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Endo I > Endodontic Disinfection > Flashcards

Endodontic Disinfection Flashcards

1
Q

instrumentation fails to:

A

contact a large portion of the hidden spaces which are filled with bacteria and substrate

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2
Q

what needs to be removed from canal for RCT to be successful

A

remove and destory bacteria and their sbustrate

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3
Q

what percentage of areas can be accessed with instrumentation

A

60-70%

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4
Q

since not all areas can be accessed with instruments what is used in adjunct with it

A
  • 8.3% sodium hypochlorite (NaOCl)
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5
Q

what do we clean and shape with

A

NaOCl and intra canal medicaments

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6
Q

how long should the needle be

A

2mm from working length

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7
Q

should the needle be bent or straight

A

bent

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8
Q

tip of syringe cannot pass beyond:

A

apical constriction

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9
Q

do not allow tip to ____ in the canal

A

bind

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10
Q

what does NaOCl do

A
  • kills micro-organisms on contacts
  • destroys and dissolves substrate
  • disorganizes biofilm
  • dilutes toxins in canal system
  • disinfects RC system and instruments
  • lburicates canals
  • floats out debris
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11
Q

when NaOCl breaks down what do we have

A

NaCl and water

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12
Q

when does NaOCl break down

A

in the bottle and in the tooth

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13
Q

how long does it take for NaOCl to become inactive in the canal and when does it need to be replenished

A

after 3-5 minutes so it must be replenished every 3-5 minutes

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14
Q

irrigate following:

A

each active instrument

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15
Q

what is used for surface disinfection and what is the concentration of NaOCl

A
  • Dakin’s solution
  • 0.25%
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16
Q

what concentration of NaOCl do we use and how does it compare to Dakins solution

A
  • 8.3%
  • it is stronger and more toxic and more effective
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17
Q

typical case requires ____ of NaOCL as irrigant per visit

A

10-12cc

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18
Q

NaOCl must be in contact with shaped canal a minimum of _______ after canal enlarged to a ___ or larger

A
  • 30 minutes
  • # 30
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19
Q

what does recapitulate mean

A

-flood canal system with NaOCl
- do this every 3-5 minutes
- then move on with next active instrument

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20
Q

when should you recapitulate

A

following each active instrument

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21
Q

how big is the syringe we get

A

12cc

22
Q

describe sodium hypochlorite

A
  • strong oxidizer
  • powerful disinfectant
  • dissolves necrotic tissue at low concentration
  • dissolves living tissue at higher concentration
  • med of choice in endo
23
Q

describe sodium hypochlorite

A
  • strong oxidizer
  • powerful disinfectant
  • dangerous and extremely toxic
24
Q

what do you do if sodium hypoclorite is swallowed

A
  • call poison center
  • dental dam must not leak
25
Q

what do you do if contact with eyes and sodium hypochlorite

A

flush with water for 15 minutes
- never forget eye protection and never pass anything over face

26
Q

even with special tip:

A
  • vigorous infection will cause irrgant to express apicaly
  • be carefule
  • do not let the tip bend
  • keep moving and loose in canal
  • tastes terrible in mouth and burns throat
  • dental dam must not leak
27
Q

what happens if irrigating needle is allowed to bind in canal

A

NaOCl can be forced out the end of the tooth into the PA tissues with disastrous results

28
Q

what are the results of NaOCl leaking into PA tissues

A
  • immediate and extreme pain for several days
  • ecchymosis
    -swelling
  • temporary disfigurement
29
Q

can you undo NaOCl accidents

A

no you can only prevent them

30
Q

why do you need to protect clothing

A

the tip od the syringe will leak as you remove it from the tooth

31
Q

what does dr edwards suggest you do to protect clothes

A

place your gloved hand under the syringe as you remove it from the tooth

32
Q

what does the sonic vibration of NaOCl endo activator do

A
  • agitates irrigation solutions during endo treatment
  • cavitation and acoustic streaming significantly improves debridement and the disruption of the smear layer and biofilm
33
Q

when would the endo activator be helpful

A

in difficult and unusual canal systems

34
Q

does endo activator diminish time for use of NaOCl

A

no

35
Q

when is the smear layer produced

A

when we do any mechanical shaping in dentin

36
Q

where is the smear layer

A

on the surface of dentinal tubules

37
Q

is the smear layer removed by NaOCl

A

no

38
Q

when should the smear layer be removed

A

before obturation or when using various sealers and cements to complete the cleaning procedure and to be able to access dentinal tubules

39
Q

what is used to remove smear layer and for how long

A

17% EDTA and works for 60 seconds

40
Q

what stops the action of EDTA

A

8.3% NaOCl

41
Q

what does EDTA stand for

A

ethylene diamine tetra-acetic acid

41
Q

what other irrigant is enouraged

A

2% chlorhexidine

42
Q

why dont we think 2% chlorhexidine is necessary

A

no biofilm removal, precipitate formation

43
Q

can we sterilize the RCS

A

no we can lower bacterial concentrations

44
Q

when are intracanal medications placed

A

within the canal system between appointments

45
Q

what is the goal of intracanal medications

A

increase local anti-microbial action and to further decrease the microbial challenge within the RC system

46
Q

what is the intracanal medication of choice

A

Ca(OH)2

47
Q

describe CaOH2

A
  • ph between 11 and 12
  • discourages most microbial growth
  • long lasting- effectiv eover extended periods
  • no reported allergic responses
  • easy to apply and remove as a paste
  • available in clinic as ultracal
48
Q

all potential portals of entry/exit must be:

A

sealed creating a dense liquid tight (hermetic) seal “obturation” and final restoration to prevent leakage

49
Q

what are we theoretically sealing in the canal

A

some micro organisms, toxins and substrate within the canal system

50
Q

what are the main take home messages

A
  • use NaOCl to dissolve organic tissue and to kill microorganisms
  • use a needle that fits loosely 2mm from WL. irrigate with an in and out gentle movment
  • replenish NaOCl every 3-5 minutes/after every active instrument
  • EDTA removes inorganic portion of the smear layer
  • CaOH: intracanal medication of choice- pH between 11 and 12

Endo I (13 decks)

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