Endo Quiz Questions Flashcards
An apexification procedure relies on maintenance of a vital pulp to promote continued root development…True or False?
False
Following trauma where the tooth loses blood supply to the pulp, the open apex tooth can reestablish a blood supply through the process called “revascularization” - True or False?
True
MTA promotes faster tertiary dentin formation than CaOH - True or False?
True
A 7 year old pt presents with a horizontal crown fx with pulp exposure that occurred two days ago. After a thorough assessment, you determine that a Cvek pulpotomy is indicated. How much pulp tissue should you resect?
2 mm
For “immediate” apexification, how do you prevent apical extrusion of obturation material?
Place collagen/collaplug
List 3 contraindications to Cvek pulpotomy…
- Tooth is unrestorable/Vertical Root Fx
- Cannot Control Bleeding
- Necrotic Pulp
What is the average success rate of a Cvek Pulpotomy?
96%
Long Term CaOH Apexification can decrease the fx resistance of the tooth. T or F?
True
List 3 advantages of Apexogenesis…
- Help form apex
- Increase root length
- Increase thickness
- Maintain vitality
List 3 required components for Regenerative Endodontics…
- Stem Cells
- Growth Factors
- Scaffold
Root canal treatment is recommended following apexogenesis (maturogenesis). T or F?
False
Ellis Class II Fx is the same as…
Uncomplicated Crown Fracture
List at least 4 risk factors for tooth fracture…
- Heavy bruxor, history of attrition
- Large Restorations
- Caries
- Unsupported enamel/Cusps
Which two permanent teeth have the highest incidence of tooth fractures?
Mandibular 1st and 2nd molars
What are the two most common symptom reported by patients who have a tooth with an incomplete fracture?
- Pain on biting
2. Thermal (Cold Sensitive)
List two findings (clinical or radiographic) that would make you suspicious of a vertical root fracture.
- “J” shaped lesion radiographically
2. Isolated DEEP PD
List the various luxation injuries from most severe to least severe…
Intrusion - Lateral Trusion, Extrusion, Sub Luxation, Concusion
List 4 potential sequelae of luxation injury. Circle the one that represents the most likely outcome of an intrusive luxation injury.
- Pulp Necrosis (Circled)
- Pulp Obliteration
- External Resorption (Surface)
- Ankylosis (Replacement Resorption)
“Baseline” vitality testing is only needed when the severity of the injury is likely to result in pulpal necrosis. T or F?
False
A tooth suffered a traumatic injury and pulp canal obliteration is noted on a 6 month recall radiograph. Pulpectomy and endodontic therapy should be initiated ASAP. T or F?
False
A root fx can occur in various location along a root. Which of the following would carry the most favorable prognosis?
Apical Third
Once a root fracture is detected, endodontic treatment of the coronal segment should be initiated ASAP. T/F?
False
Pulp testing of recently traumatized teeth may…
Facilitate a timely diagnosis of pulpal necrosis at subsequent visits
Following traumatic injury to a tooth, patients may present with clinical signs of ankylosis, which may include…
- Infraposition
- High-Pitch sound elicited upon percussion
- Lack of Mobility
What is the pH of Calcium Hydroxide?
11
What properties are associated with NaOCl?
- Antibacterial
- Deodorizer
- Lubricant
- Dissolves Tissue
What properties are associated with EDTA?
- Lubricant
2. Removes Smear Layer
What properties are associated with 2% CHX?
- Antibacterial
2. Lubricant
Replacement resorption occurs after minor injury to PDL and cementum and is usually self-limiting. T/F?
False
All pulps in avulsed teeth with mature apices will undergo necrosis. T/F?
True
An avulsed tooth with <60 min dry time should be splinted for up to 2 weeks. T/F?
True
Following replantation, all permanent teeth with immature roots require initiation of RCT within 2 weeks.
False
In the treatment of avulsion, how should the tooth be placed into the socket?
Digital Pressure
Circle the group of avulsed teeth that should be soaked in Fluoride (following removal of PDL) prior to replantation.
Mature root with > 60 minutes dry time
Underline the group of avulsed teeth that should be soaked in a doxycycline solution prior to replantation.
Immature root with < 60 minutes dry time
Number the following storage media for avulsed teth in order from best #1 to worst #5
- Tooth Socket
- Hank’s Solution
- Milk
- Saliva
- Tap Water
Replacement resorption occurs after minor injury to PDL and cementum and is usually self-limiting. T/F?
False
Little Johnny had #9 avulsed while jumping from 1 bunk bed to another. #9 was out of the mouth for 10 minutes until mom could get a cup of tap water to place it in. The tooth was out of the mouth for 10 minutes before being placed in a cup of milk. It took mom 2.5 hours from the time of the trauma to get to your office with Johnny. What is the dry time for tooth #8?
10 minutes
An asymptomatic anterior tooth exhibiting discoloration, pulp canal obliteration (calcific metamorphosis), normal periapex, and no response to cold or EPT should have root canal therapy followed by non-vital bleaching. T/F?
False
What chemical is principally used in the walking bleach technique?
Sodium Perborate
List two intrinsic and two extrinsic etiologies for discoloration of a clinical crown.
Intrinsic: tetracycline, pulp tissue/debris
Extrinsic: Coffee, Wine
What factors play a role in the development of post-bleaching cervical resorption?
- Use of heat during bleaching process
- Use of 30% H202 (Superoxol)
- Pre-existing gap at the CEJ (enamel and cementum don’t meet
- History of trauma
For the “walking bleach” technique, the protective barrier over the obturation material should at ? thick and located ? to the proximal CEJs
2 mm thick
At the proximal CEJs
What are the treatment options for post-bleaching cervical resorption?
- Calcium Hydroxide
- Orthodontic Extrusion
- Periodontal Surgery
- Extracation
After viewing an irregularly shaped moth eaten radiolucency located in the middle third of #8 a second X-ray was taken with the tube head positioned to the distal. The lesion in the xr moved to the distal. What type of resorption is it? And where is it located by all lingually?
External, lingual
A tooth has normal pulp and normal apical tissues but does not respond to cold or pet. What are some potential causes?
Recent trauma
Calcified canal
Crown
Inadequate contact
A PT complains of continuous spontaneous pain in the right posterior mandible that is greatly exaggerated with cold stimulation. An xr reveals that tooth #30 has had prev Endo. The obturation has poor length taper and density. Pas encompass both root spices of 30. Time is limited. What is the next best step to treat this patient.
Pulp vitality tests of 28-31
Can you have asymptomatic irreversible pulpitis and asymptomatic apical periodontitis?
No
Which resorption usually appears with the root canal walls clearly delineated and visible within the radiolucency of the resorption area
External
A PT presents with sinus tract apical to #14. There is no swelling or pain. Tooth 14 does not respond to cold or electric pulp testing. What is the dx?
Necrotic and chronic apical abscess
30 had root canal treatment 2 years ago. The PT complains of severe biting tenderness. An xr reveals per radiolucency at the m root apex. Fluctuate swelling is present. Dx?
Prev treated, acute apical abscess
A PT presents to sick call with tooth ache. Cold testing 9 exhibits extreme pain that lingers for 30 sec. xr reveals compost res close to pulp of 9 but no per lesion. No percussion or palpation. What is dx?
Symptomatic irreversible pulpitis, normal apex
Are antibiotics appropriate for irreversible pulpitis
No
What % of max 1 molars have 4 canals?
75%
Man 1 molars have 4 canals what % of time
30-60
Man 1 premolars have 2 canals what % of time
25%
What weine class has two merging into one
II
What weine class has single canal from orifice to foramen
I
What weine class has One canal dividing into two
Iv
What weine class has two canals that stay separate the whole length
Iii
The anatomical point that is generally accepted as the proper location to the end root canal preparation and obturation is called
Apical constriction
Define the law of the cej
The cej is the most consistent landmark to locate the pulp chamber
Law of centrality
The pulp is in the center of the tooth at the cej
4 gates glidde. Corresponds to what iso file size
110
2 peso reamer corresponds to what iso file size
90
The average diameter of the minor foramen is equal to what size file
30
The minor foramen relationship to the radiographic apex is what
.5-1.0 mm short of radiographic apex is
The most common direction of perforation while accessing anterior teeth is…
To the facial
Give 2 reasons why you should rem car and faulty res at the time of access
Ensure restorability
Make sure res material and car debris doesn’t fall into canals
Which local anes is considered long acting
.5% bupivacaine with 1:200,000 epi
What are 3 advantages of gow gates
Consistent landmarks
Low incidence of trismus
Low positive aspiration rate
One of the cardiovascular effects of an intraosseous injection using a local anes with a vasoconstrictor is an increase in blood pressure true or false
False
What are the contraindications for intraosseous injection
Root proximity
Acute site of infection
Site for potential incision and drainage
What is the direction and degree of motion in the cutting motion of balanced force technique
Counter clockwise 180-270
What are three things that can cause canal to become legged or transported
Insufficient access cavity extension
Poor control of file insertion length
Use of end-cutting files
Attempting to achieve too large a MAF size
Failure to recapitulate
Excessive axial (in-out) filing in a curve
Insufficient irrigation
Dentinal mud at apex
Which anes technique requires anesthetic with vasoconstrictor for effectiveness
Pdl
Which anes technique can use saline for the anes
Pulp all injection
Advantages of niti rotary files
Enlarge canal that has been negotiated to length Create smooth continuous taper Reduce operator fatigue Reduce time of instrumentation Instrument long sweeping curves
Disadvantages of niti rotary
Cost
Break without warning
Unable to negotiate complex anatomy
Negotiate calcified canals
T or f: torsional fracture occurs when a portion of the instrument locks while the shaft continues to rotate
T
T or f: cyclic fatigue is a repeated result of repeated flexural stresses as a file rotates around a curvature
T
T or f cyclic fatigue occurs abruptly and occurs more in smaller file sizes
F
What component is main I. Gotta percha nad Roth root canal cement
Zinc oxide
Can obturation overcome inadequate cleaning and shaping of a canal system?
No
Situations where single visit Endo therapy might be recommended
Tooth is asymptomatic
Root canal system is dry
No signs of active infection
Canals are Free of bacteria
Time permits
Which is more important for determining the stress on a rotary file, degree of canal curvature or radius
Radius
What does apical clearing accomplish
technique that involves enlargement of the apical preparation followed by dry reaming to remove dentin debris and to produce a more defined apical stop.
