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BDS3 Restorative > Endo > Flashcards

Endo Flashcards

1
Q

How do you assess a RCT?

A

Clinically assess- coronal seal, ferrule, swelling/ sinus/ TTP/ mobility/ increased pocketing

Radiographically assess- length and quality of obturation (within 2mm apex, well condensed), bone support, radiolucency.

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2
Q

What is the ideal crown to root ratio?

A

1:1.5

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3
Q

List some problems post RCT?

A

Amount of remaining tooth structure
Wide post holes
Endo complications (fractured instruments, perforations, short/ long root fillings)
Coronal micro leakage

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4
Q

How long should an unrestored RCT be left until it needs to be re-root treated?

A

3 months

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5
Q

What is a post/ core?

A

Core provides retention for crown, post retains the core (does NOT strengthen/ reinforce the teeth)

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6
Q

What are some indications for post placement?

A

Incisors/ canines/ widest canal in premolar
4-5mm root filling apically to post
No more 1/3 of root width at narrowest point, 1mm coronal dentine
Sufficient alveolar bone support (half of post length)

Minimum 1:1 post length/ crown length ratio

1.5mm ferrule (height and width of coronal dentine)

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7
Q

What are contraindications of post placement?

A

Mandibular incisors (thin/ tapering/ narrow mesiodistal roots)
Posterior tooth
Curved canals (perforations)
Insufficient ferrule

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8
Q

What is ferrule?

A

Encirclement of 1-2mm dentine above gingival level

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9
Q

Describe the qualities of an ideal post design

A

Parallel sided post (avoids wedging, causing fracture)
Non-threaded (smooth, incorporates less stress to remaining tooth)
Cement retained - buffer between masticatory forces and post/tooth

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10
Q

What are the material options for a post?

A

Cast metal/ Stainless steel - poor aesthetics, root fracture, corrosion
Zirconia - high flexoras strength/ fracture toughness, difficult retrievability and root fracture common
Carbon/ glass fibre - flex the same as dentine, aesthetic, retrievable, bond to dentine with DBAs.

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11
Q

Describe the process of prefabricated post placement?

A

No impressions/ lab visit required - 1 appt
Chairside core build-up

Post and core in different materials

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12
Q

Describe the placement of custom posts?

A

Indirect pattern fabricated from impression of post hole and wax up of post and core in lab /
Casts from direct pattern fabricated in patients mouth (Duralay)

2 appts - impression and fit (temporise between- risk of root canal contamination)

Cast post made in Type IV heat hardened gold

Irrigate canal with chlorohexidine 0.2%, dry with paper points.
Place cement, use firm apical pressure, remove excess cement.

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13
Q

What is a core build up?

A

The internal part of the tooth built up with restorative material to replace lost tooth tissue (provides retention and resistance for definitive restorations).

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14
Q

What are the material options for core build up?

A

Composite (used with fibre post)
Amalgam (needs 24 hours to fully set, avoid as retention is required)
Glass ionomer (absorbs water and core expands in size-not used)

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15
Q

What is a Nayara core?

A

Root treatment is removed, amalgam packed into the canals and tooth is built up (provides retention).
Cannot be prepared until amalgam fully set (24 hours)

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16
Q

How is gusta percha removed?

A

Soften GP (heat/ solvent)
Gates glidden to minimum size 3 (straight part of canal) - use WL and rubber stopper on gates glidden
Leave 3-5mm GP in apical third
Check GP plug remains

17
Q

What are some problems with post crowns?

A

Perforations
Core fracture
Root fracture/ crack
Post fracture

If repeated de-bonding of crown- suspect root fracture.
Long single pocket- suspect vertical fracture

18
Q

How long does it take to assess healing of a RCT?

A

4 years

19
Q

What are the requirements for post design (length etc)

A

Length should be 1:1 to crown height
4-5 mm GP should be left apically
Post should not pass beyond curvature of root
Width of post should not be more than q/3 root width at narrowest part

20
Q

What is used as an inter appt medicament in Endodontic treatment?

A

Non-setting calcium hydroxide
Antimicrobial (high pH)
Hydrolyses LPS (anti-inflammatory)
Effective at removing tissue debris
Easy to remove

Alkaline pH encourages tertiary dentine formation

21
Q

What is the purpose of obturation?

A

Produces an apical and lateral seal to prevent microorganism ingress, seals in any microorganisms and prevents reinfect ion
Creates an environment to allow healing

22
Q

What is working length?

A

Estimated- measured from coronal reference point to apex (on radiograph) and subtract 1mm
Corrected- length irrigation and obturación should be completed to (measured using apex locator)

23
Q

What is a patency file?

A

Small and flexible file used to clear the apical foramen (use size 10 K file)

24
Q

What is the master apical file?

A

The largest file taken to working length (use this size of GP)

25
Q

What material can be used as a pulp cap/ apical plug/ to plug perforations?

A

MTA - best for apical plug and perforations as requires moisture to set (pdl)
Bio dentine- sets more rapidly so can be used for director pulp cap, encourages bone formation due to high pH

26
Q

What is GP made of?

A

Rubber
Zinc oxide
Resin
Barium sulphate (radiopaque)

27
Q

What is the purpose of irrigation?

A

Dissolves organic debris
Disinfects canal
Lubricantes canal
Removes debris from prep

28
Q

Which materials are used for irrigation?

A

Sodium hypochlorite 3% - used for 10 mins to dissolve organic debris, antimicrobiano action
EDTA (17%) - used for 1 min to remove smear layer (created during prep)

29
Q

What is the purpose of cold lateral compression?

A

Seals gaps between GP points
Seals lateral canals
Seals gaps between dentine and core

30
Q

What are Herb Schilder’s endo principles?

A
  • clean and shape canal using mechanical and chemical irrigation
  • smooth, tapered, continuously flaring canal
  • maintain position of apical foramen

BDS3 Restorative (7 decks)

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