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Restorative > Endodontics > Flashcards

Endodontics Flashcards

1
Q

pain fibres associated with reversible pulpitis

A

a delta

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2
Q

pain fibres associated with irreversible pulpitis

A

c fibre

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3
Q

features of an ideal irrigant

A 
flushes bedris
kills microorganism's 
dissolves organic matter
lubricates
non toxic
inexpensive
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4
Q

advantages + disadvantages of sodium hypochlorite (0.5-5%)

A

+ = flushes, antimicrobial, tissue solvent, lubricant, inexpensive

  • = irritant
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5
Q

advantages + disadvantages of chlorhexidine gluconate as irrigant (0.2-2%)

A

+ = flushes, antimicrobial, lubricant, non-irritant

  • = expensive, no solvent
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6
Q

advantages + disadvantages of saline/water/LA as irrigant

A 
\+ = flushes, lurbricant, non irritant
- = no antimicrobial or solvent
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7
Q

3 options for antimicrobial dressing material between appointments

A
  1. CaHO2 non setting
  2. chlorhexidine gel
  3. odontopaste (ledermix)
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8
Q

features of odontopaste/ledermix

A

steroid/antibiotic
antimicrobial (CaOH2 + clindamycin hydrocholride)

good if LA was not successful when accessing (hyperaemic pulp) - reduces inflammation for next visit

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9
Q

features of CaOH2

A

pH11/12
broad spectrum antimicrobial - up to 3 month
dissolves organic debris

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10
Q

how thick must temporary filing material be

A

3mm

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11
Q

4 options for temporary filling material

A
  1. cavit
  2. sedanol
  3. IRM
  4. GIC
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12
Q

how to protect canal when temporary filling

A

cotton wool, sponge, PTFE tape

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13
Q

features of cavit

A

plaster of Paris + PDA
sets in contact with saliva
good seal in retentive non-load bearing sites
easy to remove

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14
Q

features of sedanol

A

good seal

good in retentive non-load bearing sites

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15
Q

features of IRM

A

ZnOE cement reinforced for PMM
stronger for load bearing sites - last 1yr
easy to remove

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16
Q

features of GIC

A

good for unretentive + load bearing site

difficult to remove

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17
Q

what are chelating agents used for?

A

soften dentine by demineralising - useful when trying to negotiate sclerosed/blocked canals

e.g. EDTA paste

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18
Q

5 examples of sealer cements

A
  1. CaOH2
  2. ZnOE
  3. resin
  4. calcium silicate
  5. silicone
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19
Q

disadvantage of MTA

A

can cause grey discolouration

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20
Q

4 basic requirements of access cavity

A
  1. pulp chamber fully unroofed
  2. straight line access
  3. no unnecessary tissue removal
  4. sufficient retention
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21
Q

at what depth should you find pulp chamber

A

6-7mm

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22
Q

tradiotoanl and contemporary approach to shaping

A

trad = iso stainless steel instruments - 5-10% taper by stepping back 0.5-1mm increments

contemporary = NiTi instruments - predictable taper

23
Q

difference between stainless steel + NiTI

A

stainless steel = precurved (use for ledges)

24
Q

process causing pulp to become necrotic following infection

A
  1. increase in pulpal pressure due to oedema
  2. venous stasis
  3. causes ischamia + thrombosis
  4. necrosis
25
Q

how does pulpitis in a tooth with an open apex present?

A

open pulpitis - good apical blood supply

causes hyperplastic granulation tissue

pulp polyp - chronic hyperplastic pulpitis

(bleeds on probing)

26
Q

types of pulp calcifications

A

diffuse/dystrophic

pulp stones (denticles) - coronal, true pulp, false pulp, irregular or laminated, free/adherent/interstitial

27
Q

what is a true pulp stone

A

rare, caused by odontoblasts

28
Q

what is a false pulp stone

A

concentric layers of mineralised tissue around blood vessel

29
Q

4 vital pulp therapies

A
  1. indirect pulp cap
  2. direct pulp cap
  3. pulpotomy
  4. pulp revitalisation

for teeth with deep caries but no signs of irreversible pulpitis

30
Q

in stepwise excavation when do you re-enter?

A

6 weeks

31
Q

what sort of dentine is made in direct pulp capping?

A

odontoblast like cells migrate in - reparative tertiary dentine

32
Q

if accidentally expose pulp how do you proceed

A

isolate
haemostats - sodium hypochlorite to remove micro-organisms
consider direct pulp capping or pulpotomy

33
Q

3 main reasons for RCT

A
  1. irreversible pulpitis
  2. placement of crown/bridge, later access would be hard
  3. teeth that would be unrestorable without retention from pulp space
34
Q

if you can not dry canal how should you proceed?

A

recline
apply non-setting caOH2
seal access
review 1-2 weeks

35
Q

how much supra gingival tooth tissue needs to be left for a successful ferrule?

A

2-3mm

circumferential dentine, ideally extending parallel

36
Q

where should restoration margins be in order to be a success?

A

on tooth tissue

37
Q

disadvantage to using amalgam core

A

delayed crown/onlay prep - takes 24hours to set

only posterior teeth

38
Q

how much GP is removed using gates gladden for Nayyar (amalgam) core?

A

3-4mm

39
Q

2 core options for posterior teeth

A

composite or amalgam (nayyar)

avoid using posts

40
Q

common materials for direct posts

A

fibre (most common)
pre-formed metallic - ss, titanium
ceramic - epoxy resin

41
Q

what material are indirect posts normally made from?

A

cast metal

42
Q

steps for indirect post

A
  1. prepare post channel + coronal tissue
  2. insert smooth, plastic impression post + record impression
  3. make temp post crown with smooth metal temp crown post
  4. send impression to lab + cast
  5. remove smooth impression post from model
  6. insert size matched plastic, serrated burnout post + wax up core
  7. remove pattern from model + cast in metal
  8. fit + cement post
  9. impression for permanent crown
43
Q

how much apical root filling needs to retain to provide seal?

A

4-5mm

44
Q

shape + length of posts

A

longer + wider + parallel posts more retentive

45
Q

3 cementation options for posts in increasing retention

A

zinc phosphate (always for metal)
GIC/RMGIC
composite (always for fibre)

46
Q

3 radiographic feature of peri apical periodontitis

A
  1. PAP
  2. widening of PMS
  3. loss of lamina dura
47
Q

4 outcomes of periapical periodontist

A
  1. resolution
  2. periapical granuloma
  3. focal sclerosis osteitis
  4. dentoalveolar abscess

also inflammatory root resorption, hypercemtnosis, ankylosis, radicular cyst

48
Q

radiograph appearance of hypercementosis

A

bulbous root

49
Q

what causes a radicular cyst

A

necrotic pulp/non vital tooth

pathological cavity containing fluid (not pus), lined by epithelium

proliferation of cell rests of malaise stimulated by inflammatory mediators
epithelial proliferation, bone resorption, osmotic pressure

50
Q

clinical presentation of radicular cyst

A

asymptomatic or symptomatic
+/- swelling
tooth mobility, displacement

51
Q

radiographic appearance of radicular cyst

A

round, unilocular
well defined, corticated
radiolucent

causes root resorption

52
Q

types of radicular cyst

A

pocket (more likely to heal) or true

apical, lateral or residual if left after extraction

53
Q

treatment for radiuclar cyst

A

most heal after RCT

Restorative (10 decks)

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