endo-perio/bleaching Flashcards
three main avenues for communication between periodontium/pulp
dentin tubules
lateral and accessory canals
apical foramen
perio problems that become endo problems
pulp inflammation may occur from exposure of large lateral canals w/ bone loss
t/f: pulpal necrosis can ONLY occur when the main apical foramen is affected
TRUE
consider endo lesions that start as the result of lateral canals…wont be necrotic?
endo problems that become perio problems
inflammatory byproducts of pulpal origin (pulpal diagnosis = necrotic) connect to periodontist via apical foramen or lateral/accessory canals
t/f: a vital tooth can cause swelling or bone destruction
FAAAALse
endodontic pockets characteristics
narrow defects
isolated to involved tooth
may be associated with NECROTIC tooth or a fracture
periodontal pockets characteristics
wider defects
not isolated to one tooth
look around mouth for generalized condition
primary endo classification
source: tooth
dx: endo testing, any perio findings should be GENERALIZED
tx: RCT
primary perio classification
source: periodontist (NOT TOOTH)
dx: periodontal testing, endo testing should reveal VITAL pulp
tx: periodontal therapy
how do you differentiate endo problem from perio problem
pulp testing!!!!!! perio = vital
primary endo with secondary perio classification
source: tooth extending out into periodontium
dx: endo testing and perio probing
tx: RCT (perio should resolve after)
primary perio with secondary endo classificaiton
source: periodontium
dx: perio and endo testing
tx: RCT and periodontal therapy (usually by the time the pulp is involved the problem is too severe to save the tooth tho)
true combined classification
source: pulp and periodontium (endo lesion merges with perio pocket)
dx: perio and endo testing
tx: RCT, perio therapy, possible surgery, extraction?? depends
if a combination lesion exists, always treat ________ first
endo
can perio treatment resolve and endodontic condition?
NO
what condition generally dictates the overall prognosis
perio status
internal sources of discoloration
pulpal necrosis
intrapulpal hemorrhage
remnants of pulpal tissue (most common leaving pulp horns in anterior teeth)
what conditions are probably unfavorable for internal bleaching success
obturation materials/coronal restorations
calcific metamorphosis: needs RCT? can it be bleached?
no RCT needed (usually vital)
questionable prognosis for bleaching
fluorosis: internal or external bleaching
external
systemic drugs: internal or external bleaching
internal
do you have to do RCT before internal bleaching
yes
what is the main risk associated with internal bleaching
resorption
why does resorption happen with internal bleaching
no barrier
application of heat
use of liquid superoxol (35% h2o2)
what liquid is most associated with resorption
superoxol DONT USE
what is the safest method for internal bleaching
sodium perborate –powder that can be mixed with saline
what material has a shorter shelf life and is more expenesive
opalescence endo
bleaching technique
evaluate shade beforehand
remove restorative material, go down 3 mm apical to CEJ, place base material, place bleaching material on cotton pellet in chamber, seal up with temp, recall in two weeks
