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xD3 Endo Midterm > Endo Basics Review > Flashcards

Endo Basics Review Flashcards

1
Q

Which Weine class has one single canal with one foramen?

A

Type I

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2
Q

Which Weine class has two canals converging to one foramen?

A

Type II

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3
Q

Which Weine class has 2 canals and two foramina?

A

Type III

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4
Q

Which Weine class has one canal dividing into 2 canals with 2 separate foramina?

A

Type IV

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5
Q

Maxillary Central Incisor (# roots, # canals, chamber outline, average length)

A

1 root
1 canal
Triangular pulp, 3 horns
22.5mm

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6
Q

What is the key to remember with respect to the pulp chamber and the external tooth morphology?

A

The pulp chamber forms the tooth so the shape of the pulp chamber mimics the shape of the tooth

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7
Q

What is common in maxillary central incisors that must be removed to allow access to the lingual wall of the root cavity?

A

Lingual shoulder

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8
Q

What is the difference in root canal shape of a maxillary central incisor between a young tooth and an older tooth?

A

Young maxillary central incisors have a triangular-shaped pulp chamber wherease the older ones will have an oval shape

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9
Q

Maxillary Lateral Incisor (# roots, # canals, chamber outline, average length)

A

Single root
Single canal
Compressed triangle, 2 horns
22 mm

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10
Q

Maxillary Canine (# roots, # canals, chamber outline, average length)

A

Single root
Single canal
Oval pulp NO PULP HORNS
26.5mm

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11
Q

What is common about all anterior maxillary teeth?

A

Lingual shoulder must be removed

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12
Q

What is not evident radiographically on maxillary canines and what does it require?

A

Facial curvature of root apex; must do tactile exploration with small file prior to inserting larger files

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13
Q

What is the character of mandibular incisor root canal that splits into 2 canals, but exits foramen at one common foramen?

A

2 canals in 20-40%

Usually reunite and exit at 1 common foramen

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14
Q

What Weine class is a mandibular incisor root canal that splits into 2 canals, but exits foramen at one common foramen?

A

Type II

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15
Q

In a mandibular incisor with 2 root canals, where does the division of canals usually occur?

A

Coronal to the middle third

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16
Q

Where is a mandibular incisor pulp chamber and root canal wider: labiolingually or mesiodistally?

A

Labiolingual (opposite of maxillary incisors)

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17
Q

What is the access outline of mandibular incisor and what does it depend on?

A

Oval to triangular depending on the prominence of mesial and distal pulp horns

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18
Q

What is the average length of the mandibular incisor?

A

20.7 mm

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19
Q

What commonly covers the 2nd canal in a mandibular incisor?

A

Lingual shoulder

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20
Q

In what patient would you have a more triangular access due to more prominent mesial and distal pulp horns?

A

Younger

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21
Q

What is the clinic technique to ensure removing lingual shoulder to expose the common (20-40%) 2nd canal in a mandibular incisor?

A

Extend access prep well into cingulum gingivally

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22
Q

Mandibular canine characteristics (# roots, access outline, average length).

A

Smaller overall dimensions than maxillary canine
2 roots and 2 canals not uncommon
14% have 2 canals at orifice and 6% have 2 canals at apex
Oval access, wide BL, narrow MD
25.6 mm

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23
Q

Maxillary premolars have how many roots and which is most common?

A

1,2, or 3 roots

Common = 2 roots with 2 canals

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24
Q

Where are the pulp horns and where is the pulp chamber wider in a maxillary 1st premolar?

A
  1. BL pulp horns

2. Wider BL than MD

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25
Q

What is the external access form for a maxillary 1st premolar?

A

Oval, wide BL, narrow MD, centered between cusp tips

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26
Q

What is a morphologic consideration with a maxillary 1st premolar for the preparation?

A

Mesial root concavity, if you overextend mesially you could perforate the root

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27
Q

What are 2 places the maxillary 1st premolar is prone to fractures?

A

MD root fractures

Fractures at base of cusp, particularly buccal cusp

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28
Q

What is required restoratively after root canal therapy to prevent cuspal and/or crown/root fracture of a maxillary 1st premolar?

A

Full occlusal coverage to prevent cusp or crown/root fracture

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29
Q

What is present in the lingual aspect of the buccal root at the level of the furcation?

A

Prominent dentin depression

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30
Q

Maxillary 2nd premolar has how many roots most of the time?

A

One

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31
Q

What is the majority root canal morphology for a maxillary 2nd premolar?

A

75% 1 canal at apex

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32
Q

What is the 2nd most common root canal morphology for a maxillary 2nd premolar?

A

24% 2 canals at apex

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33
Q

The maxillary 2nd premolar has how many pulp horns and which is the larger of them?

A

B and L pulp horns, the buccal is larger

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34
Q

What is the access outline for maxillary 2nd premolars?

A

Oval, wider BL than MD

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35
Q

What is the average length of a maxillary 2nd premolar?

A

21.5 mm

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36
Q

What are 2 places where maxillary 2nd premolars are prone to fracture?

A

MD root fracture at the base of the cusp (particularly the buccal cusp)

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37
Q

What is required restoratively after endo treatment of maxillary 2nd premolars and why?

A

Full cusp coverage restoration to prevent cusp or crown / root fractures

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38
Q

What is the morphology of mandibular 1st premloar root canal systems?

A

2 pulp horns with large pointed B horn and small rounded lingual horn

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39
Q

The majority (74%) of mandibular 1st premolars have how many canals at the apex?

A

One

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40
Q

What is the second most common (24.5%) number of canals at the apex of a mandibular 1st premolar?

A

Two

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41
Q

What is the racial statistic in mandibular 1st premolars?

A

2 rooted mandibular 1st premolar 3 times higher incidence in African Americans

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42
Q

What is the average length of mandibular 1st premolars?

A

21.6mm

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43
Q

What is the character of the 2 canal mandibular 1st premolar?

A

Lingual canal diverges at sharp angle away from central canal. Fast break.

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44
Q

The crown morphology of a mandibular 1st premolar does what to files?

A

Lingual incline of crown deflects files buccally

45
Q

The mandibular 2nd premolar normally has how many roots and how many root canals?

A

1 root, 1 canal (97.5%)

46
Q

What is the racial statistic in mandibular 2nd premolars?

A

Three times higher incidence of 2 roote mandibular 2nd premolars in African Americans

47
Q

What is the average length of mandibular 2nd premolars?

A

22.3mm

48
Q

What is an opening created down the center of the tooth into the pulp chamber in order to enter the root canals space?

A

Endodontic access

49
Q

Endodontic access openings are based on what?

A

Anatomy and morphology of individual tooth

50
Q

What dictates the design of access cavity or preparation for endo?

A

Pulp chamber morphology

51
Q

What determines the external surface of the tooth?

A

The internal pulp anatomy

52
Q

What are 5 objective of endodontic access?

A
  1. Excavate caries
  2. Locate all canals
  3. Completely remove pulp chamber roof and all coronal pulp tissue
  4. Achieve straight line access
  5. Conserve tooth structure
53
Q

When removing coronal pulp tissue during endodontic access, may vital tissue be left behind and only necrotic pulp tissue be remoed?

A

No. Remove ALL pulp tissue because remnants can harbor bacteria that can compromise success or discolor crown.

54
Q

What causes crown discoloration after incomplete removal of coronal pulp tissue or even trauma to a tooth?

A

Build up of hemosiderin

55
Q

Where does straight line access go?

A

Either to the apical foramen or to the initial curvature of the canal

56
Q

What can commonly inhibit straight-line access with respect to the pulp chamber and access?

A

Lingual shoulder

57
Q

What are 2 reasons why an endodontic access seeks to conserve tooth structure?

A
  1. Avoid weakening tooth

2. Maintain restorability

58
Q

What are the requirements for endodontic access?

A
  1. Knowledge of tooth anatomy
  2. Clinical inspection of tooth
  3. Preop radiographs (PA, shift shot, BW)
59
Q

When is a BW radiograph useful for endodontic treatment?

A

Visualize posterior teeth pulp chambers and their tilt/angulation

60
Q

How is a BW good for determining restorability of a tooth prior to endodontic treatment?

A

Good indicator of bone levels, extent of caries or previous restorations

61
Q

When must a rubber dam be placed?

A

Can be after access, but must be on before any file/instrument is placed into the canal space

62
Q

What are the best burs to use for access?

A

Round #4 and Round #2

63
Q

What bur is used once the pulp chamber is accessed and why?

A

Endo Z bur to go across chamber and make form without going deep, Z bur is a side cutting bur only

64
Q

What is a Gates Glidden bur used for?

A

In a slow speed for opening coronal flare of canal space

65
Q

What is an endodontic spoon excavator used for?

A

To remove pulp tissue and stones

66
Q

What is an endodontic explorer used for?

A

To locate canals

67
Q

For a maxillary central incisor, more prominent pulps horns means what?

A

The more triangular the access

68
Q

What is the bur location and placement for initial access on maxillary incisors?

A

Perpendicular to the lingual surface in the middle 1/3 of the crown

69
Q

What is the bur placement on a maxillary central incisor once the initial access outline is made?

A

Parallel to the long axis of the tooth

70
Q

How do you unroof a chamber completely?

A

After penetrating the pulp chamber, catch the round bur under the lip of the dentin roof and remove un upstroke/withdrawal

71
Q

What is a method to confirm complete roof removal?

A

Take the operative explorer and see if the tip catches when you withdraw it towards the occlusal on the M D and F walls

72
Q

What is the term for the lingual shelf of dentin that extends from the cingulum to a point approximately 2mm apical to the orifice?

A

Lingual shoulder

73
Q

What are 3 options for removing a lingual shelf?

A

Tapered diamond, carbide, gates glidden

74
Q

What will occur if the lingual shoulder is not removed?

A

File deflected buccally and will not make contact with the lingual wall of the canal

75
Q

A mandibular incisor access should be broad where?

A

FLwider, MD narrow

76
Q

As a mandibular incisor pulp recedes, what does this do to the access outline?

A

Access becomes more ovoid while a younger patient with more prominent MD pulp horns will have a more triangular access outline

77
Q

Mandibular incisors can have 2 canals what percentage of the time?

A

20-40%

78
Q

What mandibular incisor character makes access difficult and perforation easy?

A

Narrow MD

MD concavities

79
Q

Which canal will be easier to locate in a 2 canal mandibular incisor?

A

Facial. The lingual is covered by the lingual shoulder

80
Q

What should you always do with the access prep on the mandibular incisor and why?

A

Extend towards the cingulum to look for the lingual canal

81
Q

What bur is recommended for the lingual shelf removal on mandibular incisor and why?

A

Gates Glidden in slow speed because the crown is narrower MD

82
Q

What can mandibular canines have that is uncommon in maxillary canines?

A

2 roots and 2 canals

83
Q

Why is the canine access ovoid?

A

Absence of pulp horns

84
Q

What is the crown morphology difference between a mandibular canine and maxillary canine?

A

Mandibular crown is longer and more slender than maxillary canine

85
Q

How far should the incisal access of a canine be from the incisal edge to allow for streight line access?

A

2-3 mm from the incisal edge

86
Q

What is a consideration in the access of mandibular canines?

A

2nd canal. Gingival extension penetrating cingulum to allow for exploration.

87
Q

The BL access extension is normally wider on which tooth: Maxillary 1st premolar or Maxillary 2nd Premolar

A

Beneath B and L cusp tips equidistant from a line through MD of chamber

88
Q

What is the position of the canals in a maxillary premolar?

A

Beneath B and L cusp tips equidistant from a line through MD of chamber

89
Q

If 3 canals exist in a maxillary premolar, which root will most likely house the 2 canals?

A

Buccal

90
Q

What is the outline access form and orientation for a maxillary premolar with 3 canals?

A

Triangular with the base at the facial (over B root) and the apex towards the lingual / palatl root

91
Q

In a maxillary 1st premolar, where is the mesial concavity located?

A

At the level of the CEJ with thin tooth structure at mesial, causing a risk for lateral perforation

92
Q

If the file deflects buccally or linguall in a maxillary 2nd premolar, what is this indicating?

A

There is a second canal, if not already located

93
Q

If a large, centered, oivoid canal located in a maxillary 2nd premolar what does this indicate?

A

A single canal

94
Q

Which mandibular premolar is prone to multiplpe canals?

A

Mandibular first premolar. Only the mandibular 2st premolar has the likelihood of 3 canals

95
Q

What is an external orientation consideration for endo on a mandibular premolar?

A

Crown tilted lineally relative to root: mandibular 1st moreso than mand 2nd

96
Q

Due to the lingual inclincation of the mandibular first premolar, where should the access prep be started?

A

Halfway up buccal cusp versus just buccal to central groove in mandibular 2nd premolar

97
Q

What are the access laws?

A
  1. Law of Centrality
  2. Law of Concentricity
  3. 1st Law of Symmetry
  4. 2nd Law of Symmetry
  5. Law of Color Change
  6. 1st Law of Orifice Location
98
Q

What does the law of centrality state?

A

Floor of pulp chambe ralways located in center of tooth at level of CEJ

99
Q

What does the Law of Concentricity state?

A

Walls of pulp chamber are always concentric to the external surface of the tooth at the level of the CEJ

100
Q

The external root surface anatomy reflects what?

A

The internal pulp chamber anatomy (Law of Concentricity)

101
Q

The first law of symmestry states what and what tooth is the exception?

A

Canal orifices line on a line perpendicular to a line drawn MD through the center of the pulp chamber floor EXCEPT MAXILLARY MOLARS

102
Q

What does the Law of Color Change state?

A

The pulp chamber floor is always darker in color than the walls.

103
Q

What does the 1st Law of Orifice Location state?

A

Orificies of root canals are always located at the junction of the floor and the walls

104
Q

What are 4 errors in Access Cavity preparations?

A
  1. Failure to unroof pulp chamber
  2. Inforrect bur angulation during access
  3. Failure to measure estimated depth of access
  4. Incorrect tooth accessed
105
Q

What is a problem resulting from failing to completely unroof a pulp chamber?

A

Leave the pulp horn and therefore leave the pulp tissue

106
Q

What is a problem resulting from failing to correctly angle the bur during access?

A
  1. Miss the pulp chamber

2. Perforate tooth

107
Q

What is a problem resulting from incorrectly measuring the estimated depth at access?

A

Extend beyond the pulpal floor and perforate

108
Q

What is a method to avoid accessing the wrong tooth?

A

Always count and verify

xD3 Endo Midterm (7 decks)

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