Endodontics Flashcards
Causes of pulpal nerve damage: extensive decay moving into the pulp, heat from hand pieces, extensive restorations
Physical irritation
Causes of pulpal nerve damage: blow to a tooth or the jaw
Trauma
Localized area of pus (exudate) originating from an infection. Can be periodontics (around tooth) or endodontic (within the tooth)
Abscesses
This inflammatory reaction to pulpal infection may be chronic or acute onset with pain, tenderness of the tooth in response to pressure, pus formation and swelling of tissue
Endodontic (periradicular) abscess
This inflammatory reaction is frequently caused by bacteria trapped in the periodontal pocket, patient will experience rapid onset of pain, tenderness of the tooth in response to pressure, pus formation and swelling
Periodontal abscess
Diagnosis: chief complaint from patient, character and duration of pain, painful stimuli, sensitivity to biting and pressure
Subjective examination
Diagnosis: conducted by the endodontist, periodontal conditions, extensive restoration, tooth mobility, swelling or discolouration, pulp exposure, extent of decay.
Objective examination
Objective examinations: determine whether the inflammatory process has extended into the periodical tissues. The dentist taps on the Incisal of occlusal surface with the end of a mouth mirror handle parallel to the long axis of the tooth
Percussion test
Objective examination: used to determine whether the inflammatory process has extended into the periodical tissues. The dentist applies firm pressure to the mucosa above the apex of the root
Palpation test
Objective examinations: never used on metallic restoration or gingival tissue. Ice, dry ice or carbon dioxide is used to determine the response of a tooth to cold
Thermal sensitivity cold test
Objective examination: a piece of gutta percha or an instrument handle is heated and applied to the facial surface of the tooth
Thermal sensitivity heat test
What is suspected if the cold relieves pain in the tooth
Irreversible pulpitis
Objective examinations: a small electrical stimulus is delivered to the pulp, determines if the pulp is vital or non vital, placed on cervical third of the tooth
Electric pulp testing
Objective examination: good quality images, most useful diagnostic tool, most ideal for endodontic procedures
Periapical radiograph
Requirements for endodontic film
Must show 4-5mm beyond apex of the tooth and the surrounding bone or pathalogic condition. Must not have elongation or foreshortening, must have good contrast so structures are identifiable
Initial radiograph is taken when and why
At the consultation for diagnosis
Working length image is taken when and why
When the pulp is opened up and to determine the length of canal with files in the canals
Final instrumentation image is taken when and why
Right before the fill with the final size files in all canals
Root canal completion image is taken when and why
Taken after the tooth has been temporized with a temporary filling
Recall Image is taken when and why
Taken at post treatment evals to make sure it is healing properly
Diagnostic conclusion: inflammation of the pulp the pulp tissues become inflamed and can be described as being reversible or irreversible
Pulpitis
Diagnostic conclusion: mild, occurs when pulp is irritated and the patient is experiencing pain in response to thermal stimuli
Reversible pulpitis