Endo teeth Flashcards by Michael McMahan

The teeth become _____ and ____ susceptible to decay, fracture, and
breakdown.

softer; more

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T/F: Once pulp has been removed, and nerve sensation stopped, the tooth loses its
ability to monitor changes in proprioception. Meaning you can bite harder
on these teeth before you feel pain or discomfort.

True

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The tooth now is less strong and both of the above criteria result in a higher
likelihood of _______

FRACTURE

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____ fracture
Fracture in enamel only (crack line) or fracture in
enamel and dentin
The fracture line does not extend apical to the
cemento-enamel junction
There is no associated periodontal probing defect
The pulp may be vital requiring only a crown
If pulp has irreversible pulpitis or necrosis, root
canal treatment is indicated before the crown is
placed

Favorable

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____ fracture
Fracture in enamel and dentin
The fracture line may extend apical to the
cemento-enamel junction but there is no
associated periodontal probing defect
There is an osseous lesion of endodontic
origin

Questionable

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\_\_\_\_ fracture
Fracture line extends apical to the 
cementoenamel junction 
extending onto the root with an 
associated probing defect

Unfavorable

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________ tooth fractures occur because:

Greater occlusal forces
Divided occlusal surface (Cusps and Fossa)
Fillings weaken tooth ability to hold together

Posterior

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Crowns did NOT significantly improve the
success rates of endodontically treated
______teeth when ample tooth
structure remains.

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Crowns significantly improved
success rates of endodontically
treated _______ teeth

POSTERIOR

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Crowns are only indicated on RCT Treated ______ teeth when:
-They are structurally weakened by large or multiple restorations
-They need substantial changes in form or color that cannot be achieved
by more conservative means

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Need at least __mm for a ferrule.

2 mm

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If sufficient natural tooth structure remains, a _______ will
fill the RCT access and chamber to restore the lost tooth
structure.

Build up/Core

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_______ has been as used a core material for a long time
but not as much now.
-Disadvantage – not retentive, does not bond, more tooth
reduction needed
-Advantage – strength

Amalgam

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_______ are used much more now for core build up
-Disavantage – not as strong
-Advantage – usability, bonding, more conservative tooth
reduction

Composite resins

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If tooth structure is missing, and restorability is
compromised but not condemned, a ___ can
be used to add strength to the core build up as
you restore the lost tooth structure.

post

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Why do we use a ____?
-RCT teeth with inadequate tooth structure to retain a core
-Teeth that have lost more than 50% of coronal tooth structure
-Single rooted teeth since the anatomy of the pulp chamber
does not offer mechanical retention.
-Teeth with significant response to lateral forces of occlusion.

post

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Teeth that have lost more than __% of coronal tooth structure need a post

50%

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In these situations, post or no post?
-Preparation of a post space adds risk to the restorative
prognosis
-Higher likelihood of fracture or perforation
The needs for a post vary between anterior and posterior.

No post

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Post or no post?
Anterior Teeth –
Patient presents with an intact anterior moderate 
sized lingual RCT access with a resin composite 
restoration in the access
If tooth has darkened:
-Internal bleaching
-Possible veneer or composite

No opst

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In access hole, place 
bleaching material and seal 
the access with a temporary 
fill.
May need to be repeated 
several times.
Can last for a reasonable 
amount of time and may 
need to be touched up in 
the future.

Internal bleaching

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When more than \_\_\_% of coronal tooth 
structure has been lost -
A post and core will be necessary for 
retention of a crown.
The post and core is meant to resist 
lateral forces which would cause the 
crown to dislodge.

50%

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A _____ is the vertical axial wall that encircles the

tooth which a crown will use to resist fracture

ferrule

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Minimum ferrule =___mm beyond the core

2mm

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T/F: Without the proper ferrule, root fracture is much more l
ikely on anterior teeth due to high lateral forces in
mastication.

True

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When remaining tooth structure has large access and a shorter clinical crown, generally a post is or is not necessary?

No necessary

If extensive coronal destruction exists, and a post is necessary to retain the core: Use the _____ and _______ root and canal

longest and straightest

Which canal should be used for a post in max molars?

Palatal

Which canal should be used for a post in mand molars?

Distal root

_____ tooth – Significant variation in root length, curvature, bifurcation, and width. Use a post only in roots that have ample bulk and a straight root anatomy. Use a post on a premolar if: Substantial tooth structure is missing (eg –post is placed in canal to replace lost cusp). If the tooth is under substantial occlusal forces. If the height of the tooth in MI is tall Remember – a 2mm ferrule is minimally required

Premolar tooth

Which tooth is the exception to the premolar tooth assumption that would contraindicate a post? Patient habits and conditions need to be assessed to ensure occlusal forces are not heavy or lateral. It may be possible to avoid both a crown and post on this tooth after RCT with a conservative access fill.

1st mand pm

____ teeth often only need a build up and then secondary retentive features such as grooves, boxes, pins, bonding, or utilizing the access hole.

Molars teeth

_____: ability of the post to resist vertical dislodging forces Post length and taper Active or Passive design Cement used

Retention

``` ______" ability of the post and core to withstand lateral or rotational forces Amount of remaining tooth structure Post length and rigidity Anti-rotation features Presence of a Ferrule ```

Resistance:

__-__ the length of the root is ideal | Minimum length at least that of the clinical crown

½ to 2/3

__-__mm of Gutta Percha left at apex to keep the seal of the Gutta Percha

4-5 mm

A post too ____ allows the forces to act with greater | stress leading to a higher incidence of root fracture.

short

A post that does not leave __-__mm at the apical for the RCT seal will compromise the tooth: The post often is too big at the apex and can cause root fracture. The apical seal is compromised and therefore, recurrent infection can occur.

4-5 mm

As a general rule, molar post spaces greater than __ mm apical to canal orifice increases the potential for root perforation.

7 mm

Post preparation diameter should not exceed | ___ of the root at the CEJ

1/3

Leave at least __ mm of sound dentin at mid-root

1 mm

Ideal diameter of post should only be ___-__mm depending on the particulars of the tooth

0. 6mm – | 1. 2mm

A ______ instrument melts the GP and then a warmed | plugger compacts the GP vertically.

heated

Canal is instrumented with _____ or ______ rotary instrument. -Pink GP should be visualized being removed during the entire use of these instruments. -This should be done SLOWLY -Don't cut on end

Gates Glidden or Peazo Reamer

__-__ posts engage the surrounding root material | usually via threads or a serrated edge.

Active posts

______ posts fit into the canal without engaging | the surrounding root material.

Passive posts

______ posts are the most retentive -Create higher stress on the root and therefore have a higher incidence of root fracture

Threaded Parallel

_____ are close behind in retentiveness. -High stress at apex and therefore higher incidence of root fracture

Serrated Parallel

______ Posts are least retentive -Less incidence of root fracture due to least amount of stress on root -Can be adequate.

Tapered Passive

______ Post – Custom Post -Resin pattern sent to lab to be cast in metal alloy

Custom Passive

_______ Posts – Cemented in root with | core build up of composite or amalgam

Pre-Fabricated

``` _______ Post Advantages: Anti-Rotational properties Core is part of post Can be preservative of tooth structure as the post fits the space Disadvantages: Multiple appointments needed Tapered design is not as retentive Dark un-esthetic core Higher incidence of root fracture as post is harder material than root and if occlusion is off, post will not break, root will ```

Custom Cast

``` _______ Post Advantages: Increased retention within root Ease of placement More versatile to a wider range of tooth root shapes Post will often break before root will Disadvantages: Post space needs to be slightly larger than cast Core retention to post can be a problem Possible rotation Metal posts still have un-esthetic color ```

Pre-Fabricated

_____ posts have difficulties at times with narrowing of tooth root and can lead to root tip fracture.

Parallel

``` A ______ tooth with a canal shape that is ovoid presents a dilemma. A pre-fab post is not stable on its own as the canal shape allows the post to rock back and forth so: -A cast post can be made -A Pre-Fab post can used and cemented -A Two Pre-Fab post technique can be used to stabilize the Pre-Fab Post ```

PM tooth

_______ Technique One major post goes to length and height for Core build up, but canal orifice allows post to wobble. A minor (smaller) post can be placed into the canal as far down as it can go to stabilize the major post. This reduces the stress on the major post which would have been supported only by cement. Then the two posts are cemented in the canal together and core build up placed. Primarily for Anterior and select premolars.

Two Post

______ Technique A red Duralay resin impression is made of the post space. Tooth is temporized while Duralay is sent to the lab. Post is tried in and cemented. Cast post is used as build up as well.

Cast Post

The post should extend to ______ so that | the build up has the full support of the post.

the height of your build up

``` Challenging occlusion? Little occlusal room? Significant vertical overlap? Bruxer/Grinder? If so, a ____ post is the first choice as it will not break or separate. The risk is root fracture however if the forces on the tooth are still too strong. ```

Cast post

``` _______ Posts: -Main advantage is better esthetics -Modulus of Elasticity is similar to dentin -Must use Resin cement (self-adhesive) -Less Root fractures than metal posts Post will usually break before post does -Failures typically occur in teeth with little coronal tooth structure. ```

Fiber reinforced

What types of cements are good to use in post situations?

Dual or self cure resin cements