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Endo > Endodontic Access > Flashcards

Endodontic Access Flashcards

1
Q

Why do you need to gain access to the pulpal space?

A
  • Visualization
  • Instrumentation
  • Obturation
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2
Q

How do you maintain the strength of a tooth during an access?

A
  • Preserve Incisal Edge
  • Conserve Marginal Ridges
  • Maintain correct Shape, Size & Position
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3
Q

Crucial to have a _____________ understanding of the tooth/pulp you are attempting to access

A

visual and spatial

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4
Q

What is red?

A
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5
Q

What is orange?

A
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6
Q

What is yellow?

A
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7
Q

What is green?

A
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8
Q

What is blue?

A
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9
Q

What is purple?

A
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10
Q

What is pink?

A
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11
Q

T/F: you should look for a canal with the bur

A

FALSE!
- use the endo explorer

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12
Q

If you don’t find the pulp chamber at __ mm STOP

A

7

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13
Q

Maxillary central incisors are ___________ with the base of the triangle toward the incisal edge

A

triangular

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14
Q

What is the difference between maxillary laterals compared to the central?

A

narrower and less flared incisally

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15
Q

Maxillary canines have the same general form as the incisors but are closer to an _______ shape

A

oval

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16
Q

What does the law of centrality state?

A

Penetration points are where you generally expect to find the pulp and are usually in the center mass of the root form

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17
Q

Where are the penetration points for the maxillary anteriors?

A
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18
Q

Mandibular central & lateral incisors are very narrow and have 2 canals ___% of the time

A

40%

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19
Q

Mandibular central & lateral incisors have an access that is…

A

very narrow M-D and extends further incisally

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20
Q

Mandibular canines are ______ shape and similar to maxillary canine access

A

oval

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21
Q

Mandibular Incisors are VERY NARROW _____

A

M-D

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22
Q

What do you need to be aware of with mandibular incisors?

A
  • Mandibular Incisors are VERY NARROW M-D
  • We must be AWARE of this to avoid ruining the tooth by tipping our access bur to the mesial or distal and drilling out the side of the tooth
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23
Q

What type of access is used on a maxillary central incisor?

A

triangular access (base of triangle at incisal)

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24
Q

On a maxillary central incisor with access there should be about ___ mm of unprepped tooth on all sides

A

3

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25
Q

Total straight-line access on anteriors would involve access from the facial and create a…

A

weakening of the incisal edge and an esthetic issue

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26
Q

Make a mark on your entry bur at ___ mm with a permanent marker

A

7

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27
Q

What would the ideal access of a maxilalry central incisor include?

A
  • would not require a crown
  • could be adequately restored with a composite restoration
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28
Q

What are the types of burs used for access?

A

Safety-tip tapered diamond bur

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29
Q

What should you do if you don’t know for certain where you are in the tooth?

A

*STOP & TAKE A RADIOGRAPH
*Have someone else take a look
*Don’t become DISORIENTATED

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30
Q

What bur do you use to access a maxillary lateral incisor?

A

2 round

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31
Q

What kind of access do you do on a maxillary lateral incisor?

A

triangular/oval access

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32
Q

What is important to know about “incisal compromise”?

A

Total straight-line access on anteriors would involve access from the facial and create a weakening of the incisal edge and an esthetic issue.

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33
Q

What bur do you use to access a maxillary canine?

A

2 or #4 round bur

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34
Q

What kind of access do you do on a maxillary canine?

A

oval access

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35
Q

The canal of a maxillary canine is narrower in what direction?

A

narrower M-D

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36
Q

How many canals do most maxillary anteriors have?

A

single canal

37
Q

What does the law of color state?

A

the floor of the chamber is darker than the walls of the chamber

38
Q

What bur do you use to access a mandibular central incisor?

A

2 round bur

39
Q

What type of access is used on a mandibular central incisor?

A

oval access

40
Q

What percent of the time is there one canal in a mandibular central incisor?

A

60%
- two canals 40%

41
Q

Cervical access of a mandibular central incisor will miss the _________ canal

A

lingual

42
Q

The root of a mandibular central incisor is wider in what direction?

A

F-L

43
Q

What are the common canal configurations for premolar access?

A

Type I
Type II
Type III
Type IV

44
Q

What is a type I premolar access?

A

one canal from pulp chamber to apex

45
Q

What is a type II premolar access?

A

2 canals from pulp chamber, join prior to apex

46
Q

What is a type III premolar access?

A

2 canals from pulp chamber to apex

47
Q

What is type IV premolar access?

A

one canal from pulp chamber divides prior to apex (most difficult to treat)

48
Q

Maxillary first premolars have a B. & a L. canal in at least ___% of cases.

A

85%

49
Q

For a maxillary first premolar the M-D width of the access is no wider than a ___________ and the opening usually extends from near the tip of the buccal cusp lingually as a narrow oval

A

4 round bur

50
Q

Maxillary second premolars contain a second canal in at least ___% of cases

A

35%

51
Q

What do you need to worry about for maxillary premolars?

A

All premolars are very easy to perforate to the mesial or distal! Use #2 bur and align carefully with root angulation.

52
Q

Access always gained through the ____________ approach on all posterior teeth

A

occlusal

53
Q

What kind of access and what bur for a maxillary 1st premolar?

A

Thin Oval Access (Bur #2)

54
Q

What is the most prevalent canal type for a maxillary 1st premolar?

A

Two canals most prevalent
85% two canals
9% one canal
6% three canals

55
Q

In premolars canal orifices lie under respective…

A

cusp tips

56
Q

What is the most common error when accessing a maxillary 1st premolar?

A

not totally unroofed

57
Q

Final width of access for a maxillary 1st premolar is not wider than a…

A

4 round bur

58
Q

What are the steps to access a maxillary 1st premolar?

A
  • use a #2 round bur
  • remove pulpal roof
  • finish with ENDO-Z bur
59
Q

What kind of access and what bur for a maxillary 2nd premolar?

A

Thin oval (width of #2)

60
Q

What type of canal configuration is the maxillary 2nd premolar?

A
  • Most often Type I = 1 root 1 canal (75-85%)
  • Type II, III & IV less frequently
61
Q

What percent of the time does the maxillary 2nd premolar have two canals?

A

35%

62
Q

What is the difference between the maxillary 2nd premolar compared to the first?

A

Slightly less F-L extension

63
Q

If one canal found but not in center F-L, there are probably…

A

2 canals

64
Q

What is the access for a mandibular first premolar?

A

thin oval

65
Q

Mandibular 1st premolar is usually one root, 1 canal (type I) ____% of the time

A

73.5%

66
Q

Mandibular 1st premolar is type IV ____% of the time

A

19.5%

67
Q

Mandibular 1st premolar has three canals less than ____% of the time

A

1%

68
Q

What is the law of concentricity?

A

walls of the pulp chamber are always concentric to the external surface

69
Q

What is the law of the CEJ?

A

CEJ is the most consistent landmark for locating the position of the pulp chamber

70
Q

What it the law of centrality?

A

pulp chamber in the center of the tooth

71
Q

What is the biggest challenege with accessing maxillary molars?

A

MB2 canal
- as often as 95%

72
Q

Maxillary Molars are __________ difficult because the MB2 canal may require exceptional skill in locating and shaping.

A

mechanically

73
Q

_____ may require as much TIME as all 3 other canals in total !

A

MB2

74
Q

As many as ___% of Maxillary Molars have 4 canals

A

95%

75
Q

Four canals makes _______________________ far more difficult in that the MB2 canal is minute, dangerous and very time-consuming to find and to negotiate and to shape

A

Maxillary 1st Molars

76
Q

If you are NOT consistently finding and successfully treating this MB2 canal, you are doing the patient a disservice and should…

A

STRONGLY CONSIDER REFERRAL before the Malpractice Actions begin

77
Q

Endo-Z bur is used to…

A

define the walls as they meet the floor of the prep

78
Q

With mandibular molars you often cannot tell if there are 3 or 4 canals in the tooth until you…

A

enter the pulp

79
Q

If it is a singular distal canal generally in the ______ of the form as illustrated and it may be wide B-L.

A

center

80
Q

About ____% of mandibular molars have 2 distal canals so it is worth looking for them every time.

A

30%

81
Q

What is the shape of the access for mandibular molars with 3 canals?

A

Triangular Shape

82
Q

What is the shape of the access for mandibular molars with 4 canals?

A

Rhomboid shape

83
Q

Mandibular molars have C-shaped canals _____% of the time

A

2-8%

84
Q

The “C-Shaped Canal” tooth contains __________ canals associated by an irregular network of threadlike canals and areas that are variable in size, shape and complexity and are extremely difficult to find and worse to instrument.

A

3 or more

85
Q

Second molars in general are considerably more difficult than 1st molars which explains why…

A

Advanced Endo does all 2nd molars

86
Q

_____ molars are very rarely done in endo

A

Third

87
Q

_______ RCT is monumentally more difficult than anteriors and PM

A

MOLAR

88
Q

__________ is arguably the WORST error you can make at access

A

Perforation

Endo (27 decks)

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