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Conservation > Endodontic Access > Flashcards

Endodontic Access Flashcards

1
Q

Describe the basic principles of endodontic access

A
  • Sound knowledge of tooth and root anatomy
  • Parallel pre-operative radiograph
  • Prepare access before placing rubber dam
  • Good illumination and magnification
  • Locate the major pulp horn
  • Copious irrigation and note colour changes
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2
Q

Describe 2 objectives for all access cavity preparations

A
  1. Allow unimpeded entry of instruments into root canals (straight line access)
  2. Allow sealing of cavity between visits
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3
Q

Name 4 important features of access cavities

A
  1. Site
  2. Size
  3. Shape
  4. Depth
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4
Q

Describe the average root length and number of canals in maxillary central incisor

A

23mm with 1 canal

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5
Q

Name 2 features of maxillary central incisors

A
  1. Access starting at cingulum and extending towards incisal edge
  2. Triangular shape to encompass pulp horns
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6
Q

Describe the average root length and number of canals in maxillary lateral incisor

A

22mm with 1 canal

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7
Q

Describe a key features of maxillary lateral incisor

A

Apical 3-4mm has palatal curvature

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8
Q

Describe the average root length and number of canals in maxillary canine

A

26mm with 1 canal

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9
Q

Describe 1 key feature of maxillary canine

A

Rounder access cavity than incisors (no need to flare access cavity as 1 pulp horn)

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10
Q

Describe the average root length and number of canals in maxillary 1st premolar

A

21 mm with 1 (5%), 2 (90% - B,P) or 3 (5% - MB,DB,P) canals

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11
Q

Describe 2 key features of maxillary 1st premolar

A
  1. Access centre of occlusal central grove

2. Widen access B-P to locate root canal entrance

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12
Q

Describe the average root length and number of canals in maxillary 2nd premolar

A

21mm with 1 (75%) or 2 (25% - B,P) canals

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13
Q

Describe 1 feature of the maxillary 2nd premolar

A

If only 1 root canal should be centred and oval in shape (B-P) to encompass pulp horns

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14
Q

Describe the average root length and number of canals in maxillary 1st molar

A
  • 22mm (P longer than MB and DB)

- 3 (40% - MB,DB,P) or 4 (60% - MB1,MB2,DB,P) canals

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15
Q

Describe 3 features of maxillary 1st molars

A
  1. Rhomboid access cavity outline
  2. Distal aspect on mesial aspect of transverse ridge
  3. MB2 located between MB1 and P
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16
Q

Describe the average root length and number of canals in maxillary 2nd molar

A
  • 20mm (P longer than MB and DB)

- 3 (60% - MB,DB,P) or 4 (40% - MB1,MB2,DB,P) canals

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17
Q

Describe 3 features of maxillary 2nd molar

A
  1. Lower incidence of MB2
  2. DB root canal closer to centre of tooth
  3. Increased likelihood of fusion of canals (B-P)
18
Q

Describe the average root length and number of canals in mandibular incisors

A

21mm with 1 (60%) or 2 (40% - B,L) canals

19
Q

Describe 2 features of mandibular incisors

A
  1. Starts at base of cingulum

2. Should extend to nearly to incisal edge to confirm presence or absence of 2nd canal

20
Q

Describe the average root length and number of canals in mandibular canines

A

24mm with 1 (90%) or 2 (10% - B,L) canals

21
Q

Describe 1 feature of mandibular canines

A

Starts at the base of the cingulum

22
Q

Describe the average root length and number of canals in mandibular 1st premolars

A

22mm with 1 (75%) or 2 (25% - B,L) canals

23
Q

Describe 2 features of mandibular 1st premolars

A
  1. Starts in central occlusal groove

2. Access is oval bucco-lingually in shape

24
Q

Describe the average root length and number of canals in mandibular 2nd premolars

A

22mm with 1 (90%) or 2 (10% - B,L) canals

25
Q

Describe 2 features of mandibular 2nd premolars

A
  1. Starts in central occlusal groove

2. Access is oval bucco-lingually in shape

26
Q

Describe the average root length and number of canals in mandibular 1st molars

A

21mm with 3 (65% - ML,MB,D) or 4 (35% - ML,MB,DL,DB) canals

27
Q

Describe 2 features of mandibular 1st molars

A
  1. Mesial root canal orifices found below respective cusp tips
  2. If distal root canal orifice not centred then inc likelihood of 2nd canal
28
Q

Describe the average root length and number of canals in mandibular 2nd molars

A

20mm with 3 (90% - MB,ML,D) or 2 (10% - M,D) canals

29
Q

Describe 1 feature of mandibular 2nd molars

A

Increased incidence of fused root canals

30
Q

Describe isolation during endodontic treatment

A
  • Rubber dam is mandatory
  • Prevents infection of the root canal
  • Protects the patient from irrigants
  • Access cavity cut before placing rubber dam
31
Q

Name 2 ways magnification can be achieved during endodontic treatment

A
  1. Loupes

2. Microscopes

32
Q

Name 2 burs used for accessing canals

A
  1. Straight diamond fissure bur gains access through enamel

2. Size 6 round bur to remove dentine and locate relevant canals

33
Q

What is the apical constriction?

A

Narrowest part of the root canal system lying around 0.5-1mm short of the apical foramen

34
Q

Name 5 contributing factors to working length determination

A
  1. Previous radiographs
  2. Average values
  3. Diagnostic working length radiographs
  4. Electronic apex locators
  5. Tactile sensation
35
Q

Describe how to estimate working length from pre-operative radiographs

A
  • EWL from pre-operative radiographs and average root length
  • Use size 10 SS K files until reached EWL
  • Take WL radiograph or use electronic apex locator to determine WL
36
Q

Name 2 problems when taking radiographs during endodontics

A
  1. Estimating root canal lengths
  2. Film placement when instruments, rubber dam and clamps in position
  3. Identification and separation of canals
37
Q

What holder is used for taking endodontic x-rays?

A

Endo ray holder

38
Q

Name 2 ways to identify and separate canals during endodontic x-rays

A
  1. Use different sizes of flies with different numbers of rubber stops in each canal
  2. Take 2 radiographs using different horizontal x-ray tube-head positions (parallax technique)
39
Q

Describe electronic apex locators

A
  • Optimum is cemento-dentinal junction with precise position variable
  • Modern locators better than tactile or radiographic techniques
  • Accuracy 90-100% for 0.5-1mm from apex respectively
  • Still need radiographs in combined approach
40
Q

Name 5 clinical tips when using electronic apex locators

A
  1. Remove metallic restorations from access cavity
  2. File should be large enough to contact walls of root canal system
  3. Apex / 0 reading is most accurate
  4. Re-check WL with EAL after coronal 2/3 shaping
  5. Detects perforations

Conservation (27 decks)

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