Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Fixed Prostodontics 2 > Endo Teeth > Flashcards

Endo Teeth Flashcards

1
Q

Treatment Planning
Considerations when deciding on restoring an endodontically treated tooth:
(5)

A

-Must have a ”global” perspective on your patient.
-How is the existing root canal? Is it sound? Does it appear adequate? PARL?
-Is the tooth restorable? How much tooth structure is left? Will you need a post?
-How important is this tooth in the patients overall treatment plan?
-How important is this tooth in the patients functioning?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What might be needed to properly restore this tooth beyond a crown?
(4)

A

-Post
-Core
-Crown Lengthening
-Orthodontic movement?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Adequacy of the Root Canal
(6)

A

-Is the tooth asymptomatic?
-Are the canals well filled?
-Does the apex appear sealed?
-Is there any suspicion of apical pathology?
-Is there a temporary restoration present?
-Is any restoration present sealed protecting the
RCT from the oral environment?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Adequacy of the Root Canal
-How long has the present restoration been
present?
-Long standing temporary or lack of proper seal
from restoration? Possible
-Deep caries present? Possible

A

re-treat due to bacterial contamination.

crown lengthening or even deemed nonrestorable.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Treatment Planning
(6)

A

Is the tooth in a useful function in the patient’s occlusion?
Is the RCT treated tooth used as an abutment for an FPD?
Are esthetics at play in restoring the RCT tooth?
What is the prognosis of the restoration you want to place
on the RCT treated tooth?
Is the patient a bruxer? Grinder?
Is the patient home care adequate?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Prior to the RCT, examining the remaining tooth
structure is important for —.

A

restorability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Just because you can do an —, doesn’t
mean you should.
Just because you could do a —, doesn’t
mean you should.
Engage your brain to put all these pieces together
to decide how best to treat a patient.

A

RCT
crown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why do we need to examine RCT teeth more carefully and
consider crowning RCT teeth quickly?
-Once pulp has been removed, and nerve sensation stopped, the tooth loses its
ability to …
Meaning you can bite harder
on these teeth before you …
-In an RCT tooth, there is a loss of — from a variety of sources
(access, caries, bone loss from infection).
-The tooth now is less strong and both of the above criteria result in a higher
likelihood of —

A

monitor changes in proprioception.
feel pain or discomfort.
structural integrity
FRACTURE.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Favorable

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Questionable

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Unfavorable

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Fractures:
-Posterior tooth fractures occur because:
(3)

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Posterior tooth –
(2)

A

Occlusal forces more inline with vertical
axis of tooth. Therefore, vertical
fractures more likely.
Cusp coverage recommended
everytime on a posterior tooth to
prevent fracture.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

“Does every RCT treated tooth require a crown?”

A

“Crowns did NOT significantly improve the
success rates of endodontically treated
ANTERIOR teeth when ample tooth
structure remains.
Crowns significantly improved
success rates of endodontically
treated POSTERIOR teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Crowns should be placed on RCT Treated — teeth as soon as possible
with few exceptions

A

POSTERIOR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Crowns are only indicated on RCT Treated ANTERIOR teeth when:
(2)

A

-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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Crown Preparation -
Preserve and maintain
Need at least — for a ferrule.
If sufficient natural tooth structure remains, a
— are often used to help retain a core build up

A

the natural tooth structure as much as
possible as it is the strongest support of a crown.
2mm
Build up/Core will
fill the RCT access and chamber to restore the lost tooth
structure.
Pins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Amalgam has been as used a core material for a long time
but not as much now.
-Disadvantage –
-Advantage –

A

not retentive, does not bond, more tooth
reduction needed
strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Composite resins are used much more now for core build up
-Disavantage –
-Advantage –

A

not as strong
usability, bonding, more conservative tooth
reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If tooth structure is missing, and restorability is
compromised but not condemned, a

A

post can
be used to add strength to the core build up as
you restore the lost tooth structure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why do we use a post?
(4)

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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why do we NOT use a post?
(3)

A

-The purpose of a post is to retain the core in a tooth when
there is extensive loss of coronal tooth structure.
-Preparation of a post space adds risk to the restorative
prognosis
-Higher likelihood of fracture or perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

The needs for a post vary between

A

anterior and posterior.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

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:
(2)

A

-Internal bleaching
-Possible veneer or composite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

However, at this stage there is no need for a post
due to

A

ample of amount of remaining tooth
structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Internal bleaching –
(3)

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Anterior tooth –
When more than 50% of coronal tooth
structure has been lost -
(2)

A

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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Anterior tooth –
How do you decide when to place a
post/core/crown versus extraction and
implant?
Many factors –
(8)

A

Remaining tooth structure
Patient occlusion
Patient habits
Ferrule?
Crown lengthening needed?
Esthetics
Patient desires
Patient details (age, meds, etc.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Anterior Tooth –
What is a ferrule and why does this matter in your post
and core decision process?
A ferrule is the
Minimum ferrule =
— circumferentially uniform ferrule is the
minimum height. The ferrule is desired every time a
crown is done.

A

vertical axial wall that encircles the
tooth which a crown will use to resist fracture
2mm beyond the core
2mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Without the proper ferrule,

A

root fracture is much more l
ikely on anterior teeth due to high lateral forces in
mastication.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Posterior tooth –
(3)

A

When remaining tooth structure has large
access and a shorter clinical crown,
generally a post is NOT necessary.
A crown preparation with a ferrule in
harmonious occlusion with a build up
in the access is enough to resist
fracture.
Most instances a build up is adequate to
aid in crown retention.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

An “Endocrown” can be made which

A

fills the
access with crown material.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Posterior tooth –
If extensive coronal destruction exists, and a post is necessary to retain the core:

A

Use the longest and straightest root and canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Use the longest and straightest root and canal
— root of Maxillary molars
— root of Mandibular molars
AVOID – — roots of Maxillary molars
AVOID – — roots of Mandibular molars

A

Palatal
Distal

Buccal
Mesial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Premolar tooth –
Significant variation in root length, curvature, bifurcation, and width.
Use a post only in roots that have

A

ample bulk and a straight root anatomy.

36
Q

Use a post on a premolar if:
(3)

A

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

37
Q

One possible exception:
Mandibular 1st premolar.
(4)

A

The occlusion on Mandibular first premolars is
usually favorable.
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.

38
Q

As a general rule, it is preferred to NOT place a post unless

A

needed to retain the build up
material.

39
Q

Using a core build up material only is desired if it provides

A

adequate retention and resistance
form

40
Q

With extensive coronal destruction in premolars generally requires a

A

post as tooth is much smaller
in relation.

41
Q

Molars often only need a build up and then secondary retentive features such as

A

grooves, boxes,
pins, bonding, or utilizing the access hole.

42
Q

Likely the most important factor in clinical success….
Leave as much — a possible.
The more you take away, the more you …
Sometimes, you have to leave the tooth “ugly” as this improves (2)

A

tooth structure
have to add, the more you
weaken the tooth and restoration
retention and strength

43
Q

Retention:
(4)

A

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

44
Q

Resistance:
(5)

A

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

45
Q

Post Length and Diameter:
— the length of the root is ideal
Minimum length at least that of the clinical crown
— of Gutta Percha left to keep the seal of the
Gutta Percha

A

½ to 2/3
4-5mm

46
Q

When forces are applied near the incisal, the result is
…
A post too short allows the forces to act with …
These guidelines are for — rooted teeth

A

stress (R) concentrated at specific points.
greater stress leading to a higher incidence of root fracture.
single

47
Q

Post LengthA post that does not leave 4-5 mm at the
apical for the RCT seal will compromise
the tooth:
(2)

A

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.

48
Q

Post LengthAs a general rule, molar post
spaces greater than — apical to
canal orifice increases the potential
for root perforation

A

7mm

49
Q

Post LengthRoot Thickness:
-Post preparation diameter should not exceed
– of the root at the CEJ
-Leave at least –mm of sound dentin at mid-root
-Ideal diameter of post should only be — depending on the particulars of the
tooth
-Post preparation is done with instruments
particular for the post and its diameter.
-Stay away from canal –!!

A

1/3
1
0.6mm –
1.2mm
curves

50
Q

Post Length Summary
Retain – mm of Gutta Percha at the apical aspect of root
-(Unless of curvatures)
-Often this is not possible on molars due to root anatomy

A

4-5

51
Q

Molar post measurement is – from canal orifice in pulp
chamber

A

7mm

52
Q

Preserve as much root structure as possible
-The diameter of the post should not be greater than – of the root
-Post space should be surrounded by at least – of
tooth structure in the mid-root and further apically.

A

1/3
1mm

53
Q

Removal of Gutta Percha to create Post space
— isolation mandatory
Can — the Gutta Percha to then be
able to remove it. (Heat Method)
(2)
Heated removal of GP can occur anytime
-Years after RCT placed or immediately after
obturation.
…
Heated instruments are used with caution. They can
overheat the tooth and cause soft tissue — if not
careful.

A

Rubber Dam

soften/melt
-System B
-Flame and endo tool

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

burns

54
Q

Removal of Gutta Percha to create Post space
Mechanical Method
Canal is instrumented with
-Pink GP should be visualized being removed during
the entire use of these instruments.
-This should be done —
There is a safety tip on the Gates Glidden and the Peaso.
Correct — is CRITICAL
-Do not force bur into —
A slow speed handpiece is used.
Gates used at — with Electric handpiece
Peaso used at — with Electric handpiece
No HARD pressure is used. The GP is soft and should guide
the instrument.

A

Gates Glidden and/or Peazo Reamer rotary instrument.
SLOWLY
angulation
hard dentin surfaces.
800RPM
1200RPM

55
Q

Treatment Planning - Post
Mechanical GP Removal
Follow the pink GP with gentle —
movements.
Press in. Pull back. Repeat
You may need to start with a
Watch your —!!!

A

vertical
small drill and
step up to a larger one depending on
the size of the canal.
angulation

56
Q

Active posts

A

engage the surrounding root material
usually via threads or a serrated edge.

57
Q

Passive posts

A

fit into the canal without engaging
the surrounding root material.

58
Q

Threaded Parallel posts are the most retentive

A

-Create higher stress on the root and
therefore have a higher incidence of
root fracture

59
Q

Serrated Parallel are close behind in
retentiveness.

A

-High stress at apex and therefore higher
incidence of root fracture

60
Q

Tapered Passive Posts are least retentive
(2)

A

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

61
Q

Most to least retentive

A

Threaded Parallel Post
Serrated Parallel Post
Threaded Tapered Post
Serrated Tapered Post
Parallel Passive Post
Tapered Passive Post

62
Q

Active posts are often

A

screwed into the teeth with a
handpiece or special tool to engage the surrounding
root surface

63
Q

Passive Posts gain their retention and support through

A

cementation

64
Q

Passive Posts sit in close proximity to —
and rely on cement for rentention.

A

post space walls

65
Q

Custom Passive Post – Custom Post

A

-Resin pattern sent to lab to be cast in metal
alloy

66
Q

Pre-Fabricated Posts –

A

Cemented in root with
core build up of composite or amalgam

67
Q

Pre-Fabricated Posts – Cemented in root with
core build up of composite or amalgam
Shapes are (3)
Some are —
Can be (2)

A

parallel, tapered, or a combo
serrated
Metal or Fiber

68
Q

Custom Cast Post
Advantages:
(3)

A

Anti-Rotational properties
Core is part of post
Can be preservative of tooth structure as
the post fits the space

69
Q

Custom Cast Post
Disadvantages:
(4)

A

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

70
Q

Pre-Fabricated Post
Advantages:
(4)

A

Increased retention within root
Ease of placement
More versatile to a wider range of tooth root shapes
Post will often break before root will

71
Q

Pre-Fabricated Post
Disadvantages:
(4)

A

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

72
Q

Pre-Fabricated Post
Caution–

A

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

73
Q

Clinical Treatment Decision:
A premolar 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:
(3)

A

-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

74
Q

Two Post Technique

A

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

75
Q

Cast Post Technique
(4)

A

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.

76
Q

With a tapered post, how do you keep it from
being able to rotate?
(3)

A

Small grooves in canal can allow cement to fill
those spaces decreasing rotation
Using multiple posts
A Cast post that includes a slight fill in a
neighboring canal.

77
Q

Once posts are in, concerns for re-treatment
arise due to preparations of the

A

canals. Often
too wide, too much tooth removed to be able
to remove post cement, and then re-treat.

78
Q

The post should extend to the height of your — so that
the build up has the full support of the post.

A

build up

79
Q

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 facture however if the forces
on the tooth are still too strong.

A

Cast

80
Q

Post Materials:
Metal Posts:
(4)

A

-Cast Metal (type 3 Gold with Gold and Palladium)
-Stainless Steel – very rigid, used most often
-Titanium alloy – biocompatible but weaker
-Brass – not used, corrosion occurs

81
Q

Post Materials:
Non-Metal Posts:
(3)

A

-Fiber-Reinforced composite (glass/quartz)
-Ceramic (zirconia) post / composite core
-Possible other ceramic post/core (milled or pressed in
lab). Not enough data to recommend.

82
Q

-Ceramic (zirconia) post / composite core
(2)

A

-Difficult to remove
-increased fracture potential

83
Q

Fiber reinforced Posts:
-Main advantage is better —
-Modulus of — is similar to dentin
-Must use — cement (self-adhesive)
-Less — than metal posts
Post will usually break before post does
-Failures typically occur in teeth with —

A

esthetics
Elasticity
Resin
Root fractures
little coronal
tooth structure.

84
Q

Pre-Fab Post summary:
Used by a majority of clinicians
Can be used in (2) situations
Either (3) in cross section
Can be (2)

A

immediate or emergency
parallel or taper and round
fiber reinforced or metal alloy
-Usually stainless steel or titanium alloy

85
Q

Cementation:
—- cements do not increase post
retention in a significant way
-Better to use —
-Showed to improve retention.
-A pre-treatment of the dentin prior to
cementation can have significant
increase in — of bond.

A

Luting
Dual or Self cure Resin cement.
strength

Fixed Prostodontics 2 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions