endodontic Case Selection

Question 1

What 3 factors should be evaluated prior to carrying out endodontic treatment?

Answer 1

• medical
• psychological
• social factors

Question 2

Name 6 medical contraindications to endodontic treatment

Answer 2

• pregnancy
• cardiovascular disease
• cancer
• diabetes mellitus
• bisphosphonate therapy
• allergy

Question 3

How should you treat a patient who is pregnant (endodontics)

Answer 3

• not a contraindication to endodontic therapy
• first trimester emergency intervention only
• pain and infection managed in collaboration with obstetrician/physician

Question 4

Why is endodontic therapy a contraindication for pts with CVD, and how should they be treated

Answer 4

• if they have had a MI within the past 6 months
• emergency treatment should be provided in consultation with the pts cardiologist

Question 5

What are 3 stress reduction protocols when providing endodontic therapy to a pt with CVD?

Answer 5

short appointments

sedation

pain and anxiety control

Question 6

Why might cancer be a contra indication for providing endodontic therapy to a pt?

Answer 6

• a thorough history is essential
• treatment for cancer?
• chemotherapy and radiotherapy to the head and neck region can compromise healing
• consult with oncologist

Question 7

how should a pt with diabetes be managed for endodontic therapy?

Answer 7

• pts with controlled/uncontrolled diabetes must be carefully monitored
• appointments should not disrupt a pts normal insulin and meal schedule
  (minimise stress)

Question 8

What does BRONJ stand for

Answer 8

bisphosphonate-related osteonecrosis of the jaw

Question 9

Why is a pt taking bisphosphonates a contraindication for endodontic therapy? and what is recommended

Answer 9

• BRONJ
• non-surgical endodontic treatment of teeth that might otherwise be extracted
• use the ENTIRE health care team, when developing treatment plans for these patients

Question 10

Which administration of bisphosphonates has a greater risk when carrying out endodontic therapy?

Answer 10

IV bisphosphonates greater risk than oral administration

Question 11

Why would allergies be a contraindication of endodontic therapy?

Answer 11

if pt allergic to later rubber: a dam should be made of vinyl

Question 12

Why is perio so important when doing a dental evaluation for endodontic therapy?

Answer 12

poor perio prognosis may necessitate tooth loss

periodontal probing is essential- BPE and tooth of interest