Endo - techniques Flashcards

1
Q

In what patient groups do you have to exercise caution with in regards to endodontic treatment? (4)

A

1st trimester
Diabetics - poor healing/outcomes
Use of bisphosphonates
Cancer - chemo/radiotherapy compromises healing

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2
Q

In what patients is endodontic treatment contraindicated? (1)

A

myocardial infarction within last 6 months

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3
Q

what are the complications of endodontic treatment? (4)

A

perforation
broken instruments/separation
extrusion of the irritant NaOCl
Pain

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4
Q

what chemicals are used for irrigation? (2)

A

sodium hypochlorite 3%

EDTA 17%

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5
Q

what are the advantages of irrigation? (5)

A
cools the file and the tooth 
prevents packing 
disinfectant as it is antimicrobial 
reduces friction
dissolves tissue
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6
Q

why do we irrigate the canal with saline in-between the use of sodium hypochlorite and EDTA?

A

EDTA reduces the effectiveness of the sodium hypochlorite

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7
Q

when can Endo treatment not be carried out in one visit? (1)

A

If the patient has an acute infection and has symptoms

- need to use intra-canal medicaments

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8
Q

what inter canal medicaments can be used between visits? (2)

A

GOLD STANDARD = NS calcium hydroxide

odontopaste - contains steroids

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9
Q

When would we opt to use odontopaste over NSCaOH (medicament)?

A

if the patient has a hot pulp which doesn’t respond to LA

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10
Q

what are the advantages of using NSCaOH as medicament? (3)

A

Easy to remove since doesn’t set
Antimicrobial since very alkaline
removes tissues debris

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11
Q

what are the DISADVANTAGES of using sodium hypochlorite as irrigation? (6)

A
allergy 
apical extrusion 
modifies the organic content of dentine 
doesn't remove the smear layer
ophthalmic injury 
discolouration of clothes
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12
Q

what irritant removes the smear layer?

A

EDTA

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13
Q

list the constituents of GP. (4)

A

gutta percha 20%
zinc oxide 65%
plasticisers 5%
radio pacifiers 10%

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14
Q

Describe the Herb Schilder principle for Endodontics treatment (2)

A

smooth continuously tapering funnel shaped canal

With an apical restriction that remains at the same point and the same size

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15
Q

list the ideal properties of sealers (7)

A
tacky
radiopacity 
bacteriostatic 
insoluble in tissue fluids 
slow set
easily mixed 
no shrink when set
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16
Q

list the uses of sealers (3)

A

lubricates
seals the spaces between the dentine wall and the core
seals voids and irregularities

17
Q

define estimated working length

A

the estimated length from the reference point that instrumentation is limited to

18
Q

define corrected working length

A

The length in which the instrumentation and obturation should be limited to.

19
Q

What is the function of a NaOCl irrigant? (3)

A
  • Dissolves: organic matter, necrotic tissue and vital tissue i.e. pulp remnants and collagen.
  • Helps disrupt the smear layer (but doesn’t entirely remove)
  • Hypochlorite = antibacterial action.
20
Q

What are important factors to consider in NaOCl use? (5)

A

Concentration - 3%
Volume - 30ml
Contact - for 10 mins

Mechanical agitation - manual dynamic irrigation using gutta percha points and pumping motion.

Exchange - improved by mechanical agitation

21
Q

How would we manage NaOCl/irrigant extrusion? (7)

A
  • Stop all treatment
  • Inform patient
  • If patient in pain - use block local anaesthetic at the site
  • If there is bleeding - allow it to continue until haemostats occurs
  • Place a steroid-containing intracanal medicament (Odontopaste) in the root canal - do not use pressure to apply.
  • Do not obturate but seal the coronal access cavity
  • Review after 24 hours
22
Q

What is the aim of obturating? (2)

A

To fill the whole canal to prevent the passage of microorganisms and fluid.

To block the apical foramen, accessory canals and dentinal tubules

23
Q

when is it ok to obturate?

A

No symptoms or signs of active disease
- If the patient has acute infection with symptoms present the chemomechanical disinfection and obturation will have to be done in separate visits.

24
Q

What are the ideal properties of an obturation material? (8)

A
  • Biocompatible
  • Dimensionally stable
  • Able to seal
  • Unaffected by tissue fluids
  • Insoluble
  • Non-supportive of bacterial growth
  • radiopaque
  • Removable from the canal in the need for pretreatment
25
Q

what material do we use to obturate? what is it?

A

Gutta Percha- Polymer of isoprene

26
Q

what obturation technique do we use with GP cones?

A

cold lateral compaction

27
Q

what sealer do we typically use?

A

GI sealer - bonds to dentine