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xD3 Endo Final > Endo/Perio and VRF (Detar) > Flashcards

Endo/Perio and VRF (Detar) Flashcards

1
Q

Can your cold test a tooth with a full coverage crown?

A

Yes

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2
Q

What is a secondary diagnostic test to confirm cold test findings?

A

EPT

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3
Q

What is a disease that has slow progression, is usually painless, involves multiple teeth, with a clinical presentation of visible biofilm?

A

Marginal periodontitis

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4
Q

What is a disease that has variable progression, variable symptoms, hidden / not visible biofilm, typically only involving on tooth?

A

Apical periodontitis

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5
Q

What are all the ways of communication between the pulp and periodical tissue?

A
  1. Dentinal tubules
  2. Accessory canals: lateral canals, furcation canals
  3. Apical foramen
  4. Palatogingival grooves
  5. Perforations in furcation, strip perforations, apical perforations
  6. Fractures, longitudinal cracks
  7. Resorptive defects
  8. Root caries
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6
Q

The main communication between the periodontium and the pulp is where?

A

Root apex at the apical foramen

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7
Q

How can an endodontic problem lead to a periodontal problem (apical periodontiis)?

A

Pulp necrosis communicates causing periapical inflammation and destruction leading to resorption of bone, cementum and dentin

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8
Q

What is a further risk of an endodontic problem causing a periodontal problem?

A

The endodontically-caused periodical inflammation can extend cervically and involve the lateral periodontium

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9
Q

In a mixed endodontic / periapical infection, what should be treated first, the Endo or the Perio?

A

Endo

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10
Q

Why treat the endo before the perio?

A
  1. Endo treatment removes possible source of irritation
  2. Allow periodontal healing
  3. Allows better assessment of true periodontal condition
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11
Q

What is the general rule of the effect of periodontitis causing an endodontic problem?

A

As long as apical foramen is notn involved, the pulp should be able to protect itself from insults inducted by periodontal disease

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12
Q

What are 6 Simon’s classification of endo-perio lesions?

A
  1. Primary Endo
  2. Primary Endo with Secondary Perio
  3. Primary Perio
  4. Primary Perio with Secondary Endo
  5. True combined
  6. Concomitant
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13
Q

What is the Simon’s Classification where there is an Endo infection that is draining out of the apical foramen?

A

Primary Endo

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14
Q

What is the Simon’s classification where there is Endo draining out the apical foramen and creating a periodontal pocket, with the absence of sub gingival calculus?

A

Primary Endo, Secondary Perio

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15
Q

What is a periodontal pocket with no endodontic involvement, presence of sub gingival calculus?

A

Primary Perio

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16
Q

What is a periodontal pocket that has caused endodontic problems (maybe a person with a history of deep pocket and poor oral health finally gets a hot tooth in that area?

A

Primary Perio, Secondary Endo

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17
Q

What is a perio pocket and an endodontic problem both perpetuating each other?

A

True combined Endo-Perio

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18
Q

What is the difference in probing depths on an a primary endo tooth and a primary perio tooth?

A

Primary endo will have a narrow pocket. Primary perio with have a wide pocket.

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19
Q

What is a suppurating primary endodontic disease that remains untreated over a period of time causing secondary periodontitis?

A

Primary endo with secondary perio

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20
Q

What is an indicator that the problem might be primary periodontitis with secondary endodontic disease?

A

Surrounding teeth are also periodontally involved

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21
Q

What are differentials for narrow, isolated probing depth?

A
  1. Primary endo

2. Vertical root fracture

22
Q

What is a longitudinal fracture beginning in the root (typically at apex) and extending coronally?

A

Vertical root fracture

23
Q

The 2 major causes of vertical root fractures - post placement and condensation forces - both exert what force on the root causing the vertical root fracture?

A

Wedging forces

24
Q

Vertical root fractures are almost always in what teeth?

A

Root canal treated teeth

25
Q

Root morphology that is prone to vertical root fractures?

A

Roots narrower M-D

26
Q

Teeth that have roots narrow M-D and which re prone to vertical root fractures?

A
  1. Mandibular incisors
  2. Manibular permolar
  3. Mandibular molar mesial and distal roots
  4. Maxillary molar and MB root
27
Q

What is a problem in diagnosing vertical root fractures?

A

Mimics other problems (primary perio, primary endo, combined lesion, perio abscess)

28
Q

Can a vertical root fracture be asymptomatic?

A

Yes

29
Q

What is a common objective finding for a vertical root fracture?

A

Isolated, narrow probing depth

30
Q

What are the common lesions associated with a vertical root fracture?

A

J-shaped or halo type lesion, possible teardrop shape

31
Q

What is the only reliable diagnostic test for a vertical root fracture?

A

Surgical flap reflection

32
Q

What would be expected finding for a vertical root fracture that has had a surgical flap reflection to diagnose it?

A

Punched out bony defect over the VRF

33
Q

What are the 2 treatments for VRF?

A
  1. EXT

2. Root amputation

34
Q

Would it be assumed that there is a VRF on a healthy tooth having a J-shaped radiographic lesion with no previous endo or post retained restoration?

A

No, but VRF is on the differential

35
Q

Would a fracture that started on the crown and then extended down onto the root be considered a vertical root fracture?

A

No, that is a longitudinal fracture (started on crown and extended down onto the root)

36
Q

Should you assume there is a fracture if you see a J-shaped lesion radiographically?

A

No

37
Q

What is the classification for long-standing endo untreated with chronic apical abscess (CAA) draining, along with plaque / calculus at gingival margin of the sinus tract, having solitary but wider probing depth due to periodontitis?

A

Primary Endo, Secondary Perio

38
Q

If you just treat the endo in a primary endo, secondary perio lesion, to what extent will the tooth and bone heal after successful endo treatment?

A

To the level of the secondary periodontitis lesion

39
Q

If you just treat the Endo in a Primary Endo, Secondary Perio lesion, to what extent will the tooth and bone heal after successful Endo treatment?

A

To the level of the secondary periodontitis lesion

40
Q

What is the status of the pulp in a Primary Endo, Secondary Perio lesion?

A

Necrotic Pulp

41
Q

What is the status of the pulp in a primary perio lesion?

A

Vital pulp

42
Q

What ist he probing character of a primary periodontitis lesion?

A

Wide

43
Q

What is the thought about the controversial Primary perio with secondary endo lesion?

A

Pulp does not degenerate as long as the main canal is not involved

44
Q

In the controversial Primary Perio with secondary endo prognosis, on what therapy does the prognosis depend: the perio or the endo?

A

Perio

45
Q

Pulp necrosis and periodontal disease is what Simon’s classification (it is endodontic destruction progressing cervically meeting periodontal disease progressing apically)?

A

True combined endo perio lesion

46
Q

What is the nature of the bony defects in a true combined lesion?

A

They are extensive

47
Q

For a true combined lesion, the prognosis of the tooth depends on the destruction of which component: perio or endo?

A

Depends on extent of destruction by perio component

48
Q

What are the separate and distinct endo and periodontal lesions?

A

Concomitant endo-perio

49
Q

What is the treatment of concomitant endo-perio considering the effect they don’t touch each other?

A

Treat both endo and perio components

50
Q

When looking at radiographs, look where to assess the periodontal involvement?

A

Bone level near CEK, looking especially for large vertical bone defects

51
Q

What is the most common place for a lateral canal, which can contribute to perio-endo communication?

A

Apical 1/3

xD3 Endo Final (8 decks)

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