Endo Flashcards
Can you name 6 risks of endodontic treatment
Failure to negotiate canals to WL
Hypochlorite accident
Matieral extrusion
Instrument seperation
Perforation
Root fracture
Post operative - pain and swelling
What is the average life expectancy of a RCT
7-10 years
Where are majority of acessory and lateral canal locate
In the apical third
Name 6 reasons for irrigation
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
What is the function of sodium hypochlorite
Disinfection and dissolves organic material
What is the function of EDTA
Removes the smear layer
What are three reasons that we may get extrusion of the sodium hypochlorite thiurgh the canal
Syringe locked in canal
High pressure injection
Injecting too depp
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
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
What are 7 things we should do to prevent a sodium hypochlorite accuident
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
What taper do k files have on them
2 degres
What is a glide path
Exploration of root canal with a small diameter K file to estimated working length
What are 4 advantages of the crown down technique
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
What is balanced force
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
What is the benefit of reciproc blue over normal recipoc
Increased flexibility and cylic fatigue resistance
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
Should be instrumented and obturated in the same visit - this avoids possibility of contramination of a previously sterile root canal
Non vital teeth with symptoms or swellings should revcive an inter-visit medicaments to completely disinfect and reduce inflammation - what could you use
Non setting CaOH - it has a ph of 12.5 and is antibacterial therfore reducing inflammatory potential
If your paitent has a hot pulp - what is an inter-visit medicatment you would consider placing
Odontopaste - antimicrobials paste with a steroid ; reduces inflammation
Name 3 functions of obturation
Seals in remaining bacteria
Provides apical and coronal seal
Prevents re infection
What are three criteria of a tooth before it can be obturated
Fully dry
Biomechanically cleaned
Asymptomatic
Name 3 methods of obturation
Cold lateral compaction
Thermafill
Warm vertical compression
What are 4 constituents of GP
Zinc oxide
Radiopacifeirs
Plasticisers
Waxes
Name 4 functions of sealers
Lubrication
Fills space between GP and root canal
Fills voids and irregularities in cancal
Provides a fluid tight seal
What is cyclic fatigue
Generation of tension/compression cycles leading to instrument failure
What is endo stripping
Vertical perforation in middle section of a curved root caused by excessive instrumentation oof internal wall
Name 4 reasons a tooth may still have Symtoms following am RCT
Bone ; microorganisms within the bone creating an inflammatory process leading to symtoms
Lateral acessory canals
Tooth not sterile
Infection into PDL
Name the 2 indications for re-trematent of a RCT
Teeth with inadequate root filling wiht radiological findings/symtopms
Teeth with inadequate root canal filling when coronal restoration requires replacement
What is watch windings
Back and forward oscillation of 30-60 degrees used wiht small diameter files
What is herb schillers 3 principles
Clean and shape using mechanical and chemical irrigation
Smooth tapered continously flaring cancal
Maintain position of apical foramen
Reversible pulpitis is findings indicating that the inflammation shouls resolve and the pulp return to normal following Managment of aetiolgies - what are the symtoms
Discomfort felt with cold and sweet - goes away once stimulus removed
Not spontaneous pain
Symptomatic Irreversible pulpitis is findings indicating that the pulp is incapable of healing and RCT is indicated - what are the symptoms
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
Why can symptomatic irreversible pulpitis sometimes be hard to diagnose
Because sometimes the inflammation has not yet reached the periapical tissues thus resulting in no pain or discomfort to percussion
What is asymtomatic irreversible pulpitis
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.
What is symtomatic apical periodontitis
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
Severe pain to percussion is highly Indicative of what
Degenerating pulp and RCT is needed
What is aysymptomatic apical periodontitis
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).
What are symtoms of a chronic apical abscess
Gradual onset
Little or no discomfort
Intermittent discharge of pus through an associated sinus tract
Typically signs of osseous destruction as a radioluncey
What are the symptoms of an acute apical abscess
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
