DT 3 Endodotics Flashcards
Define endodontics
treatment of the dental pulp
and the tissues that surround the root of the tooth
Education required for Endodontics
DDS requires 3 years
what was done historically to relieve tooth pain ?
pulp chambers were covered with gold foil or asbestos
year endodontics was recognized as specialty
1963
WHO describe removal of pulp tissues?
Pierre Fauchaud
How does endodontic disease occur?
infected/inflammation of pulp tissue and nerves
cause of pulp inflammation/infection
physical damage by decay, or injury
abscess?
a localized area of pus
What affect does chronic damage to the pulp have?
Nercosis
dead blood vessels of tooth
symptoms of pulpal nerve damage
pain during mastication
sensitivity to hot/cold
noticeable facial swelling
Fever
Crack/discolored tooth
TEnder gingiva
Fracture
Tooth is broken
chewing on hard foods,
grinding your teeth at night,
Avulsion
displacement of a tooth from its socket in alveolar bone due to trauma
When is endodontics indicated?
pulpal nerve damage
fractured
avulsion
tooth is structurally sound enough to be restored back to function,
contraindications to endodontic treatment
-tooth not structurally sound
extensive coronal damage
bone loss
tooth loose
root fracture
infection
subjective examination
evaluation of symptoms or problems described by the patient/ history of the patient’s pain.
(what we hear)
objective examination
evaluation of the status of the tooth and surrounding tissues
(what we see)
The first logical diagnostic tools for ENDO ar:
exam and radiographs
Diagnostic test: control tooth vs. suspect tooth
control tooth is healthy tooth of the same type
suspect tooth - tooth bothering pt
The purpose of percussion
determine if inflammation has reached the periapical tissues.
tapping on incisal and occlusal with mirror handle
The palpation test
helps detect sensitivity / swelling
done by applying firm pressure to the mucosa above the apex of the root.
tooth Mobility test
uses 2 mirror handle ends
normal mobility is 1-2 mm
Thermal Test _COLD
no response- pulp is dead
cold relive pain= irreversible pulpitis
cold painful= irreversible pulpitis
Thermal Test
not as reliable as cold test
positive response = irreversible pulpitis
electric pulp test
delivers a small electrical stimulus to the pulp
can’t be used with patients who have pacemakers.
Radiographs taken for Endo
Pariapical
Aa Diagnostic Periapical is taken to determine ____
abscess or inflammation present
of Radiographs RCT procedures
3
PA during- detemine canal length
PA after- make sure canal filled
PA recalls- make sure no re-infection and seal is maintained
Bleaching non-vital
tooth dies and the pulp is not removed BLOOD cause stain
tooth opened on lingual
pulp cleaned and bleached applied
repeated after 3-7 days
Hemisection
root and crown split lengthwise and removed
typically done on MANDBILUAR molars
Apicoectomy
removal of apical area of root that has PREVIOUS RCT
Root apex and abscess removed using a bur and sutured
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Endo procedure: Open and drain
tooth is drilled, dental pulp is removed
tooth is left open so the abscess can continue to drain
2nd appt= pt. return for the RCT to seal the tooth
Pulpotomy
Removing the coronal portion of an exposed pulp
covering it with a sedative dressing to preserve pulp vitality
Emergency pulpectomy
dental pulp is removed
the canals are filled and topped with a filling
Performed on vital primary teeth and
Root canal therapy involves
access to pulp through crown
removal of infected pulp
cleaning RC space
filling space with material
place filling on top
RCT : Single appointment
everything complete in 1 appointment
typically 60 to 120 min
RCT: Multi appointments
2-3 appt to complete
60-90 min appt
often booked 1-3 weeks apart
RCT Calcified Canals
secondary dentin fills canal due to aging
makes it difficult to access pulp
RCT Exceptional Anatomy
root are slightly curved
RCT: Difficult Access
there are limited openings
RCT is succeful __% of time
90-95% of the time-
Indications for RCT surgical intervention
endo infection
fractured/curved roots
Delay in RCT will lead to
Intrinsic Stains
non vital bleaching is done on
tooth that has RCT but is stained from blood that leaked into dental tubules
Indirect Pulp Cap
pulp tissue is visible through dentin
Direct pulp cap
pulpal exposure after decay is removed
