISSOLVES NECROTIC/ ORGANIC TISSUE.

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9
Q

What are 3 important procedural factors for ensuring EFFECTIVENESS OF SODIUM HYPOCHLORITE?

A

VOLUME, FREQUENCY, PENETRATION OF IRRIGATING NEEDLE.

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10
Q

What is the recommended volume of sodium hypochlorite for each canal?

A

20mL per canal.

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11
Q

What are 5 disadvantages of Sodium hypochlorite?

A
  • Highly toxic.
  • Unpleastant taste.
  • Unable to remove smear layer.
  • Can damage clothing.
  • Can damage eyes.
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12
Q

4 reasons why sodium hypochlorite irrigation beyond the root apex may occur.

A
  • Wide apical foramina.
  • Apical constriction destruction (over-instrumentation, root resorption).
  • Extreme pressure during irrigation.
  • Binding of irrigation needle tip.
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13
Q

What are symptoms of a sodium hypochlorite accident (6)?

A
  • Extreme pain, burning sensation.
  • Hematoma and ecchymosis.
  • Swelling.
  • Profuse bleeding from root canal.
  • 2nd infection and tissue necrosis.
  • Paraesthesia.
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14
Q

What is the treatment for a sodium hypochlorite accident?

A
  • Inform patient.
  • Minimize swelling, control pain, prevent secondary infection.
  • cold/warm compresses, anelgesia, antibiotics (prevent 2nd infection), refer to OS for removal of necrotic tissue.
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15
Q

How is the smear layer produced and what does it contain?

A
  • Cleaning and shaping produces a layer that covers instrumented walls.
  • Contains inorganic and organic substances, microorganisms, necrotic materials.
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16
Q

Why should the smear layer removed?

A
  • Protects microbes from the effects of disinfectants.
  • Prevents complete adaptation of obturation materials to root canal surfaces.
17
Q

How does 17% EDTA remove the smear layer?

A

Reacts with calcium ions in dentine to form SOLUBLE CALCIUM CHELATES.

18
Q

What is a disadvantage of 40% citric acid?

A

Can leave precipitation crystals.

19
Q

What is used for endodontic irrigation (syringe etc).

A
  • 3mL Luer lock syringe.
  • 27 gauge needle with side vent.
20
Q

4 steps to follow to ensure safe irrigation?

A
  • Bend needle 2-3mm short of working length.
  • Keep needle constantly moving in canal.
  • Ensure needle doesn’t bind to canal.
  • Put pressure with forefinger.
21
Q

What is the irrigating sequence?

A
  • Irrigate with full 3mL syringe after every rotary file.
  • Recapitulate with size 10 flexofile.
  • Irrigate again with 3mL syringe.
22
Q

What is the irrigating sequence once preparation is complete?

A
  • 3mL syringe sodium hypochlorite.
  • 3mL syringe of citric acid.
  • 3mL syringe of sodium hypochlorite.
23
Q

What are the 5 functions of CaOH?

A
  • Kills bacteria and inactivates endotoxin.
  • Reduced inflammation.
  • Helps eliminate apical exudate.
  • Controls inflammatory root resorption.
  • Prevents contamination between appointments.
24
Q

How does CaOH achieve its antimicrobial activity?

A
  • Release of OH ions in aqueous solution.
  • Effects on bacterial cells (3): Damage to bacteria cytoplasmic membrane, DNA damage, protein denaturation.
25
Q

2 aims of interappointment medicament?

A
  • Reduce and prevent multiplication of microorganisms that remain following careful cleaning and shaping.
  • Prevent reinfection through coronal and apical leakage.
26
Q

How is CaOH placed into root canals?

A
  • Dry the canals with STERILE paper points (finishing file used).
  • Completely fill using spiral filler or disposable tips measures 2mm SHORT of WL - do not extrude.
27
Q

What is a weeping canal?

A

Discharge present at each canal opening.

28
Q

How is a weeping canal/ canal with exudate treated?

A

use CaOH to dress the canal (calcifying potential, high pH, may cauterise residual chronically inflamed pulp).

Module 5 - Endodontics (11 decks)

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