Endo Final Study guide Flashcards
Using a straight stainless-steel (SS) file will create a ledge in the:
outer wall of the canal
What type of file is used for scouting?
10 stainless steel hand file or #8 SS hand file can also be used
Continual clockwise rotation of SS file will result in the file:
becoming locked into dentin & fracturing
Which canal is hardest to access on the maxillary first molar?
MB2 canal (as often as 95%)
A maxillary first molar has an MB2 canal what percent of the time?
95%
Which tooth has 2 roots most of the time?
Maxillary first premolar (85% has two canals, 9% has one canal, 6% has three canals)
How should you check local anesthetic?
Using endo ice
(slides also mention percussion & EPT. Use whatever caused the pain prior to using LA)
T/F: Use whatever agent caused pain prior to LA to check the LA
True
T/F: If you miss a canal, you can still get a successful RCT
False
T/F: You must always used a rubber dam in endodontic treatment
True
How many teeth should be isolated with a rubber dam during endodontic treatment?
Only one
T/F: You should always use LA during endodontic treatment
True
What size should the canal be enlarged to for NaOCl infiltration?
30 sized file
(think 30/30 rule: canal should be atleast widened to a side #30 file diameter and infiltrated for atleast 30 min)
What does the 30/30 rule state?
Canal should be atleast widened to size a size #30 file diameter & infiltrated for atleadt 30 min)
How long should you irrigate with NaOCl for?
30 min
After you use EDTA, what should you then use to stop the EDTA from working?
8.3% NaOCl
What is the least severe type of luxation?
Concussion
List in order from least to most severe types of laxation:
- Concussion (least)
- Subluxation
- intrusion
- extrusion
- lateral luxation
- avulsion
- crown fracture
- crown-root fracture
- root fracture
- bone fracture (most)
T/F: Rigid & semi flexible splinting are used for stents to have little movement to prevent ankylosis
False
(Short-term flexible splints and long-term rigid splints are used to prevent ankylosis)
Does the following description indicate localized swelling or cellulitis?
May drain spontaneously
Localized swelling
Does the following description indicate localized swelling or cellulitis?
Patient will NOT run a fever
Localized swelling
Does the following description indicate localized swelling or cellulitis?
Patient will be seriously ill (facial pain, fever, cannot open mouth)
Cellulitis
Does the following description indicate localized swelling or cellulitis?
It is acceptable to infiltrate and drain fully
Localized swelling
Does the following description indicate localized swelling or cellulitis?
Incise and drain and antibiotics may beed to preceded pulp extirpation
Cellulitis
Does the following description indicate localized swelling or cellulitis?
Patient could experience hospitalization
Cellulitis
Does the following description indicate localized swelling or cellulitis?
Patient should be referred to an endodontist
Cellulitis
Does the following description indicate localized swelling or cellulitis?
It is acceptable to do an infra-orbital block
Localized swelling
Does the following description indicate localized swelling or cellulitis?
It is acceptable to consider incise & drain
Localized swelling
Option selection and prognosis for a horizontal root fracture (HRF) depends on:
- level of fracture
- restorability
- periodontal health
- vitality of pulp
- stage of root development
(time since injury, age of patient, cooperation of patient, availability to follow-up, approximation opportunities & stabilization options)
Which has a worse prognosis, vertical root fracture or horizontal root fracture?
Vertical root fracture
If your patient has localized pain to percussion, what anatomical feature is involved?
PDL
What is the taper on a blue Vortex file?
0.4
(find taper by counting the marks and multiplying that number by 0.2- for example: 2 marks = 2 x 0.2= 0.4 taper)
What is the WORST error you can make when accessing a canal?
Perforation
What is the MOST COMMON error you can make when accessing maxillary first premolars?
Not totally unroofed
T/F: Internal root resorption has an excellent prognosis before it perforates to PDL. External root resorptions prognosis is worse than internal respiration.
Both statements are true
What is the shape of access on a maxillary central incisor?
Triangular with base towards incisal
What is the shape of access on a mandibular molar?
Trapezoidal- need to do trapezoidal and not triangular to find the DL canal (remember that a missed canal is a failed RCT)
Which area is the hardest to anesthetize?
Mandibular molar with hot irreversible pulpitis (2nd mandibular molar)
Which tooth has the greatest challenge for access?
Maxillary first molars with four canals
What can cause a challenge with local anesthetics ability to work?
acidic environment/low pH
T/F: Activator does not diminish the time of use for NaOCl
True
What can you reasonably assume from a J lesion?
Vertical root fracture
(slides say you must open the tooth surgically to confirm)
Vital pulp therapy is used to:
Keep the apices vital until it closes, and the roots thicken/straighten
Treatment aimed at preserving and maintaining pulp tissue that has been compromised by trauma, caries, or restorative procedures in a healthy state:
Vital pulp therapy
Your patient comes in with pain present on their tooth. When exposed to endo ice, the pain lingers for 20 seconds. What is your pulpal diagnosis?
Symptomatic irreversible pulpitis
A draining sinus tract is only found in what apical diagnosis?
Chronic apical abscess (CAA)
A complicated crown fracture means:
there is an enamel-dentin fracture with pulpal involvement
The most important factor for success of a preimplantation of an avulsed tooth is the:
Extra-oral dry time
(must be between 0-15 minutes for PDL to survive; this prevents ankylosis and external root resorption)
T/F: You should rinse off avulsed tooth with water before reinsertion
False- ideally used Save-A-Tooth, then Via Span, then milk or green tea, then contact solution, then saliva, never use water
Which tooth has the narrowest M-D width for access?
Mandibular incisors (central incisors)
When can you do supplemental injections/buccal infiltration?
After IA block is proven to be numb
What length should you mark your bur at for access on a molar to avoid perforation?
7mm
What is the EFFECTIVE WORKING TIME for pulpal anesthetic?
30-90 minutes
Most pulpal anesthetic will be lost around what time? (AVERAGE WORKING TIME)?
45 minutes (file says 30-45)
T/F: Dental trauma affects the patient for life
True
T/F: You should NOT complete RCT if you can not use a rubber dam and cannot find an alternative
True
What is the order for hand files?
White, yellow, red, blue, green, black
(Will you really be going back)
T/F: The accessory rotatory file is the only file that has 0.12 taper
True
T/F: Non-perforation is better than external root resorption
True
What is the working length of NaOCl irrigation in a canal?
2mm
A patient comes to your office with food impaction, cervical caries present on #27 and #28, and gingival inflammation. The patient experiences pain with percussion and palpation. What should you do?
- remove all caries
- refer to periodontist for crown lengthening before completing restorations
A patient comes to your office with toothbrush abrasion and hypersensitivity to cold. The patient responds normal to all other clinical tests, what is your pulpal diagnosis?
Reversible pulpitis
A patient comes to your office with previously initiated RCT. What should you do?
Refer to an endodontist
On a mandibular incisor, it is possible to see 2 canals. Which canals are you likely going to miss if you do not create access incisally?
Lingual canal
Which bur is recommended to use for mandibular incisor access?
2 round bur
What is the most important factor when working with 8.3% NaOCl?
Do not let the needle bind
T/F: A end-activator significantly reduces the time necessary for NaOCl to be present in the canal when irrigating
False
(only saves time for the Dr because they can do other things while the machine irrigates)
NaOCl turns into salt & water. How long does this process take to occur?
3-5 min
T/F: You should always start with the tooth in question for clinical testing
False
(You should start with 2-3 adjacent teeth first to establish a baseline)
