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3rd yr- CSB- summary sheets > Endodontics > Flashcards

Endodontics Flashcards

1
Q

What is the cause of Endodontics disease

A

Fungi, bacteria

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2
Q

Describe Endodontic microbes

A

Virtually all bacteria that cause Endodontics disease are anaerobic but some facultative anaerobic

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3
Q

Describe bacteria found in the apical region

A
  1. Lower bacterial count
  2. Strict anaerobes
  3. Less accessible to treatment measures
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4
Q

Describe bacteria found in the coronal region

A
  1. Higher bacterial count
  2. Facultative anaerobes
  3. More accessible to treatment
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5
Q

Where do bacteria in the apical region get their nutrients

A

Nutrients gained from peririadicular

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6
Q

Where do bacteria in the apical region get their nutrients

A

Nutrients from oral cavity

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7
Q

Are facultative or strict anaerobes easier to kill with the irrigant

A

Strict anaerobes are easier to kill with irrigant

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8
Q

How can biofilms be resistant to eradication

A
  1. Physical barrier
  2. Mechanical
  3. Shape
  4. Metabolism
  5. Transfer
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9
Q

What is clinical diagnosis

A

The diagnosis and management of pulpal disease and periapical disease

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10
Q

What are the problems with diagnosing Endodontics

A

We are reliant on the patient description of symptoms which may be confusing

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11
Q

How do we go about diagnosing Endodontics disease

A
  1. Palpate soft tissues and look for swellings and sinus
  2. see if the tooth is TTP or is it mobile
  3. Use hot and cold objects
  4. Ask the patient SOCRATES
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12
Q

What problems are associated with diagnosing multi rooted teeth h

A

Patients may have one dead root and one vital root so symptoms and special test results may not be accurate

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13
Q

What should you always do before starting Endodontic treatment

A

RUBBER DAM AND ISOLATE

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14
Q

What shape are we aiming to create when shaping the root

A

Aim to achieve a continuously tapering funnel from apex to access cavity that flows with the shape of the original canal

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15
Q

Which foramen should remain in the same position following shaping

A

Apical foramen should remain in its original position

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16
Q

What type of prep are we doing when carrying out root canal treatment

A

Chemo mechanical

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17
Q

What is chemo mechanical prep

A

Shaping with instruments

Cleaning with irritants

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18
Q

How far does irrigant go from the end of the needle

A

1MM

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19
Q

What do we create first when shaping

A

A coronal flare

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20
Q

How do we create a coronal flare

A

Using gates gladdens or the pro taper gold system

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21
Q

What is Patency filing

A

Taking a small file al the way through the spec to rid of any debris

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22
Q

Which file do we use to patency file

A

10K

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23
Q

What is recapitulation

A

Taking MAF down to the working length to check its maintained

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24
Q

Name the 2 types of metal used in Endodontics

A

Nickel titanium

Stainless steel

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25
Q

What is nickel titanium used for

A

Rotary instruments

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26
Q

What is stainless steel used for

A

Used for hand filing

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27
Q

Which metal is safer to work wit

A

Nickel titanium as you down have to manipulate rotary files

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28
Q

What procedural errors can occur in Endodontics

A
  1. Dentine debris can stop the file from going all the way to the working length
  2. Ledges can form
  3. Perforation
  4. irrigant
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29
Q

How can we form a ledge during shaping

A

Pushing file apically too hard and file ends up cutting its own canal

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30
Q

How can files fractures

A
  1. Torsional failure

2. Cyclic fatigue

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31
Q

What is torsional failure

A

When a file splits die to too much pressure being put on it

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32
Q

How can we avoid torsional failure

A

Can be avoided by not pushing too hard and twisting too much

33
Q

What is cyclic fatigue

A

When the file is held around the curve too long and further bending on the inside causes the file to snap

34
Q

How can we avoid cyclic fatigue

A

Constantly move the file in and out

35
Q

Are thicker or thinner files more lilted to fracture

A

Thicker due to cyclic fatigue

36
Q

What is a big problem in curved canals

A

A tight radius

37
Q

What is an apical granuloma

A

A formation of tissue that forms at root tip

38
Q

What disease do you have if you have an apical granuloma

A

Periapical periodontitis

39
Q

After treatment when should an RCT be assessed

A

At least once a year

40
Q

Talk through some favourable outcomes following RCT

A
  1. Absence of pain
  2. No swelling or other symptoms
    3, No sinus tract
  3. No loss of function
  4. Radiographical evidence of a normal PDL space around the root
41
Q

What suggests the outcome of an RCT is unfavourable

A

If the radiographic lesion has remained the same size

42
Q

If the radiographic lesion has not gotten smaller following RCT what do we do

A

Advised to assess lesion further until its resolved for at least 4 years
If the lesion persists after 4 years RCT is considered to be associated with post treatment disease

43
Q

What is the loose criterial we follow when asking the outcome of RCT

A

Tooth is:

  1. functional
  2. Pain free
  3. No signs of swelling
  4. Lesion has resolved
44
Q

How do we tell a patient the RCT has failed

A

The disease has persisted despite RCT

45
Q

If a file were to snap in the patients mouth how would you tell them

A

The file has separated

46
Q

How can we improve survival rate of an RCTed tooth

A
  1. Extend filling to within 2mm of the radio-graphic apex
  2. Filling should be well condensed with no voids
  3. Good quality coronal restoration
47
Q

What can decrease the survival rate of an RCT tooth

A
  1. Pre op presence of sinus
  2. Increase size of lesion
  3. Presence of flare up
  4. Perofration
  5. Mixing chlorohexidine and sodium hypocholite
  6. Missing a canal
  7. Fractured instrument
48
Q

What do we look at when assessing a radiograph for an endodontic case

A
  1. Root length
  2. Degree of canal sclerosis
  3. Canal symmetry
  4. Canal curvature
49
Q

What is a problem we can face when asking root shape on a radiograph

A

The root can change direction suddenly and we can not see this on a radiograph

50
Q

List some factors that might increase the difficulty of treatment

A
  1. Multiple portals of exit
  2. Spliting of root canals
  3. Deep canals
51
Q

Name the most common cause of RCT failure

A

Veronica root fracture

52
Q

List some distinctive features fo vertical root fracture

A
  1. Sinus at mid root level
  2. When going round the tooth the probe may suddenly drop 13-14mm
  3. Circumferential bone loss will be seen on both sides of the tooth
53
Q

If a patient has a vertical root fracture what might you have to do

A

Extract

54
Q

When taking a history what do we note down

A
  1. Complaint of
  2. History of presenting complain
  3. Previous dental history
  4. Medical history
  5. Social history
55
Q

What might a patient with acute periapical periodontitis present with

A
  1. May present with acute inflammation
  2. Tooth may be slightly higher int eh socket
  3. If tooth is touched at the apex it will really Hirt
56
Q

What might a patient with chronic periapical periodontitis present with

A

May present with no pain

57
Q

What might a patient with acute periapical abcess present with

A
  1. excruciating pain

2. Face may be swollen

58
Q

List the stages of a normal treatment planning

A
  1. Definitive direct restorations
  2. Endodontics therapy
  3. Temporary crowns
  4. Denture design
  5. Crowns
  6. Fixed/ removable partial dentures
  7. Recall
59
Q

Outline the steps we follow when doing an RCT

A
  1. Access
  2. Coronal flare
  3. Working length
  4. Irrigate
  5. Obturate
60
Q

When are radiographs taken during RCT

A

4 times

  1. Pre op
  2. Working length
  3. Master point
  4. Post op
61
Q

What do we assess when looming at a root filled tooth

A
  1. Endodontics assessment
  2. Periodontal assessment
  3. Coronal tissue assessment
62
Q

What do we look at when assessing the coronal tissues

A
  1. Height. thickness of tooth tissue
  2. Position of tooth tissue
  3. Restorations
  4. Aesthetisc
  5. Occlusion
63
Q

Why might we restore root filled teeth

A
  1. Function
  2. Aesthetics
  3. To prevent re infection
  4. Prevent further bone loss
64
Q

When would we restore a tooth immediately

A
  1. When we want a good coronal seal

2. When risk of tooth fracture is high

65
Q

When might we delay restoring a tooth

A
  1. If risk of endoodntic failure is present

2. If the tooth requires Endodontics revision or apical surgery

66
Q

What are the benefits fo restoring a tooth straight away

A
  1. Permanet coroanl seal
  2. Protection from risk of root fracture
  3. Restoration places tooth in function early
67
Q

What are the drawbacks fo restoring a tooth straight away

A
  1. If RCT fails then expensive to replace restoration
68
Q

What are the benefits of delaying tooth restoration

A
  1. Endodntic success confirmed
  2. Less risk of having to damage restoration
  3. Expense of new crown avoided
69
Q

What are the drawback of delaying tooth restoration

A

Potentially a long delay before permeant restoration placed

  1. Increased risk of tooth fracture
  2. Increased risk of loss of coronal seal
70
Q

How can we restore a root filled tooth

A
  1. cut down GP and place a plastic restoration
  2. Nayyar core
  3. Pre fabricated restoration
  4. Cast post and core restoration
71
Q

What are the advantages of Nayyar core

A
  1. Can be placed immediately after Endodontics
  2. Uses coronal tooth structure to improve retention
  3. Reduces stress
  4. Easy to remove
72
Q

What are the problems with putting a post in

A

They weaken the tooth

73
Q

Describe how healthy periapical tissues look on a radiograph

A
  1. Radiolucent line of the PDL membrane space
  2. Radiopaque line that represents lamina dura
  3. Some teeth have a clear line all the way around
74
Q

What superimposed shadows may be seen on a radiograph that could be mistaken for periapical pathology

A
  1. maxillary antra
  2. Nasopalatine foramen and incisive canals
  3. Mental cyst
75
Q

What is rarefying osteitis

A

Radilucent inflammation of the bone

76
Q

What is osseous dysplasia

A

A begin disease that causes radiolucencies on apical regions of teeth

77
Q

Talk through the disease progression of a cyst

A
  1. Acute periapical periodontitis
  2. Rarefying osteitis
  3. Apical abscess
  4. Cyst
78
Q

Talk through the disease progression for periapical periodontitis

A
  1. Pulpitis
  2. Reversible pulpitis
  3. Irreverisble pulpitis
  4. Periapical periodontitis
79
Q

Talk through the disease progression for a periapical granuloma

A
  1. Chronic periapical periodontitis
  2. Rarefying osteitis
  3. Sclerosing osteitis
  4. periapical granuloma

3rd yr- CSB- summary sheets (6 decks)

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