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Endo > Endodontic Disinfection > Flashcards

Endodontic Disinfection Flashcards

1
Q

If we chemically remove the contents of the pulpal system & introduce a dye:

A

A far more COMPLEX anatomy is revealed

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2
Q

Instrumentation fails to contact with a large portion of the hidden spaces which are filled with…

A

bacteria (and substrate)

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3
Q

We must remove and destory both the __________________ to be successful with a root canal

A

bacteria and their substrate

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4
Q

We can access only ___% of the complex anatomy & “protected areas” by any instrumentation

A

60-70%

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5
Q

What are the benefits of using irrigants in a root canal treatment?

A
  • Removal of debris and wetting of the canal walls
  • Destruction of organic debris.
  • Destruction of microorganisms
  • Opening dentinal tubules by removal of the smear layer.
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6
Q

What is the major form of disinfection?

A

sodium hypoclorite

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7
Q

What are the major weapons in disinfection?

A

CLEANING AND SHAPING WITH NaOCL and INTRA-CANAL MEDICAMENTS

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8
Q

How does NaOCl work?

A
  • kills micro-organisms on contact
  • destroys & dissolves
    substrate
  • Disorganizes Biofilm
  • Dilutes toxins in canal system
  • Disinfects RC System & Instruments
  • Lubricates Canals
  • Floats out Debris
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9
Q

When NaOCl breaks down, what do we have?

A

NaCl & H2O

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10
Q

When does NaOCl break down?

A
  1. In the bottle
  2. In the TOOTH
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11
Q

What are the properties of sodium hypochlorite?

A
  • Strong Oxidizer
  • Powerful Disinfectant
  • Dissolves Necrotic Tissue @ low concentration
  • Dissolves Living Tissue @ higher concentration
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12
Q

Why is sodium hypochlorite dangerous?

A

Extremely TOXIC
- Never forget Eye Protection and never PASS anything over Face

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13
Q

____% NaOCl (Clorox) is 33.2 times STRONGER and MORE TOXIC – also
more effective!

A

8.3%

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14
Q

NaOCl becomes inactive after ____ min.

A

3-5

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15
Q

How often does NaOCl need to be replenished?

A

3-5 minutes

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16
Q

Important to irrigate following each…

A

active instrument

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17
Q

NaOCl must be in contact with shaped canal a minmum of ______ minutes after canal enlarged to #30 or larger

A

30 minutes

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18
Q

MUST NOT have tip of syringe beyond ________ constriction

A

apical

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19
Q

Set the bend at ___ mm short of WL

A

2 mm

20
Q

Typical case requires about _____ cc. of NaOCl as irrigant per visit

A

10-12

21
Q

Vigorous injection will cause irrigant to express…

A

apically

22
Q

What is important about using NaOCl in the mouth considering it is toxic?

A
  • Do NOT let the tip BIND
  • Keep tip MOVING & LOOSE in canal
  • Tastes Terrible in mouth (Burns throat)
  • Dental Dam must NOT leak
23
Q

If the irrigating needle is allowed to bind in the canal, NaOCl can be…

A

easily forced out the end of the tooth into the P/A tissues with
disastrous results

24
Q

What are the results if the irrigating needle is allowed to bind in the canal?

A
  • Immediate & Extreme pain for several days
  • Ecchymosis
  • Swelling
  • Temporary disfigurement
25
Q

How can you undo a NaOCl accident?

A

There is NO WAY to UNDO a NaOCl accident after it happens

26
Q

Who needs eye protection while using NaOCl?

A

*Your Patient
*Your Assistant
*Yourself

27
Q

How do you protect clothes from NaOCl leaking from the tip?

A

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

28
Q

___% EDTA is introduced to the canal system and allowed to work for 60 seconds.

A

17%

29
Q

What do you put in the tooth following EDTA?

A

followed by 8.3 % NaOCl to stop action of Ethylene Diamine Tetra-acetic Acid

30
Q

What does EDTA stand for?

A

Ethylene Diamine Tetra-acetic Acid

31
Q

What is Ethylene Diamine Tetra-acetic Acid (EDTA)?

A
  • Cheleating Agent
  • Removes Inorganic Tissue
32
Q

What is a smear layer?

A

SMEAR LAYER is produced when we do any mechanical shaping in dentin. It lies on the surface of the dentinal tubules.

33
Q

Smear layer is NOT removed by NaOCl and the SMEAR LAYER occludes access to the Dentinal Tubules so must be removed to complete the CLEANING procedure before…

A

OBTURATION or when using various Sealers and Cements

34
Q

Some studies will encourage ____________ OR OTHER irrigants as well; we don’t believe this is necessary. No Biofilm removal, precipitate formation.

A

2% Chlorhexidine

35
Q

Can we sterilize the root-canal system?

A

Tt may NOT ALWAYS be possible to eliminate 100% of the micro-organisms, toxins and substrate within the complex canal systems present.

36
Q

What is an endo activator?

A

sonic/ultrasonic vibration of NaOCl
- This device agitates irrigation solutions during endodontic treatment. Evidence-based endo has shown that cavitation and acoustic streaming significantly improve debridement and the disruption of the smear layer and biofilm

37
Q

What are intracanal medications?

A

Medications placed within the canal system between appointments. Intended to increase local anti- microbial action and to further decrease the microbial challenge within the RC system.

38
Q

_______: near universal acceptance as the intracanal medication of choice- pH between 11 and 12

A

CaOH

39
Q

What does CaOH do?

A
  • Discourages most microbial growth
  • Long lasting (effective over extended periods)
  • No reported allergic responses
  • Easy to apply & remove as a paste
  • Available in clinic as “Ultraca
40
Q

What is the pH range of CaOH?

A

11 and 12

41
Q

Use ______ to dissolve organic tissue and to kill microorganisms

A

NaOCl

42
Q

Use a needle that fits loosely ___ mm from WL. Irrigate with an in-and-out gentle movement

A

2.0 mm

43
Q

Replenish NaOCl every ______ minutes/after every active instrument

A

3-5

44
Q

_________ removes inorganic portion of the “smear layer”

A

EDTA

45
Q

CaOH: intracanal medication of choice- pH between _______

A

11 and 12

Endo (27 decks)

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