Endo Glossary Flashcards
abscess
localised colllection of pus within a tissue space
access cavity
opening prepared in a tooth to gain access to the root canal system for the purpose of cleaning, shaping and obturating
accessory canal
any branch of the main pulp canal or chamber that communicates with the external surface of the root
acute apical abscess
inflammatory reaction to pulpal infection and necrosis characterised by rapid onset, spontaneous pain, tenderness of tooth to pressure, pus formation and swelling of associated tissues
allodynia
pain resulting form a non-noxious stimulus to normal skin or mucosa
anaesthetic test
special investigation in which a tooth suspected of being the source of referred pain is anaesthetised with LA, if the pain is alleviated the suspected tooth may be the source of the pain
anatomic apex
tip of the root as determined by morphology
apex
tip/end of root
apex locator
an electronic device used as an aid in determining the root canal working length or perforation; operates on the principles of resistance, frequency or impedance
apexification
method to induce a calcified barrier in a root with an open apex or the continued apical development of an incompletely formed root in teeth with necrotic pulps
apexogenesis
vital pulp therapy procedure performed to encourage continued physiological development and formation of the root end
apical constriction
apical portion of the root canal having narrowest diameter; position may vary but it is usually 0.5-1.0mm short of the centre of the apical foramen
apical delta
pulp canal morphology in which the main canal divides into multiple accessory canals at or near the apex
apical gauging
measurement of the terminal diameter or shape of a canal after the initial crown-down shaping
apical patency (patency filing)
technique where the apical portion of the canal is maintained free of debris by instrumentation with a small file through apical foramen
apicetomy
see root-end resection
asymptomatic apical periodontitis
inflammation and destruction of apical periodontium that is of pulpal origin, appears as an apical radiolucent area and does not produce clinical symtoms
atypical odontalgia (phantom tooth pain)
pain with all the classic features of pulpagia usually following an extraction but not appearing to be of peripheral origin
austenitic phase
crystalline unstressed phase of stainless steel and nickel titanium alloy
backfiling
injection and/or compaction of GP into canal after creation of apical seal
balanced force technique
technique for cleaning and shaping the root canal system that allows opposing physical forces to guide each preparation instrument; uses clockwise rotation to engage dentine and counter-clockwise rotation whilst maintaining apical pressure to cut dentine
baradontalgia
tooth pain caused by a change in ambient pressure, often reported whilst flying or diving
bifurcation
anatomic area where roots of 2 rooted teeth divide
bioceramic
group of bioactive ceramic materials that are biocompatible with good physical and chemical properties used in endodontics as pulp capping or root end filing materials
biofilm
community of bacteria/fungi held together by an extracellular matric that adheres to a surface
bite test
diagnostic procedure in a which a tooth suspected of being cracked is subjected to differential occlusal forces on individual cusps in an attempt to replicate the reported discomfort; usually accomplished by having the pt bite on various plastic, wood or rubber objects
bleaching
use of a chemical agent to remove tooth discolouration
blunderbuss canal
term denotes an incompletely formed root in which the apical diameter of the pulp canal is greater than the coronal diameter
bony crypt
osseous cavity made or modified in bone during periradicular surgery
braiding technique
wrapping of multiple small files around an object in the root canal to aid in its removal
broach
thin, flexible, fragile usually tapered and pointed metal hand instruments with sharp projections curving backwords and obliquely
primarily use to remove pulp tissue or other easily engaged materials from the canal
buccal object rule
method of determining the relative location or objects that are superimposed on an intra-oral radiograph
Rule: when 2 different radiographs are made of a pair of objects, the image of the buccal object moves, relative to the image of the lingual object, in the opposite direction from which the X-ray beam is directed
C-shaped canal
pulp canal anatomy having the cross sectional shape of the letter ‘c’
found in the mandibular 7s in which mesio-buccal and distal canals communicate due to fusion of the mesial and distal roots
calcium hydroxide Ca(OH)2
odourless, strongly basic, frequently used as an intracanal medicament in nonsurgical endodontic procedures and also secondary to traumatic injuries; preparations appear to encourage calcification; different preparations may be used in pulp capping, pulpotomy, apexogenesis and apexification procedures in the secondary dentition; appears to inhibit inflammatory resorption and demonstrates anti-microbial activity.
canals
The space within the root of the tooth extending from the pulp chamber to the apical foramen; may be narrow, have lateral branches and/or exhibit irregular morphology.
carbamide peroxide (CH6N2O3)
Hydrogen peroxide coupled to urea; frequently marketed in an acidified, anhydrous glycerine base as a patient-applied extracoronal tooth-bleach system; breaks down into urea, ammonia, carbon dioxide (carbonic acid in saliva) and hydrogen peroxide.
cemental tear
complete or incomplete separation along the cementodentinal interface
type of root surface # typically seen in single rooted teeth
may present itself as a periapical or periodontal lesion
cementodentinal junction
The region at which the dentine and cementum are united; commonly used to denote the point at which the cemental surface terminates at or near the apex of a tooth; position can range from 0.5 to 3.0 mm from the anatomic apex.
cementoenamel junction
the region at which the enamel and cementum meet in the cervical region of the tooth; cementum may overlap the enamel; cementum and enamel may meet abruptly, or a gap may exist.
central sensitisation
increased synaptic efficacy established in somatosensory neurons in the dorsal horn of the spinal cord following intense peripheral noxious stimuli, tissue injury or nerve damage. This heightened synaptic transmission leads to a reduction in pain threshold, an amplification of pain responses and a spread of pain sensitivity to non-injured areas.
chelation
removal of inorganic ions from tooth structure by a chemical agent ususally disodium salt of EDTA
sometime used in an attempt to enlarge narrow canals or remove the smear layer after canal prepartion
chlorohexidine
Bis-biguanide antiseptic agent used to prevent colonization of microbes and to kill or inhibit microorganisms on surfaces; known for its substantivity.
chronic apical abscess
Inflammatory reaction to pulpal infection and necrosis characterized by gradual onset, little or no discomfort and the intermittent discharge of pus through an associated sinus tract.
circumferential filing
peripheral planing of all root canal walls equally during preparation
condensing osteitis
diffuse radiopaque lesion representing a localised bony reaction to a low-grade inflammatory stimulus, usually seen at apex of a tooth
cone beam-computed tomography CBCT
3D radiographic image from a cone shaped beam for evaluating teeth and supporting structures
CBCT reference planes: AXIAL
plane parallel to the ground
which separates the head from the feet
CBCT reference planes: SAGITTAL
plane from front to back
which divides the body into right and left
CBCT reference planes: CORONAL
plane from side to side
which divides the body into front and back
core build up
restoration used to replace missing coronal tooth structure in a root-filled tooth
cracked tooth
thin surface disruption of enamel and dentine and possible cementum, of unknown depth or extension
crow-down preparation
technique of canal prep involving early flaring with rotary instruments followed by incremental removal of canal debris and dentine from the orifice to the apical foramen
curettage
surgical procedure to remove diseased or reactive tissue and/or foreign material around the root
cyclic fatigue
instrument failure due to repetitive stress caused by work hardening and metal fatigue
divided into 2 stages starting with crack initiation in which microcracks form and start to grow preferentially along specific crystallographic planes or grain boundaries followed by crack propagation continuing until final fracture. Also known as flexural fatigue.
cyst
epithelium-lined pathologic cavity that may contain fluid, semi-solid material or cellular debris.
Below are only a selection of cystic lesions and consideration should be made of other diagnostic entities.
Lateral periodontal cyst - small odontogenic cyst of the periodontal ligament found most often in the mandibular canine and premolar areas; associated with a vital pulp and postulated to originate from the rests of Malassez, the rests of the dental lamina or a supernumerary tooth bud.
Periapical pocket cyst (bay cyst) - apical inflammatory cyst containing a sac-like, epithelium-lined cavity that is open to and continuous with the root canal.
Periradicular cyst (apical cyst, periapical cyst, radicular cyst) - an odontogenic cyst associated with a tooth with a necrotic pulp that develops within a periradicular inflammatory lesion; derives its epithelium from the cell rests of Malassez.
True cyst - apical inflammatory cyst with a distinct pathologic cavity; completely enclosed in an epithelial lining so that no communication to the root canal exists.
dens invaginatus (dens in dente)
Developmental defect resulting from infolding of the crown before calcification has occurred; may appear clinically as an accentuation of the lingual pit in anterior teeth; in its more severe form, gives a radiographic appearance of a tooth within a tooth, hence the term “dens in dente”; most common in the maxillary lateral incisors but may occur in any tooth of the dental arch.
dental dam
Latex or non-latex sheet used to isolate a tooth or teeth from the oral environment and to prevent migration of fluids or foreign objects into or out of the operative field; single or multiple holes punched through barrier allow placement around the tooth or allow teeth to be isolated; provides a dry, visible and clean operative field
dental dam clamp
metal device that is placed around a tooth at the level of the gingiva to secure a dental dam in position
available in varying configurations to fit different teeth
dental dam forceps
instrument used to spread a dental dam clamp allowing it to be placed around or removed from a tooth
dental dam frame
metal device used to stretch dental dam, hold it and secure its edge away from operative site
dental dam punch
device used to punch holes in dental dam
dental granuloma
Histologic term used to describe tissue formed adjacent to the apex of a tooth with pulp pathosis; characterized by chronic inflammatory cells such as macrophages, plasma cells and lymphocytes and sometimes a cluster of multinucleated giant cells; capillaries, fibroblasts and collagen fibers also present
dentinal fluid
Intratubular and extracellular fluid that is thought to be an ultrafiltrate of blood from the terminal pulpal capillaries. It diffuses through the space around the odontoblastic process and possibly through the intracellular structure of the odontoblast itself prior to entering the dentinal tubule and continuing a slow outward movement under a pressure gradient and eventually leaving the tooth through dentinal tubules
dentine
mineralized tissue that forms the bulk of the crown and root of the tooth, giving the root its characteristic form; surrounds coronal and radicular pulp, forming the walls of the pulp chamber and root canals;
composition is approximately 67% inorganic, 20% organic and 13% water
primary dentine
dentine formed during tooth development; exhibits well-organized pattern of tubules and cell processes.
secondary dentine
circumpulpal dentine formed by normal pulp function after tooth formation is complete; tubular pattern is regular, but number of tubules is less than that found in primary dentin; secondary dentin is separated from primary dentine histologically by a hyperchromatic line or demarcation zone.
tertiary dentine
dentine formed by external influences, including caries and attrition, and can range from regular tubular dentine that differs little from primary and secondary dentine (reactionary dentin), but can be very dysplastic and/or irregular, and atubular when there is odontoblast loss depending on the differentiation status of the formative cell.
reactionary dentine
tertiary dentine matrix secreted by surviving odontoblast cells in response to an appropriate stimulus.
reparative dentine
tertiary dentine matrix secreted by odontoblast-like cells in response to an appropriate stimulus after the death of odontoblasts; stimuli tend to be much stronger than those causing reactionary dentine formation.
sclerotic dentine
dentine characterised by calcification of the dentinal tubules as a result of injury or normal aging; it appears translucent in ground sections due to the difference in refractive indices of calcified dentinal tubules and adjacent normal tubules when examined by transmitted light.
dentine blush
red to pink discoloration of denitne due to pulpal haemorrhage, usually result of trauma or operative procedures
dentine bridge
Tertiary (reparative) dentine formation that provides closure of a previously exposed pulp or forms across the excised surface of a pulp after pulpotomy; can be irregular in structure, contains tunnel defects and is less calcified than secondary dentine; may be facilitated by chemical agents such as calcium hydroxide, mineral trioxide aggregate (MTA), or other bioceramic materials.
desensitise
eliminate or reduce painful dentinal response to irritating agents
diagnosis
science of detecting and distinguishing deviations from health and the cause and nature thereof
differential diagnosis
Process of identifying a condition by comparing the symptoms of all pathologic processes that may produce similar signs and symptoms
dilaceration
Deformity characterised by displacement of the root of a tooth from its normal alignment with the crown; may be a consequence of injury during tooth development. Common usage has extended the term to include sharply angular or deformed roots.
disinfection
Non-specific term implying the destruction of pathogenic microorganisms, but not necessarily of spores; usually by chemical agents.
down packing
Compaction of incremental segments of heat-softened gutta-percha to create an apical plug.
dysesthesia
Unpleasant abnormal sensation, whether spontaneous or evoked. Special cases of dysesthesia include hyperalgesia and allodynia. A dysesthesia should always be unpleasant and a paresthesia should not be unpleasant.
EDTA (ethylenediaminetetraacetic acid)
Odorless, white, crystalline solid whose various salts are soluble in water; disodium salt of ethylenediaminetetraacetic acid in a buffered aqueous solution is used as a chelating agent in root canal preparation; used to remove calcium, demineralize and soften dentine, and remove the smear layer.
elastic limit
point at which internal structure changes to prevent return to original form
elasticity
quality that allows a structure or material to return to its original form upon removal of an extreme force
elbow
narrow portion of a curved canal immediately coronal to a transportation or zip
endodontic/periodontal lesion
Process involving interaction of diseases of the pulp and periodontium.
endodontics
branch of dentistry concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including the biology of the normal pulp and the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.
endodontology
study of endo
enucleation
Removal of tissue lesion in its entirety; in endodontics, the term usually refers to the surgical removal of periradicular lesions.
envelope flap
Horizontal intrasulcular surgical flap with no vertical releasing incisions.
ethyl chloride
colourless, extremely volatile, flammamble liquid used in endo to apply cold as a pulp test
external bleaching
The use of a chemical agent on the outside of a tooth to remove discoloration from tooth structures; most frequently used agent is carbamide peroxide.
extrusion
Term used to describe when irrigants, gutta percha or endodontic sealers exit the apical foramen and contact the periodontal tissues.
fatigue
transitional weakening of a material due to cyclic loading and unloading characterised by frature below its ultimate tensile strength
fenestration
A window-like opening or defect in the alveolar plate of bone frequently exposing a portion of the root; usually located on the facial aspect of the alveolar process.
ferrule
band/ring of tooth structure surrounding the crown or root of a tooth to provide strength for the restorative material
file
tapered and pointed metal instrument with cutting edges used to enlarge the root canal by rotation or filing action; classified principally on activation method, alloy, cross-sectional shapes, taper, tip design and length of cutting flutes.
filing
Dynamic movement of a hand file to optimally effect canal debridement; predominantly a push- pull (rasping), rotational (reaming) movement or a combination of the two. Engine-driven filing motions can be rotary, reciprocating or oscillating.
surgical flap
Section of tissue, such as gingival mucosa, that has been partially detached from the underlying tissue but retains uninterrupted blood supply through an intact base; classified:
by position - apically positioned, lateral or vertical sliding;
by geometric shape - curved (semilunar), rectangular, scalloped, trapezoidal or triangular; or
by location of the incision - intrasulcular, submarginal or vertical.
flare-up
acute exacerbation of an asymptomatic pulpal and/or periradicular pathosis after the initiation or continuation of root canal treatment
fluctuant
Tactile sensation of fluid motion noted during palpation of a mass or swelling such as an abscess.
foramen
Openings in the root structure that communicate with the dental pulp and generally contain neural, vascular and connective elements..
Accessory foramen - orifice on the surface of a root communicating with a lateral or accessory canal.
Apical foramen - main apical opening of the root canal. Can be between 0 -3 mm from the radiographic apex
fracture
Split or break in tooth structure. A disruption of the enamel and/or dentine and/or cementum that is assumed to be of greater depth than a crack, of unknown depth or extension, visible or not visible clinically or radiographically, and with separated or unseparated segments.
Vertical root fracture - fracture in the root whereby the fractured segments are incompletely separated; it may occur buccal-lingually or mesial-distally; it may cause an isolated periodontal defect(s) or sinus tract; it may be radiographically evident.
Horizontal root fracture (oblique root fracture) - fracture due to traumatic injury confined to the root in a transverse plane separating the root into coronal and apical segments, with the fracture being confined either partially or completely within bone. The fracture can be buccal-lingually or obliquely oriented.
fremitus
palpable movement of a tooth when subject to occlusal forces
front surface mirror
mirror with reflective surface above backing reduces image distortion
full mucoperiosteal flap
Flap involving an intrasulcular horizontal incision and including epithelium, attached gingiva, alveolar mucosa and periosteum; triangular and rectangular flaps are examples.
furcation
anatomic area of a multi-rootes tooth where the roots diverge
furcation canal
accessory canal located in the furcation
gates-glidden drill
rotary, power-driven, flame-shaped bur with spiral inclined cutting edges mounted on a slender non cutting shaft and tipped with a guiding pilot point
gow gates mandibular nerve block
technique to administer local anaesthetic to the mandibular branch of the trigeminal nerve before it branches into the inferior alveolar nerve. The technique utilises extra-oral landmarks whereby the needle is directed at a higher puncture point, aiming for the vicinity of the mandibular condyle.
guided endodontic access
Utilization of cone beam computed tomography, specialized software and a digital impression 3-D scan to virtually plan the canal access preparation and produce a 3D-printed guide/template. This provides minimally invasive endodontic access preparations especially in calcified cases.