Endodontic Radiography and Restoration of the End-Treated Tooth

Question 1

How do we use radiographs in endodontics?

Answer 1

assist in diagnosis
assist in treatment procedure/planning
help monitor patients status

Question 2

What do we look for in radiographs?

Answer 2

normal, anatomical structures
root/pulpal anatomy
periapical pathosis or other abnormal findings

Question 3

List some of the normal anatomic structures that are most commonly confused with periapical pathology.

Answer 3

1. mental foramen
2. maxillary sinus (and/or sinus recess)
3. incisive foramen
4. nasal fossa (nasopalatine canals)
5. mental fossa
6. submandibular gland fossa

Question 4

Fill in the following characteristics of endodontic lesions:

1. the ___ ___ is no longer intact (trace the PDL on the films)
2. a classic lesion looks like a “___ ___”
3. the radiolucency stays at the apex with ___ films

Answer 4

1. the lamina dura is no longer intact (trace the PDL on the films)
2. a classic lesion looks like a “hanging drop”
3. the radiolucency stays at the apex with angled films

Question 5

What cannot be determined by a radiograph?

Answer 5

PULPAL diagnosis (ie the absence of a periapical radiolucency, you can not tell irreversible pulpitis from pulpal necrosis on a radiograph)

Question 6

T/F. Radiographs can help determine PERIAPICAL, not pulpal diagnosis.

Answer 6

True.

Question 7

For start and finish films, use the ___ ___. For working films (during treatment under the rubber dam), use ___.

Answer 7

Rinn positioner; hemostats

Question 8

Object and film are parallel and central beam passes through the object at a ___ ___ to provide the least amount of distortion.

Answer 8

right angle

Question 9

What is Clarke’s Rule?

Answer 9

SLOB Rule

Same Lingual Opposite Buccal

Question 10

If an object moves in the SAME direction that you angled the beam, its ___. If an object moves in the OPPOSITE direction from the beam, its ___.

Answer 10

lingual; buccal

Question 11

___ leakage is a major cause of failure.

Answer 11

Coronal

Question 12

T/F. A quoted guideline for retreatment is lack of adequate seal for 2 to 3 months (however, lit varies as little as 3 days).

Answer 12

True.

Question 13

Why will waiting for complete healing to place a final restoration guarantee failure?

Answer 13

due to coronal leakage (esp if surgery is the next treatment step)

Question 14

Okay if minimum tooth structure is lost and not likely to fracture (eg lingual access on maxillary anterior - pulpal necrosis from trauma)

Answer 14

direct restorations (eg. amalgam, composite)

Question 15

___ restorations (eg. crown, onlay) most common, necessary when more than minimal tooth structure is lost.

Answer 15

indirect

Question 16

What are the basic rules of a post and core prep?

Answer 16

1. must leave at least 4mm gutta percha
2. can’t prepare post space around a curve
3. made in largest, straightest canal
4. can be made immediately after RCT