Endo

Question 1

Can you name 6 risks of endodontic treatment

Answer 1

Failure to negotiate canals to WL
Hypochlorite accident
Matieral extrusion
Instrument seperation
Perforation
Root fracture
Post operative - pain and swelling

Question 2

What is the average life expectancy of a RCT

Answer 2

7-10 years

Question 3

Where are majority of acessory and lateral canal locate

Answer 3

In the apical third

Question 4

Name 6 reasons for irrigation

Answer 4

Mechanical prep alone doesnt remove all the bacteria

Reaches areas which the files cannot get to

Flushes out the debris

Organic and non organic content dissolved

Removes smear layer

Lubritacation

Question 5

What is the function of sodium hypochlorite

Answer 5

Disinfection and dissolves organic material

Question 6

What is the function of EDTA

Answer 6

Removes the smear layer

Question 7

What are three reasons that we may get extrusion of the sodium hypochlorite thiurgh the canal

Answer 7

Syringe locked in canal
High pressure injection
Injecting too depp

Question 8

You are irrigating for a paitent during a root canal when they ask you to stop as they feel extreme pain and swelling - what has happened and what do you do - 8 marks

Answer 8

Stop and give patient LA for pain relief
Reassure the paitent - tell them what has happened and this complication can be controlled
If bleeding through canal - allow this to happen until haemostatis achieved
Irrigate with saline 15 mins
Dress tooth with non setting CaOh and cornel seal restaotion
Review in 24 hours
Advice for paitent surrounding analgesia ice pack for 24 hours with warm compress
May need antibiotics

Question 9

What are 7 things we should do to prevent a sodium hypochlorite accuident

Answer 9

Check on the radiographic - do we have an open apex or any perforations
Pre-op build up required
Disposable build and eye wear for paitent
Isolate the dam with oraseal
Test integrity of dam wiht CHX
Only fill syringe 3/4 of way to aid control
Label each syringe correctly and use index finger rather than thumb

Question 10

What taper do k files have on them

Answer 10

2 degres

Question 11

What is a glide path

Answer 11

Exploration of root canal with a small diameter K file to estimated working length

Question 12

What are 4 advantages of the crown down technique

Answer 12

Removes bulk of infected tissue
Reservoir for irrigant
Keeps reference point for WL -makes straight line access easier
Limits spread of infection at apical foramen

Question 13

What is balanced force

Answer 13

Use this in step back
Insert file into canal until it binds - rotate 60 degrees clockwise to engage dentine
Then 60-120 degreees to cut off engaged dentine
Repeat 3x

Question 14

What is the benefit of reciproc blue over normal recipoc

Answer 14

Increased flexibility and cylic fatigue resistance

Question 15

If a tooth had a vital pulp and no tenderness and it is getting a RCT - what should the treatment include that day and why

Answer 15

Should be instrumented and obturated in the same visit - this avoids possibility of contramination of a previously sterile root canal

Question 16

Non vital teeth with symptoms or swellings should revcive an inter-visit medicaments to completely disinfect and reduce inflammation - what could you use

Answer 16

Non setting CaOH - it has a ph of 12.5 and is antibacterial therfore reducing inflammatory potential

Question 17

If your paitent has a hot pulp - what is an inter-visit medicatment you would consider placing

Answer 17

Odontopaste - antimicrobials paste with a steroid ; reduces inflammation

Question 18

Name 3 functions of obturation

Answer 18

Seals in remaining bacteria
Provides apical and coronal seal
Prevents re infection

Question 19

What are three criteria of a tooth before it can be obturated

Answer 19

Fully dry
Biomechanically cleaned
Asymptomatic

Question 20

Name 3 methods of obturation

Answer 20

Cold lateral compaction
Thermafill
Warm vertical compression

Question 21

What are 4 constituents of GP

Answer 21

Zinc oxide
Radiopacifeirs
Plasticisers
Waxes

Question 22

Name 4 functions of sealers

Answer 22

Lubrication
Fills space between GP and root canal
Fills voids and irregularities in cancal
Provides a fluid tight seal

Question 23

What is cyclic fatigue

Answer 23

Generation of tension/compression cycles leading to instrument failure

Question 24

What is endo stripping

Answer 24

Vertical perforation in middle section of a curved root caused by excessive instrumentation oof internal wall

Question 25

Name 4 reasons a tooth may still have Symtoms following am RCT

Answer 25

Bone ; microorganisms within the bone creating an inflammatory process leading to symtoms
Lateral acessory canals
Tooth not sterile
Infection into PDL

Question 26

Name the 2 indications for re-trematent of a RCT

Answer 26

Teeth with inadequate root filling wiht radiological findings/symtopms

Teeth with inadequate root canal filling when coronal restoration requires replacement

Question 27

What is watch windings

Answer 27

Back and forward oscillation of 30-60 degrees used wiht small diameter files

Question 28

What is herb schillers 3 principles

Answer 28

Clean and shape using mechanical and chemical irrigation
Smooth tapered continously flaring cancal
Maintain position of apical foramen

Question 29

Reversible pulpitis is findings indicating that the inflammation shouls resolve and the pulp return to normal following Managment of aetiolgies - what are the symtoms

Answer 29

Discomfort felt with cold and sweet - goes away once stimulus removed
Not spontaneous pain

Question 30

Symptomatic Irreversible pulpitis is findings indicating that the pulp is incapable of healing and RCT is indicated - what are the symptoms

Answer 30

Sharp pain upon thermal stimulus, the pain will linger
There will be unprovoked/ spontaneous pain and sometimes referred pain.
Postural changes may affect the pain
OTC analgesia ineffective

Question 31

Why can symptomatic irreversible pulpitis sometimes be hard to diagnose

Answer 31

Because sometimes the inflammation has not yet reached the periapical tissues thus resulting in no pain or discomfort to percussion

Question 32

What is asymtomatic irreversible pulpitis

Answer 32

C linical diagnosis based on subjective and objective indings indicating that the vital inlamed pulp is incapable of healing and that root canal treatment is indicated.
These cases have no clinical symptoms and usually respond normally to thermal testing but may have had trauma or deep caries that would likely result in exposure following removal.

Question 33

What is symtomatic apical periodontitis

Answer 33

Represents inflammation of the periodontium - producing clincal Symtoms involving painful response to biting and or percussion.
This may or may not be accompanied with radiographic changes

Question 34

Severe pain to percussion is highly Indicative of what

Answer 34

Degenerating pulp and RCT is needed

Question 35

What is aysymptomatic apical periodontitis

Answer 35

Inflammation and destruction of the apical periodontium that is of pulpal origin.

It appears as an apical radiolucency and does not present clinical symptoms (no pain on percussion or palpation).

Question 36

What are symtoms of a chronic apical abscess

Answer 36

Gradual onset
Little or no discomfort
Intermittent discharge of pus through an associated sinus tract
Typically signs of osseous destruction as a radioluncey

Question 37

What are the symptoms of an acute apical abscess

Answer 37

Rapid onset
Spontaneous pain
Extreme tenderness to pressure
Pus formation
Swelling of assacoted tssiues
May be no radiographic signs of osseous destruction
Paitent often experiences malaise fever and lyphadenopathy