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YR 2 - CSA > Endo > Flashcards

Endo Flashcards

1
Q

Define Endodontology

A

the understanding of the dental pulp form, function, health, injuries and the science of diseases

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2
Q

What is Endodontics?

A

the skills required for the prevention and treatment of endodontic infections

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3
Q

What do you have to Consider in Regards to the tooth?

A
  • history of pulp-dentine complex
  • pulp function
  • pulp space anatomy
  • cause of injury
  • peri-radicular pathology
  • technical aspects determining success
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4
Q

What are the 4 Functions of the Pulp?

A
  • development of the tooth
  • sensation
  • nutrition - blood supply
  • defence
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5
Q

Describe No. of Roots of each Teeth

A

lowers central, lateral, canine, premolars = 1 root
lower molars = 2 roots

upper central, lateral, canine = 1 root
upper 1st pre-molar = 1 or 2
upper 2nd pre-molar = 1
upper molar = 3

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6
Q

What do you Need to Know About Each Tooth?

A
  • pulp chambers
  • canal shapes
  • no of roots
  • no and length of root canals
  • how to gain access
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7
Q

What are 5 Pulp Responses?

A

Inflammation
Secondary Dentine
Recovery
Necrosis
Arterio-Venous Shunts

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8
Q

What is the Process of Caries Infecting the Pulp?

A
  • demineralisation
  • extends in the dentine
  • pulp is inflamed
  • pulp lays down tertiary dentine
  • to relieve intra-pulpal pressure, arterio-venous shunt is formed
    = infection stays in one place
  • flow of dentinal fluid from the pulp causes pain
    = more inflammation, more pain
  • pulp chamber calcifies and shrinks
  • pulpal necrosis
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9
Q

What are the Last Nerve Cells to Die?

A

C-fibres - explains the severe pain

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10
Q

What Tissues and Areas do you Anaesthetise?

A

upper incicisor
= buccal infiltration and/or palatal

upper molars
= buccal infiltration and palatal

lower canine
= mental infiltration and or lingual

lower molar
= ID block, long buccal infiltration, lingual block

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11
Q

Why May Anaesthesia not work?

A

Hyperaemic Pulp
- large number of dilated congested blood vessels

Infection
- nerve c fibres = hyperextendable so may not block conduction
- pH can be too acidic

Patient Factors
- increased vascularity - solution removed rapidly
- individual response
- pain threshold

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12
Q

What do you Isolate With?

A

rubber dam
oraseal putty - seal small gaps

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13
Q

Why do you Isolate? (4)

A
  • protect patient airway from risk of ingestion/inhalation from instruments
  • protect patient airways from irrigants
  • prevent oral bacteria recontamination
  • improves access and visualisation
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14
Q

what should be ensured regarding the condition of the tooth before endodontic treatment is commenced?

A
  • the crown is deemed restorable
  • caries and defective restorations are removed
  • it will be a sound coronal restoration
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15
Q

What is the Purpose of Pre-Operative Radiographs?

A
  • no of roots
  • no of canals
  • morphology
  • current restorations
  • caries presence
  • presence of canal sclerosis/stones/previous RCT
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16
Q

What Is the Aim of Coronal Access?

A
  • remove roof of pulp chamber
  • no damage to pulp floor
  • good visualisation
  • retentive for temp restoration
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17
Q

What is the Difference between Gates-Glidden Burs and Regular burs

A

safe ended - no cutting flutes or diamond at the tip
- can remove safely around the pulp chamber floor

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18
Q

How do you Mechnically Prepare the 2/3 Chamber Access?

A

Step-Down Technique
- create funnel shape
- removes most heavily infected area
- prevent bacteria being carried apically
ONLY FOR THE CORONAL 2/3

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19
Q

How do you Create a Tapered Funnel?

A

use the smallest file
work up to the apex constriction until it is loose
irrigate each file
keep increasing the file size until master apical is reached

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20
Q

How do you Mechanically Prepare the 1/3 Apical?

A

K-flex files

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21
Q

What Chemicals are Used?

A

EDTA with files
= lubricate canals
= remove smear layer

Sodium Hypochlorite irrigant

22
Q

4 Pros and 2 Cons of NAOCl

A
  • destroy microorganisms
  • dissolve organic matter
  • lubricant
  • biocompatible
  • bleach clothes
  • problems if contact with healthy tissue
23
Q

What Intra-Canal Medicant is Used between Visits and Why (7)?

A

calcium hydroxide paste

  • easy to use and remove
  • cheap
  • long-lasting
  • antibacterial
  • anti-inflam
  • non-irritant
  • promote periapical healing
24
Q

Why May a Temp Restoration be Placed?

A

when the treatment is not completed in one visit

  • seal the tooth
  • restore function
  • prevent over-eruption
  • restore aesthetics
25
What are some Common Temporary Materials?
kalzinol (zincoxide eugenol), glass ionomer, polycarboxylate cement
26
What are the 2 Aims of RCT?
provide hermetic seal of the canal system prevent microorganisms from entering and re-infecting t
27
What is Used to Obturate the Canals? Describe its Properties.
GP points - gutta percha made of zinc oxide and radioopaquers properties - visco-elastic - softened by heat/solvents
28
How does the Apical Region Differ from Coronal Region?
- low oxygen levels - nutrients are from periradicular tissues rather than oral cavity - bacteria is less accessible to treatment
29
What is Periapical Disease?
disease progresses to periapical as there is no physical or biological barriers to microbial ingress
30
What are the 4 Zones of Inflammation in Periapical Disease?
Inf = infected C = Contaminated Irr = irritated Stim = stimulated
31
What is in a Periapical Lesion?
granuloma consisting of: 45% epithelialise granulomatous tissue - fibroblasts fibrous capsule over: - small blood vessels - lymphocytes - plasma cells - macrophages
32
Describe Reversible Pulpitis
short duration sharp pain sensitive to cold and sweet pain is in response to stimulus
33
Irreversible Pulpitis
long duration throbbing, aching pain sensitive to hot, can be relieved by cold exacerbated by pressure spontaneous
34
Which 3 Neurons are Responsible for Pain?
AB = small diameter, myelinated = touch and pressure = low threshold = fast Ad = small diameter, myelinated = temperature = low threshold = fast C = large diameter, unmyelinated = high threshold = slow dull pain
35
What are the Problems on Diagnosing?
can only correctly diagnose when the tissue is removed - by then too late relies on patients symptoms to be accurate
36
Define SOCRATES
Site Onset Character Radiation Alleviation Time Exacerbating factors Severity
37
How can you Check Neural Response?
Electric Pulp Test Cold test
38
What is the Best Choice of Radiograph?
periapical
39
4 Pulpal Diagnoses in Order of Severity.
Dentine Hypersensitivity Reversible Pulpitis Irreversible Pulpitis Pulpal Necrosis
40
5 Endodontic Diagnoses in Order of Severity/
Acute Apical Periodontitis Chronic Apical Periodontitis Acute Exacerbation of Chronic Periodontitis Chronic Periapical Periodontitis with Suppuration Peripapical Abscess
41
How can you detect the Apical Constriction?
EAL - electronic apex locator diagnostic radiograph
42
What is the Apical Constriction?
the point at which PDL and root dentine meet
43
How do you Establish the Working Length?
use EAL - get zero reading and subtract 0.5mm - the zero reading is the point in which the canal ends - if you work to zero = wide apical constriction
44
What are other Chemical Irrigants aside from NaOCl and why are they not used?
EDTA - not antimicrobial, doesn't dissolve organic tissue Chlorhexadine - does not dissolve organic tissue - highly toxic when mixed with NaOCl = para-chloroaniline - carcinogenic precipitate
45
How much Irrigation is Used?
30ml
46
What is a heated plugger used for?
removing excess GP compacting GP in the coronal 1/3 root canal DO NOT LEAVE GP IN THE PULP CHAMBER
47
Describe Chemomechanical Preparation.
mechanical and chemical preparation of the canal - using Gates-Glidden burs - step-down technique - files to clean - use EDTA chelating agent - irrigate
48
What Intra-Canal Medicament is used to Be Placed in the Canals between Visits?
calcium hydroxide paste
49
Endodontic Sealers are used on the GP Points, give 3 Materials that are used.
zinc oxide eugenol, calcium hydroxide, glass ionomer
50
Endodontic Sealers are used on the GP Points, give 3 Materials that are used.
zinc oxide eugenol, calcium hydroxide, glass ionomer
51
After the Tooth has been Prepared, what are the 11 Steps.
1. choose GP with the same size point as master apical file 2. dry canals with paper points 3. place sealer on GP and insert 4. place finger spreader to compact against the wall 5. fill in the space with accessory GPs 6. repeat until you cant find any more in 7. take radiograph to ensure the root is filled to the correct length 8. use heated plugger 9. seal it in 10. final restoration 11. final radiograph

YR 2 - CSA (22 decks)

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