Endo - Case selection and treatment planning Flashcards
Is pregnancy a contra-indication of endo treatment?
No, but only emergency treatment should be carried out In the first trimester.
Always communicate with the patient OB.
What should be considered for patients with CVS?
If they have had an MI in the last 6months then don’t carry out the treatment. Infection risk too high.
Emergencies should be consulted with patients cardiologist
What are some ways in which you can make appointments more appropriate for CVS patients?
Stress-reducing protocols;
Pain and anxiety relief
Sedation
Short appointments
Cancer considerations?
A patient who has had head and neck chemo or radiotherapy may have healing problems.
Consult oncologist.
Diabetics should be monitored closely as can be compromised by acute endodontic infections. How would you make appointments better suited for these patients?
Appointments early in the morning after a meal.
As to not keep them waiting and interfere with their meals or insulin routine.
Minimise stress
What are bisphosphates used for?
They are used to strengthen bone in patients with osteoporosis and certain types of cancers.
What can bisphosphates cause? and what treatment increases the risk of this?
BRONJ
Ex
Communicate with the entire healthcare team for these patients
As Ex is a key cause of BRONJ, what might you do to teeth that would have otherwise been Ex?
Non-surgical endodontic treatment
What must every patient have before endodontic treatment is even considered? and what tool do you use to do this?
Periodontal status
BPE is taken using a BPE probe
If poor periodontal prognosis then no endo treatment is indicated
What are some possible restorative considerations?
How extensive is the caries.
Poor root to crown ratio
Misalignment of teeth
Presence of pre-existing full coverage or extremely large and deep restoration.
What are 3 important tools to have for vision into the canal?
Magnification
Good lighting
Front surface mirror
There are two types of root resorption, internal and external. Describe them both.
Internal is where it originates from the pulp, as a result of untreated chronic pulpitis. (appears continuous with the canal)
Whereas external root resorption originates from the PDL tissues and doesn’t involve the pulp.
What are the 5 types of root canals, making treatment difficult?
One RC from chamber to apex.
Two root canals leave the chamber and converge into one at the apex
One root canal leaves the chamber splits into two and reconverges into one at the apex.
Two root canals leave the chamber and two are present at the apex.
One root canal leave the chamber but two root canals are present at apex
If on a radiograph a canal is shorter (from the apex) than normal what could this mean?
That the canal divided and the angle at which the radiograph was taken couldn’t pick it up.
Root calcification happens more coronally.
Where does root calcification take place in the root?
More coronally
