Endodontics Flashcards
What is the Basrani classification of fractured teeth?
Class A1, A2a, A2b
Holstroms Veterinary Dental Techniques 3rd edition
A1: enamel fracture of crown
A2a: crown enamel and dentin fracture
A2b: crown enamel, dentin and pulp exposed
What is the Basrani classification of fractured teeth?
Class B
Class C
Holstroms Veterinary Dental Techniques 3rd edition
Class B: root fracture
Class C: crown and root fracture
According to Holstrom’s Veterinary Dental Techniques, what is the time of fracture cut off for performing vital pulp therapy on pulp-dentin fracture on a patient older than 18 months?
48 hours
According to Holstrom’s Veterinary Dental Techniques, what are the timing cut offs for vital pulp therapy for patients younger and older than 18 months?
Younger than 18 months: 2 weeks or less
Older than 18 months: 48 hours or less
According to Holstrom’s Veterinary Dental Techniques, the ideal working length is located where in relation to the apex?
1mm short of the apex
According to Holstrom’s Veterinary Dental Techniques, what rpm should rotary instruments be run at?
350rpm
Most low speed handpieces turn at 3000rpm
What fibers in the dentin pulp complex are you testing when performing sensibility tests (i.e. thermal or electrical conduction)?
A-delta fibers
In the study “Reliability of Electric Pulp Test, Cold Pulp Test
or Tooth Transillumination to Assess Pulpal
Health in Permanent Dog Teeth” what was considered the most and least reliable diagnostic test to evaluate pulp health in dogs?
- Most reliable - EPT (electric pulp test)
- Least reliable - TTI (tooth transillumination)
According to Zacher’s 2021 review “Decision-Making and Management of Immature Permanent Teeth with Crown Fractures in Small Animals - A Review,” indirect pulp capping includes placement of what agent(s) as a base layer?
Manfra Marreta JVD 2021, Issue 2
Hard setting calcium hydroxide
MTA
newer generation bioceramic materials
Followed by glass ionomer or resin-modified glass ionomer then composite
According to Zacher’s 2021 review “Decision-Making and Management of Immature Permanent Teeth with Crown Fractures in Small Animals - A Review,” how many millimeters of calcium hydroxide or MTA should be applied to the pulp during VPT?
JVD 2021, Issue 2
2-3mm
In the study “Reliability of Electric Pulp Test, Cold Pulp Test
or Tooth Transillumination to Assess Pulpal
Health in Permanent Dog Teeth” EPT identified what percentage of nonvital and vital teeth respectively?
96% nonvital, 100% vital
According to Zacher’s 2021 review “Decision-Making and Management of Immature Permanent Teeth with Crown Fractures in Small Animals - A Review,” for apexification the working length should be how many millimiters short of the apex and how many millimeters of the apex should be filled with MTA?
1-2mm short of the apex
fill the apical most 4-5mm
Accoding to Zacher’s “Decision-Making and Management of Immature Permanent Teeth with Crown Fractures in Small Animals - A Review,” what are appropriate techniques for treating fractured teeth with vital pulps?
JVD 2021
Bonding and sealing
Indirect pulp capping
Pulpotomy with direct pulp capping/vital pulp therapy
Accoding to Zacher’s “Decision-Making and Management of Immature Permanent Teeth with Crown Fractures in Small Animals - A Review,” what are appropriate techniques for treating fractured teeth with nonvital pulps?
JVD 2021
Regenerative endodontic therapy
Apexification followed by conventional root canal therapy
What intraoperative findings are consistent with irreversible pulpitis?
Zacher “Decision-Making and Management of Immature Permanent Teeth with Crown Fractures in Small Animals - A Review,” JVD 2021
Excessive or deep pulpal hemorrhage from exposed or amputated pulp
Persistent hemorrhage for greater than 5 minutes following partial coronal pulpotomy
When immature teeth sustain crown fractures when is extraction indicated?
Zacher “Decision-Making and Management of Immature Permanent Teeth with Crown Fractures in Small Animals - A Review,” JVD 2021
Extensive alveolar bone loss that cannot be reversed
Insufficient crown structure for restoration
owners unable to pursue ongoing treatment
When the pinkish hue of a near pulp exposure is observed how many millimeters of pulp remains?
Zacher “Decision-Making and Management of Immature Permanent Teeth with Crown Fractures in Small Animals - A Review,” JVD 2021
~0.5mm
Indirect pulp capping indicated
In the study “Reliability of Electric Pulp Test, Cold Pulp Test
or Tooth Transillumination to Assess Pulpal
Health in Permanent Dog Teeth” TTI identified what percentage of nonvital and vital teeth respectively?
Nonvital 59% and Vital 95%
What does thermal testing rely on?
Rapid temperature change of the tooth causes a sudden fluid flow within the tubules which stimulates the A-delta fiber nociceptors in the dentin-pulp complex.
In Luotonen’s 2014 article “Vital pulp therapy in dogs: 190 cases (2001–2011),” what was the range in hours of time since exposure to treatment and what was the correlation between time of exposure and treatment success?
J Am Vet Med Assoc. 2014
3 to 250 hours
Time since exposure had no significant correlation with success of treatment
In the human literature, what factor is most important overall for success of vital pulp therapy?
Zacher “Decision-Making and Management of Immature Permanent Teeth with Crown Fractures in Small Animals - A Review,” JVD 2021
Removal of all inflamed superficial pulp
More necessary for success than timing
What intraoperative error can lead to VPT failure?
Zacher “Decision-Making and Management of Immature Permanent Teeth with Crown Fractures in Small Animals - A Review,” JVD 2021
Deep penetration of pulp dressing material into pulp
In Luotonen’s 2014 article “Vital pulp therapy in dogs: 190 cases (2001–2011),” what the overall failure rate of VPT with calcium hydroxide vs MTA?
Overall failure rate for VPT with calcium hydroxide was 5 times greater than with MTA
MTA: 92%
Calcium hydroxide: 58%
In Luotonen’s 2014 article “Vital pulp therapy in dogs: 190 cases (2001–2011),” what was the association between antibiotic use and outcome?
No significant correlation with antibiotic usage and outcome when multivariate analysis used
What is the definition of apexification?
a method to induce a calcified barrier in a root with an open apex or the continued apical development of an incompletely formed root in teeth with necrotic pulps
When MTA is used for apexification when is the apical barrier created?
Zacher “Decision-Making and Management of Immature Permanent Teeth with Crown Fractures in Small Animals - A Review,” JVD 2021
Created immediately upon placement at apex
May perform apexification in 1 or 2 step procedures with MTA vs multiple procedures and months for apical hard tissue barrier to form when calcium hydroxide used
The 2012 human Mahidol study found that regenerative endodontics vs apexification with calcium hydroxide or MTA increases dentinal wall thickness and root length by what percent?
Zacher “Decision-Making and Management of Immature Permanent Teeth with Crown Fractures in Small Animals - A Review,” JVD 2021
Regenerative endodontics:
Increased dentinal wall thickness by 28%
Root length by 15%
Calcium hydroxide, MTA dentinal wall thickness: 1.5%, 0.0%
Calcium hydroxide, MTA root length: 0.4%, 6.1%
The 2012 human Mahidol study found tooth survival rates following regenerative endodontics and apexification with MTA and calcium hydroxide to what percent respectively?
Zacher “Decision-Making and Management of Immature Permanent Teeth with Crown Fractures in Small Animals - A Review,” JVD 2021
Regenerative endodontics: 100%
Apexification MTA: 95%
Apexification calcium hydroxide: 77%
What are the components of MTA?
Thorne “Successful Use of MTA Fillapex as a Sealant for Feline Root Canal Therapy of 50 Canines in 37 Cats,” JVD 2020
Portland cement and bismuth oxide
What does EPT (electrical pulp testing) rely on?
It relies on an ionic shift within the dentinal tubules. By applying an electrical current to the tooth surface, the ionic movement in the dentinal fluid causes a local depolarization and impulse propagation through the A-delta fibers.
What are the components of MTA Fillapex?
Thorne “Successful Use of MTA Fillapex as a Sealant for Feline Root Canal Therapy of 50 Canines in 37 Cats,” JVD 2020
salicylate resin, fluent resin, natural resin, bismuth oxide, nanoparticulated silica, titanium dioxide
A GRADUAL change in tooth temperature excites what type of fibers and elicits a diffuse ache over a sharp sudden pain?
C fibers
What are the characteristics of MTA that make it an ideal root sealant and pulp capping material?
Thorne “Successful Use of MTA Fillapex as a Sealant for Feline Root Canal Therapy of 50 Canines in 37 Cats,” JVD 2020
Biocompatible
Bactericidal effects
Noncytotoxic, radiopaque
Impervious durable seal, dimensionally stable
Good marginal adaption
Can promote osteogenesis, odontogenesis, regeneration of periradicular tissues
MTA is the material of choice for what endodontic procedures?
Thorne “Successful Use of MTA Fillapex as a Sealant for Feline Root Canal Therapy of 50 Canines in 37 Cats,” JVD 2020
Repair of root perforations
Root end filling
Pulp capping
Pulpotomy
Apexification
Root filling material
What are the advantages of MTA Fillapex as a root canal filling material?
Thorne “Successful Use of MTA Fillapex as a Sealant for Feline Root Canal Therapy of 50 Canines in 37 Cats,” JVD 2020
Good sealing → slight expansion on setting
Good dentinal tubule, accessory and lateral canal penetration due to presence of nanoparticles
In Thorne’s 2020 study “Successful Use of MTA Fillapex as a Sealant for Feline Root Canal Therapy of 50 Canines in 37 Cats,” what were the outcome success rates for successful RCT, NEF and failure?
JVD 2020, Issue 2
Success: 64%
NEF: 28%
Failure: 8%
Success based off of 1 6 month recheck RAD
What type of sealer is AH Plus?
An epoxy resin sealer
In Thorne’s 2020 study “Successful Use of MTA Fillapex as a Sealant for Feline Root Canal Therapy of 50 Canines in 37 Cats,” was presence of preop periapical lucency, preop external root resorption, sealant extrusion or type of treatment performed statistically significantly associated with outcome?
Type of treatment: crown reduction + RCT stat sig more likely to fail
Pre-op PA lucency not associated with outcome (in agreement with previous cat RCT study Strom 2018)
Preop external root resorption not stat sig associated with outcome –> in contrast to previous studies
In Strom’s 2018 study “Radiographic outcome of root canal treatment of canine teeth in cats: 32 cases (1998-2016),” what were the outcome success rates for successful RCT, NEF and failure?
JAVMA 2018
Successful: 49% (18/37)
NEF: 32%
(12/37)
Failure: 19% (7/37)
Overall success rate 81%
In Strom’s 2018 study “Radiographic outcome of root canal treatment of canine teeth in cats: 32 cases (1998-2016),” what variables were stat sig associated with outcome?
JAVMA 2018
Periapical EIRR prior to RCT 10 fold increase in rate of failure
Patient age greater or equal to 5 years increased rate of failure
How many dentinal tubules do dogs have per square millimeter of dentin?
50,000 to 100,000
What type of sealer is GuttaFlow 2?
Silicone sealer
In Goodman’s 2020 study “The Incidence of Radiographic Lesions of Endodontic Origin Associated With Uncomplicated Crown Fractures of the Maxillary Fourth Premolar in Canine Patients,” what was the overal incidence?
Neimic, JVD 2020
24.3%
In Goodman’s 2020 study “The Incidence of Radiographic Lesions of Endodontic Origin Associated With Uncomplicated Crown Fractures of the Maxillary Fourth Premolar in Canine Patients,” what factors were not associated with increased LEOs?
Neimic JVD 2020
Right vs left side
Age
Sex
Working status
In Goodman’s 2020 study “The Incidence of Radiographic Lesions of Endodontic Origin Associated With Uncomplicated Crown Fractures of the Maxillary Fourth Premolar in Canine Patients,” what factor was stat sig associated with fractured teeth?
Weight
For each kg increase in wt, 3.8% increase chance of having a fractured tooth
Association of weight with LEO not stat sig
What is the working time and curing time of AH plus compared to GuttaFlow 2?
AH plus: working time 4 hours, setting time 8 hours
GuttaFlow 2: working time 10-15 minutes, setting time 30 min
Do AH Plus and Gutta Flow 2 shrink or expand on setting?
AH plus shrinks (1.76%)
Gutta Flow 2 expands (0.2%)
Lothamer’s 2017 article, “Apical Microleakage in Root Canals Obturated with 2 Different Endodontic Sealer Systems in Canine Teeth of Dogs,” what were the differences in microleakage between the Gutta Flow 2 and AH plus groups?
Snyder, Goldschimdt, Soukup. JVD 2017
No stat sig difference in prevalence of microleakage between groups
Magnitude of dye penetration between groups not significant
In Adrian’s study, “Radiographic Outcome of the Endodontic Treatment of 55 Fractured Canine Teeth in 43 Dogs (2013-2018),” what were the outcome success rates for successful RCT, NEF and failure?
JVD 2022
Success: 93% (51/55)
NEF: 5.5% (3/55)
Failure: 2% (1/55)
Overall success rate 98%
In Adrian’s study, “Radiographic Outcome of the Endodontic Treatment of 55 Fractured Canine Teeth in 43 Dogs (2013-2018),” what variables influenced success in regards to presence of a preoperative periapical lucency?
JVD 2022
Teeth with preop PAL were more likely to fail (40% success rate)
Obturation material: teeth obturated with GP cone + flowable GP had higher success rates when preop PAL present
Teeth with crowns had higher success rates when PAL present
How is a periapical lucency typically defined via imaging for root canal outcome papers?
Widening of the periapical periodontal ligament space greater than double the width of the PDL space in other areas surrounding the root
In humans after what time point if a periapical lucency has not decreased in size is root canal therapy considered to have failed?
4 years
Kuntsi-VaattavaaraVerstraete, Kass. “Results of root canal treatment in dogs: 127 cases (1995-2000) JAVMA 2002
In Kuntsi-Vaattavaara and Verstraete’s 2002 paper “Results of root canal treatment in dogs: 127 cases (1995-2000),” what were the outcome success rates for successful RCT, NEF and failure?
JAVMA 2002
Successful: 69% (87/127)
NEF: 26% (33/127)
Failure: 6% (7/127)
Overall success rate 94%
In Kuntsi-Vaattavaara and Verstraete’s 2002 paper “Results of root canal treatment in dogs: 127 cases (1995-2000),” perioperative periapical lucencies and EIRR increased the risk of failure by how much respectively?
JAVMA 2002
Periapical lucency 9.5x more likely to fail
EIRR 2.3x
Nonvital pulps also had lower success rates
In Kuntsi-Vaattavaara and Verstraete’s 2002 paper “Results of root canal treatment in dogs: 127 cases (1995-2000),” what teeth had an increased risk of failure compared to the maxillary fourth premolar?
JAVMA 2002
mandibular fourth premolars and first molars
Canines
In Kuntsi-Vaattavaara and Verstraete’s 2002 paper “Results of root canal treatment in dogs: 127 cases (1995-2000),” what variables were not associated with root canal outcome?
Age
Sex
Small vs large breed dogs not associated with outcome
Voids and obturation method not associated with outcome
In Lee and Verstraete’s 2022 study ““Radiographic outcome of root canal treatment in dogs: 281 teeth in 204 dogs (2001-2018),”what were the outcome success rates for successful RCT, NEF and failure?
Success: 71%
(199/281)
NEF: 25% (71/281)
Failure: 4% (11/281)
Overall success rate 96% virtually unchanged from same groups’ 2002 paper 94%
In Lee and Verstraete’s 2022 study ““Radiographic outcome of root canal treatment in dogs: 281 teeth in 204 dogs (2001-2018),” what affect did preop PAL and EIRR have on outcome?
JAVMA 2022
PAL and EIRR NOT sig associated with increased risk of failure
Opposite of 2002 study!
In Lee and Verstraete’s 2022 study ““Radiographic outcome of root canal treatment in dogs: 281 teeth in 204 dogs (2001-2018),” what factor was significantly associated with outcome?
JAVMA 2022
Mandibular first molar teeth had a stat sig higher incidence of failure
Maxillary PM4 teeth had high rates of failure but not stat sig
What is the success rate of surgical endodontics in humans?
Fulton, Arzi, Lommer. “Outcome of surgical endodontic treatment in dogs: 15 cases (1995-2011).” JAVMA 2012.
90%
In Fulton’s 2012 study “Outcome of surgical endodontic treatment in dogs: 15 cases (1995-2011),” what were the success rates?
Arzi, Lommer, Verstraete. JAVMA 2012
Success: 66% (10/15)
NEF: 33% (5/15)
Overall success rate 100%
In Fulton’s 2012 study “Outcome of surgical endodontic treatment in dogs: 15 cases (1995-2011),” did choice of root end filling material influence outcome
No influence on outcome
Vast majority MTA used
In Hernandez’s 2014 paper “Scanning Electron Microscopic Evaluation of Tooth Root Apices in the Dog,” what teeth had significantly greater numbers of apical foramina?
JVD 2013
Mandibular first molars
Mandibular first molars 57 vs maxillary fourth premolars 36 and maxillary canines 38
What are the principles of the endodontic triad?
Preparation, sterilization and obturation
What were the organisms that were frequently isolated in “Microbiological Aspects of Naturally Occurring Primary Endodontic Infections in Dogs “?
Pasteurella, Bacteroides, Propionibacterium
What were the main findings of “Microbiological Aspects of Naturally Occurring Primary Endodontic Infections in Dogs” regarding associations between number of bacterial species involved and radiographic signs of endodontic disease?
There were no statistical significant associations
The number of bacterial species in root canals in the paper “Microbiological Aspects of Naturally Occurring Primary Endodontic Infections in Dogs “ were found to _____ after they were over 12 months.
Decrease
Pasteurella, Bacteroides, Propionibacterium are what kind of pathogens in the oral cavity if dogs?
Opportunistic, and have been found in subgingival plaque in dogs aka normal flora in dogs
What is the sieved plug of the apical delta?
Hernandez. “Scanning Electron Microscopic Evaluation of Tooth Root Apices in the Dog. JVD 2014.
An extension of the cementum within the root canal forming the apical delta measuring 2 +/-0.4mm
In Hernandez’s 2014 paper “Scanning Electron Microscopic Evaluation of Tooth Root Apices in the Dog,” what is the average apical foramen diameter in humans vs the average apical foramina in dogs?
Hernandez. “Scanning Electron Microscopic Evaluation of Tooth Root Apices in the Dog. JVD 2014.
Humans average 380 micrometers
Dogs 80% < 50 micrometers
After how many days is pulp necrosis expected after the pulp has been exposed?
65 days
Of the three teeth that were observed in the paper “Scanning Electron Microscopic Evaluation of Tooth Root Apices in the Dog” which tooth had the most significant amount of apical foramina?
The mandibular first molar with a mean of 57.3 +/-18.9
Maxillary fourth premolar 36 +/- 11.6
Maxillary canine 38 +/- 9.3
What is a “sieved plug”?
Cementum at the apical level of the root that separates the dental pulp from the periodontium.
In the study “The Incidence of Radiographic Lesions of
Endodontic Origin Associated With
Uncomplicated Crown Fractures of the
Maxillary Fourth Premolar in
Canine Patients” what was the percentage of UCF’s that had lesions of endodontic origin?
24.3%
In the study “The Incidence of Radiographic Lesions of
Endodontic Origin Associated With
Uncomplicated Crown Fractures of the
Maxillary Fourth Premolar in
Canine Patients” explain what parameter that was statistically significant made a dog more likely to have an UCF?
Weight was a significant factor
Average weight of control - 14.9 kg
Average weight of all UCF - 21.5 kg
Average weight of UCF with a LEO - 24 kg
Average weight of UCF without a LEO - 15 kg
In Feigin’s 2022 study ““Analysis and Assessment of Pulp Vitality of 102 Intrinsically Stained Teeth in Dogs,” what percentage of intrinsically stained teeth were nonvital?
Feigin, Bell, Shope, Snyder. JVD 2022, Issue 1
88%
In Feigin’s 2022 study ““Analysis and Assessment of Pulp Vitality of 102 Intrinsically Stained Teeth in Dogs,” what percentage of intrinsically stained teeth transilluminated abnormally and what percentage of teeth had signs of endodontic disease?
Feigin, Bell, Shope, Snyder. JVD 2022, Issue 1
Transilluminated abnormally: 92%
Endodontic disease: 57%
In Feigin’s 2022 study ““Analysis and Assessment of Pulp Vitality of 102 Intrinsically Stained Teeth in Dogs,” were teeth locally affected by intrinsic staining (< 50% crown) more or less likely nonvital or vital?
Feigin, Bell, Shope, Snyder. JVD 2022, Issue 1
more likely to be nonvital (61%) than vital (38%)
In Feigin’s 2022 study ““Analysis and Assessment of Pulp Vitality of 102 Intrinsically Stained Teeth in Dogs,” discolored teeth with pulp necrosis were what percent more likely to have a periapical lucency vs discolored teeth without pulp necrosis?
Feigin, Bell, Shope, Snyder. JVD 2022, Issue 1
29% more likely to have radiographic PAL
In Feigin’s 2022 study ““Analysis and Assessment of Pulp Vitality of 102 Intrinsically Stained Teeth in Dogs,” what percentage of intrinsically stained teeth did not show any RAD evidence of endodontic disease and what percent of those teeth were nonvital?
Feigin, Bell, Shope, Snyder. JVD 2022, Issue 1
42% intrinsically stained teeth did not show any RAD evidence of endodontic disease
77.5% found to be nonvital
What are the differential diagnoses for instrinsic staining?
Feigin, Bell, Shope, Snyder. “Analysis and Assessment of Pulp Vitality of 102 Intrinsically Stained Teeth in Dogs.” JVD 2022, Issue 1.
amelogenesis imperfecta, dentinogenesis imperfecta, tetracycline ingestion during tooth development, dental fluorosis, tooth resorption, hyperbilirubinemia, pulp necrosis, injury, and aging
In Hale’s 2001 study “Localized intrinsic staining of teeth due to pulpitis and pulp necrosis in dogs,” how was pulp vitality determined?
JVD 2001
Visual inspection of pulp for presence of bleeding via pulpotomy during root canal therapy (49/84 teeth)
Or exploratory pulpotomy prior to extraction (15/84 teeth)
In Hale’s 2001 study “Localized intrinsic staining of teeth due to pulpitis and pulp necrosis in dogs,” what percentage of teeth were determined to have gross signs of partial or total pulp necrosis?
JVD 2001
92%
In Hale’s 2001 study “Localized intrinsic staining of teeth due to pulpitis and pulp necrosis in dogs,” what percentage of teeth had signs of endodontic disease?
57%
In Hale’s 2001 study and Feinin’s 2022 intrinsically stained teeth studies what percent of teeth were nonvital and what percent had radiographic signs of endodontic disease respectively?
Hale: 92% nonvital, 57% rad signs
Feinin: 88% nonvital, 57% rad signs
Changes associated with apical periodontitis are able to be visualized on histology and radiographs after how many days respectively?
Menzies, RA, Reiter, AM, & Lewis, JR. Assessment of apical periodontitis in dogs and humans: a review. J Vet Dent. 2014
Histo changes: 7 days
Radiographic changes: 15 days
In Menzies’ 2014 paper”Assessment of apical periodontitis in dogs and humans: a review,” what percent of obligate anaerobes are present in teeth with apical periodontitis with intact crowns vs those with pulp exposures?
JVD 2014
Intact crowns 90%
Pulp exposure 70%
True periapical cysts are thought to arise from proliferation of what structure?
Menzies, RA, Reiter, AM, & Lewis, JR. Assessment of apical periodontitis in dogs and humans: a review. J Vet Dent. 2014
Cell rests of Malassez
How can one distinguish clinically between condensing osteitis vs osteosclerosis?
Menzies, RA, Reiter, AM, & Lewis, JR. Assessment of apical periodontitis in dogs and humans: a review. J Vet Dent. 2014
Condensing osteitis present in teeth with endodontic pathology
Osteosclerosis for teeth wiht no evidence of endodontic disease or only superficial carious lesions
Differentiation of stem cells into primary cementoblasts requires cross-communication between what cells?
Menzies, RA, Reiter, AM, & Lewis, JR. Assessment of apical periodontitis in dogs and humans: a review. J Vet Dent. 2014
Hertwig’s epithelial root sheath and ectomesenchymal cells in the dental follicle
How soon can CBCT identify apical periodontitis in dogs compared to RAD?
Menzies, RA, Reiter, AM, & Lewis, JR. Assessment of apical periodontitis in dogs and humans: a review. J Vet Dent. 2014
CBCT as soon as 7 days
RAD 15 days
In Luotonen’s 2014 article “Vital pulp therapy in dogs: 190 cases (2001–2011),” what was the overall success rate?
JAVMA 2014
85%
In Luotonen’s 2014 article “Vital pulp therapy in dogs: 190 cases (2001–2011),” what two factors were statistically significantly associated with increased risk of failure?
AVMA 2014
Use of Calcium hydroxide failure rate > 5 fold that with MTA
Deep penetration of dressing material into pulp (2.4 times more frequent with Calcium hydroxide used)
In Neimic’s 2001 study, “Assessment of vital pulp therapy for nine complicated crown fractures and fifty-four crown reductions in dogs and cats,” what reason for treatment in dogs was associated with a 100% failure rate?
JVD 2001
CCFs
all treated > 7 days after fracture
In Neimic’s 2001 study, “Assessment of vital pulp therapy for nine complicated crown fractures and fifty-four crown reductions in dogs and cats,” what was the success rate for teeth treated with crown height reductions and vital pulp therapy?
100%
In Neimic’s 2001 study, “Assessment of vital pulp therapy for nine complicated crown fractures and fifty-four crown reductions in dogs and cats,” what was the success rate for cases that had > or < 2 years of follow up respectively for all teeth treated?
JVD 2001
> 2 years: 71%
< 2 years: 93%
In Clarke’s 2001 study “Vital pulp therapy for complicated crown fracture of permanent canine teeth in dogs: A three-year retrospective study,” at the 36 month radiographic follow up, what percent of teeth were vital for the treatments groups with pulp exposures < 48 hours, 2-7 days and 1-3 weeks respectively?
JVD 2001
< 48 hours: 88% vital
2-7 days: 41% vital
1-3 weeks: 23% vital
In Riehl’s 2016 article “Detection of Pulpal Blood Flow In Vivo with Pulse Oximetry in Dogs,” what were the mean vital tooth SpO2 levels and the mean tongue control SpO2 levels and were they significantly correlated?
Riehl, Hetzel, Snyder, Soukup. Frontiers. 2016.
Mean tooth SpO2: 86%
Mean tongue control SpO2: 98%
Not significantly correlated
Oxygen saturation measured from control 99% of time, measured from tooth 24% of time
In Srecnik’s 2019 article “Microbiological Aspects of Naturally Occurring Primary Endodontic Infections in Dogs,” what were the three most commonly identified bacteria genera isolated from root canals?
JVD 2019
Pasteurella, Bacteroides, Propionibacterium
In Srecnik’s 2019 article “Microbiological Aspects of Naturally Occurring Primary Endodontic Infections in Dogs,” how were the canals sampled?
JVD 2019
Teeth cleaned and disinfected with bleach for 90 seconds, flushed with sterile saline
Canals accessed through fracture site or additional access if UCF with high speed handpiece and sterile saline irrigation
Sterile H-file inserted into root canal to apex and manipulated with a few strokes to obtain sample
In Srecnik’s 2019 article “Microbiological Aspects of Naturally Occurring Primary Endodontic Infections in Dogs,” what were the relationships between number of bacterial spp and duration of fracture, and what associations were found between number of bacterial spp and rad or clinical signs of endodontic disease?
JVD 2019
Number of bacterial spp declined with duration of fractures over 12 months
No stat sig associations found between number of bacterial spp involved in root canal infection and any clinical or radiographic signs of endodontic disease
What is the definition of Young’s modulus/elastic modulus?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
inherent stiffness of an object
higher modulus = faster deformation with stress
What is superelasticity?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
resistance of permanent deformation
What is the austenite phase (A-phase) of NiTi alloy?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
The austenite phase (A-phase) is a hexagonal lattice that is strong and hard. As stress (shearing force) occurs there is a transformation from the austenite phase to the martensite phase (M-phase)
What is the martensite phase (M-phase) of NiTi alloy?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
The martensite phase is more elastic and has greater tensile strength than the austenite phase.
Once the stress is released, the M-phase transforms back to austenite due to martensite high memory trait
What is a phase of NiTi alloy associated with precipitates or dislocations in aging files?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
R-phase: rhombohedral distortion of cubic austenite phase
What property of NiTi alloy allows it to return to its normal shape on unloading before deformation or shape memory?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
Low modulus of elasticity
How many bending cycles can steel withstand vs NiTi alloy?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
Stainless steel 20 cycles
NiTi alloy 1000 cycyles
Smaller vs larger files are prone to fracturing due to what method of failure respectively?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
Smaller files: torsional failure
Larger files: cyclic fatigue
torsional failure: instrument tip is locked within canal while shaft continues to rotate
Cyclic failure/fatigue: instrument rotates in a curved canal leading to motion induced repeated compressive and tensile stress
What are the characteristics of first generation NiTi files?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
U-shaped tip
Radial lands
Fixed tapers
What are the advantages and disadvantages of first generation LightSpeed files (LS1)?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
Advantages: instrument tip and radial land help them avoid ledging and transportation
Disadvantages: concern for file separation
What are the differences between second generation and first generation NiTi files?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
Active cutting edges without radial lands –> higher cutting efficiency
Positive rake angles introduced –> higher cutting efficiency
Increased taper
Electropolishing
What is electropolishing?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
an electrochemical process that reduces the microscopic surface roughness by immersing the material in a highly ionic solution with an electric current.
What are the disadvantages of micropolishing NiTi files?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
Reported to dull cutting edge leading to an increased forward pressure when advancing file that can lead to taper lock
What advancements were made in third generation NiTi files?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
Improvements in metallurgy in the utilization of heating and cooling methods to reduce cyclic fatigue and improve incidence of broken files
M-wire technology: applying heat treatments at various temperatures to wire blanks –> includes martensite and R-phase for improved elastic status
What advancements were made with fourth generation NiTi files?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
Focus on reciprocation: back and forth up and down motion
What is the fourth generation self-adjusting file system (SAF)?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
Hollow, open tube design that exerts uniform pressure on surrounding dentinal walls
Handpiece produces vibrating movements and constant irrigation
Adaption to canal can minimize file separation and breakage
What are the characteristics of fifth generation NiTi file systems?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
Offset center of rotation
Produces mechanical wave of motion that travels along length of file
Offset design minimizes contact and engagement between file and dentinal walls
ProTaper Next
What is the recommended rpm for use of LightSpeed LS1 vs LSX files?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
LS1: 2000rpm
LSX: 2500rpm
What is the difference between LightSpeed LSX and LS1?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
LSX does not have half sizes so less files
LS1 requires coronal flaring
What overall advancements have been made in NiTi technology to reduce torsional failure and cyclic fatigue?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
Single file reciprocating systems
M-wire technology
The image below demonstrates what first generation NitTi file feature?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
Radial lands
The blue color of this file is indicative of what enhancement feature?
Guillory, Vall. Past, Present, and Future Trends of Nickel Titanium Rotary Instrumentation. JVD 2022
Titanium oxide enhancement
Improves cutting efficiency and wear resistance
What kind of NiTi file is this?
LightSpeed
What generation of NiTi file is this and what sort of motion does it use?
Fourth generation reciprocating file
What are the 3 Biological Bases of Regenerative Endodontic Procedures as described by Hargreaves et al?
Feigin, Shope. “Regenerative Endodontics,” JVD 2017, Issue 3
1.) Appropriate source of stem cell/progenitor cells
2.) Growth factors that are capable of promoting stem cell differentiation
3.) Appropriate scaffold for regulation of cell differentiation
What are the key growth factors in pulp and dentin formation?
Feigin, Shope. “Regenerative Endodontics,” JVD 2017, Issue 3
Morphogenic protein
Transforming growth factor beta (TGF-beta)
Fibroblastic growth factor
Found in platelets and dentin
What materials/structures are used to provide the physical scaffold of regenerative endodontics?
Feigin, Shope. “Regenerative Endodontics,” JVD 2017, Issue 3
Dentin and blood clot
PRP, PRF
What are the componets of triple antibiotic paste (TAP) used for regenerative endodontics?
Feigin, Shope. “Regenerative Endodontics,” JVD 2017, Issue 3
1 : 1 : 1 ciprofloxacin, metronidazole, minocycline
What reported factors affect the results of regenerative endodontic treatment?
Feigin, Shope. “Regenerative Endodontics,” JVD 2017, Issue 3
Effective disinfection of root canal and sealing of coronal access to prevent microleakage of contaminants
Diameter of open apex
Patient age
What is the smallest open apex diameter that has been found to result in successful regenerative procedures in human endodontics?
Feigin, Shope. “Regenerative Endodontics,” JVD 2017, Issue 3
0.5mm
Teeth with diameters of greater than what amount have demonstrated greater increase in root thickness, length and apical narrowing for human regenerative endodontics?
Feigin, Shope. “Regenerative Endodontics,” JVD 2017, Issue 3
> 1mm
In human patients regenerative endodontics should be performed on what age range?
Feigin, Shope. “Regenerative Endodontics,” JVD 2017, Issue 3
8 and 16 years
Is regenerative endodontics recommended for deciduous teeth?
Feigin, Shope. “Regenerative Endodontics,” JVD 2017, Issue 3
No –> possible trauma or discoloration of developing permanent tooth
Concentration of NaOCl greater than what percent can be cytotoxid to the periodontal ligament cells and stem cells of the apical papilla?
Feigin, Shope. “Regenerative Endodontics,” JVD 2017, Issue 3
> 3%
Concentrations of chlorhexidine above what percent have been found to induce serious cytotoxic effects on stem cells?
Feigin, Shope. “Regenerative Endodontics,” JVD 2017, Issue 3
> 2%
In a study by Stambolsky et al what treatment group showed the maximum percentage of roots with vital tissue, deposition of hard tissues on radicular dentin and apical closure?
Feigin, Shope. “Regenerative Endodontics,” JVD 2017, Issue 3
NaOCl/TAP/PRP
What treatment factors/choices can result in discoloration of the tooth crown after regenerative endodontics in humans?
Feigin, Shope. “Regenerative Endodontics,” JVD 2017, Issue 3
Presence of minocycline in TAP
Contact of MTA with blood clot
In their 2017 review article “Regenerative Endodontics,” the authors Feigin, Shope. conclude that dogs with what age range with a nonvital tooth and open apex could be suitable candidates for regenerative endodontics?
Feigin, Shope. “Regenerative Endodontics,” JVD 2017, Issue 3
5 months up to 2 years
Exposed pulp maintains vitality for up to how many days according to Cvek et al?
Shabahang. “Treatment Options: Apexogenesis and Apexification,” JOE 2013
7 days
What is the best method for determining working length in teeth with open apices - radiographs or electronic apex locators?
Shabahang. “Treatment Options: Apexogenesis and Apexification,” JOE 2013
Radiographs
Electronic apex locators not accurate in teeth with wide open apices
Exposing root dentin to calcium hydroxide for greater than what time frame results in structural changes in dentin and higher susceptibility to root fracture?
Shabahang. “Treatment Options: Apexogenesis and Apexification,” JOE 2013
1 month
What is MTAD composed of and what is its purpose in apexifiection and apexinogenesis?
Shabahang. “Treatment Options: Apexogenesis and Apexification,” JOE 2013
Mixture of doxycycline, citric acid and detergent
Effective final rinse prior to obturation to disinfect and remove smear layer
What are the disadvantages of calcium hydroxide as a direct pulp capping agent?
Tucker. “A Systematic Review Comparing Mineral Trioxide Aggregate to Other Commercially Available Direct Pulp Capping Agents in Dogs,” JVD 2021, Issue 1.
Irritation and necrosis of pulp directly beneath capping material
high solubility in oral fluids
dissolution over time
lack of inherent adhesive properties
presence of tunnel defects within calcific barrier → failure to produce hermetic seal to underlying pulp against microleakage
Has Biodentin (BMTA) been shown to form significantly thicker calcific barriers than ProRoot MTA and what is the mechanism of action?
Tucker. “A Systematic Review Comparing Mineral Trioxide Aggregate to Other Commercially Available Direct Pulp Capping Agents in Dogs,” JVD 2021, Issue 1.
Yes, but PMTA out performed other products (CaOH, dental adhesive resins, other bioceramics)
BMTA has greater release of calcium and hydroxyl ions during initial setting of material with reduced ion release over time → more favorable conditions for pulp repair
How does Endocem Zr (EMTA) compare to ProRoot MTA (PMTA) in respective to quantity and quality of calcific barrier formation?
Reduced quantity and quality of calcific barriers with greater inflammatory response compared to those treated with PMTA
In Tucker’s 2021 review article “A Systematic Review Comparing Mineral Trioxide Aggregate to Other Commercially Available Direct Pulp Capping Agents in Dogs,” PMTA outperformed what direct pulp capping agents?
Tucker. “A Systematic Review Comparing Mineral Trioxide Aggregate to Other Commercially Available Direct Pulp Capping Agents in Dogs,” JVD 2021, Issue 1.
Calcium hydroxide
TheraCal
DAR (dental adhesive resins)
PMTA performed as well or better than other MTA-like cements in terms of calcific barrier formation and biocomptability
According to Sasser’s 2020 review article “Endodontic Disinfection for Orthograde Root Canal Treatment in Veterinary Dentistry,” what organism is most frequently isolated following failed endodontic treatment?
JVD 2020, Issue 1
Enterococcus faecalis
What methods can be utilized to increase the effectiveness of sodium hypochlorite?
Sasser. “Endodontic Disinfection for Orthograde Root Canal Treatment in Veterinary Dentistry”
JVD 2020. Vol 37 (1)
Increase temp –> 140 degrees complete dissolution of pulp tissue
Increase contact time (5-10 minutes)
Utilization agitation/activation methods
NaOCl loses dissolving and antibacterial capacity in 2 min, therefore one should replenish
What are the major advantages of NaOCl as an endodontic irrigant?
Sasser. “Endodontic Disinfection for Orthograde Root Canal Treatment in Veterinary Dentistry”
JVD 2020. Vol 37 (1)
Dissolves necrotic pulp tissue and organic debris of smear layer
Removes exposed collagen fibrils –> decreases collagen exposed for adherence of E. faecalis
What concentration of bleach can weaken the tooth structure by affecting the collagen matrix?
Sasser. “Endodontic Disinfection for Orthograde Root Canal Treatment in Veterinary Dentistry”
JVD 2020. Vol 37 (1)
5.25%
What functions as an irrigant can chlorhexidine not do?
Sasser. “Endodontic Disinfection for Orthograde Root Canal Treatment in Veterinary Dentistry”
JVD 2020. Vol 37 (1)
Does NOT remove collagen fibrils
Does NOT dissolve organic debris
Cannot destroy biofilm
What is the argument for EDTA as the final rinse during root canal therapy?
Sasser. “Endodontic Disinfection for Orthograde Root Canal Treatment in Veterinary Dentistry”
JVD 2020. Vol 37 (1)
Improves bindng of resin base sealer to dentin
What is the main argument for using MTAD as the final rinse for root canal therapy?
Sasser. “Endodontic Disinfection for Orthograde Root Canal Treatment in Veterinary Dentistry”
JVD 2020. Vol 37 (1)
Does not change the flexural strength, modulus of elasticity of dentin unlike bleach
Not better than bleach at disinfecting
Calcium hydroxide has limited action againist what intracanal bacteria and components?
Sasser. “Endodontic Disinfection for Orthograde Root Canal Treatment in Veterinary Dentistry”
JVD 2020. Vol 37 (1)
Biofilms
E. faecalis
What is the wavelength of erbium-doped yttrium aluminum garnet (Er:YAG)
Sasser. “Endodontic Disinfection for Orthograde Root Canal Treatment in Veterinary Dentistry”
JVD 2020. Vol 37 (1)
2940nm
High affinity for hydroxyapatite
In Rodrigues’s 2019 study “Endodontic Microbiome of Fractured Non-vital Teeth in Dogs Determined by 16S rRNA Gene Sequencing,” what were the most abundant genera of bacteria for endodontic samples and healthy subgingival plaque respectively?
Frontiers 2019
The endodontic microbiome of 10 non-vital teeth with exposed pulp cavities was assessed using a 16S rRNA gene sequencing approach. The results were compared to the microbiome of the subgingival plaque of the same teeth.
Endodontic samples: Bacteriodetes most abundant, Snowella also sig more abundant
Subgingival plaque: Porphyromonas and Fusobacterium
In Cardoso’s 2018 article “Dental dam application for endodontics in dogs – a novel clamp kit,” what are the advantages of using a dental rubber dam for endodontics?
JVD 2018
Better control of cross-infection
Prevents soft tissue contact of chemicals
Improves treatment efficiency
In McCoy’s 2015 article “Managing endodontic instrument separation,” what are the two most common causes of instrument separation?
JVD 2015
Instrument fatigure from overuse
applying excessive apical pressure
What is the file-braiding technique for broken instrument removal from canals?
McCoy. “Managing endodontic instrument separation,” JVD 2015
Insertion of two hand instruments like barbed broaches, K or H-files within canal and using braiding technique to grasp object for removal
What direction should fluted instruments be turned during retrieval from canal to unscrew flutes engaged in dentin?
McCoy. “Managing endodontic instrument separation,” JVD 2015
Counterclockwise
NiTi files should be discarded after how many uses to prevent fracture?
McCoy. “Managing endodontic instrument separation,” JVD 2015
3-6 uses
In Hernandez’s 2010 study “Scanning Electron Microscopy of Pulp Cavity Dentin in Dogs,” what was the difference in dentinal tubule diameter, area and tubular density between Group 1 (dogs < 7yro) and Group 2 (dogs > 2 yro)?
JVD 2020
Group 1/younger animals dentinal tubule diameter sig greater than Group 2/older animals
No significant difference in tubular density
Group 1 = 1.87 um diameter and 1.91 um2 area
Group 2 = 1.53 um diameter and 1.22 um2 area
In Hernandez’s 2010 study “Scanning Electron Microscopy of Pulp Cavity Dentin in Dogs,” what was average tubular density and was it influenced by age or occlusal function?
Average tubular density: 72,000-75,000 tubules/mm^2
Not influence by age or occlusal function
What are the differences between Dens invaginatus Type I, II and IIIA and B?
Type I: the invagination is confined to within the crown of the tooth and does not extend beyond the level of the amelo-cemental junction.
Type II: the invagination extends into the pulp chamber but remains within the root canal with no communication with the periodontal ligament.
Type IIIA: the invagination extends through the root and communicates laterally with the periodontal ligament space through a pseudo-foramen.
Type IIIB: the invagination extends through the root and communicates with the periodontal ligament at the apical foramen
In Stein’s 2004 study “Comparison of hand-instrumented, heated gutta-percha and engine-driven, cold gutta-percha endodontic techniques,” which method required less time, provided better radiographic appearance and had no apical dye leakage?
JVD 2004. In vitro study using mandibular first molar
Rotary instruments and Simplifill/gutta-percha master cone
44% apical leakage in teeth treated with k-file instrumentation and SuccessFil
In Ulbricht’s 2002 study “Comparison of two heated gutta-percha obturation techniques of the mandibular first molar in the dog,” the ThermaFil Plus vs SuccessFil vertical compaction technique required less time and better radiographic fill and which technique had more apical dye leakage?
JVD 2002. In vitro study
ThermaFil Plus: less time, better radiographic endodontic fill but had significantly greater apical dye leakage
100% of roots obturated with ThermaFil Plus had apical dye leakage
Only 11% apical dye leakage with SuccessFil
In Mendoza’s 2000 study “Comparison of two heated gutta percha and sealer obturation techniques in canine teeth of dogs,” the warm vertical or heated lateral technique resulted in radiographically better endodontic fill and apical dye leakage respectively?
JVD 2000. In vitro study
Better radiographic endodontic fill: heated lateral method
More apical dye leakage: heated lateral method
Concluded that the vertical compaction technique may provide better apical seal with fewer complications
In Verez-Fraguela’s 2000 study “Effects of ultrasonic dental scaling on pulp vitality in dogs: an experimental study,” what output frequency of an uncooled ultrasonic scaler can cause acute pulpitis on teeth treated for what time frame?
JVD 2000
Output frequency 29 KHz on teeth treated for longer than 30 seconds
In Paula-Silva’s 2009 study “Outcome of root canal treatment in dogs determined by periapical radiographs and cone-beam computed tomography scans,” favorable outcomes were detected in what percent of roots when evaluated with dental radiographs vs CBCT respectively?
J of Endo 2009
dental rads: 79% favorable outcome
CBCT: 35% favorable outcome
unfavorable outcome was noted in 35% of roots using radiographs, but 65% when determined by CBCT
3 times more unfavourable outcomes detected by CBCT vs RAD
In Paula-Silva’s 2009 study “Outcome of root canal treatment in dogs determined by periapical radiographs and cone-beam computed tomography scans,” what was the association between 1 and 2 visit endodontic procedures on success rate as detected on dental radiographs vs CBCT?
J of Endo 2009
Unfavorable outcomes occurred stat sig more frequently after 1 visit vs 2 vist therapy when determined by CBCT
Dental rads showed no sig difference between 1 and 2 visit procedures
In Paula-Silva’s 2009 study “Outcome of root canal treatment in dogs determined by periapical radiographs and cone-beam computed tomography scans,” CBCT detected lesions how much sooner than RAD?
CBCT detected 33% PAL at 14 days compared to none in RAD group
In Wilson’s 1999 study “Timing of apical closure of the maxillary canine and mandibular first molar teeth of cats,” by what age had the apices of the mandibular first molar and maxillary canine teeth closed respectively?
JVD 1999
Mandibular first molar: 7 months
Maxillary canine: 11 months
In Kruse’s 2016 article, “Periapical bone healing after apicoectomy with and without retrograde root filling with MTA: a 6-year follow up of a randomized controlled trial,” at the 6 year follow up what were the success rates of the MTA root-end filling group (MTA group) vs smoothing of the orthograde gutta-percha after apicoectomy group (GP group)
J Endo 2016
MTA group: 86%
GP group: 55%
In Lee’s 2015 study “Comparative study of pulpal responses to pulpotomy with ProRoot MTA, RetroMTA and TheraCal in dogs’ teeth,” what pulp capping material had lower quality calcific barrier formation, extensive inflammation and less favorable odontoblastic layer formation?
TheraCal
Less favorable pulpal response than ProRoot MTA and RetroMTA
In Ahangari’s 2013 study “The effect of propolis (RESIN LIKE MATERIAL MADE FROM BEES) as a biological storage media on periodontal ligament cell survival in an avulsed tooth: an in vitro study,” which storage media performed best at the three hour time frame?
This study aims to compare propolis 50%, propolis 10%, Hank’s balanced salt solution (HBSS), milk and egg white on periodontal ligament (PDL) cell survival for different time points.
Propolis 10% sig better than egg white
Propolis 10% and 50% sig better than milk
In Rayyan’s 2022 article “Effect of Sodium Hypochlorite in Dental Unit Waterline on Aerosolized Bacteria Generated from Endodontic Procedures,” aerosols were disseminated at what maximum distance from the patient’s head?
J Endo 2022
3m
In Rayyan’s 2022 article “Effect of Sodium Hypochlorite in Dental Unit Waterline on Aerosolized Bacteria Generated from Endodontic Procedures,” what type of endodontic procedure generated the greatest bacteria load and what was the effect of adding 0.1% NaOCl to the waterlines?
J Endo 2022
VPT generated the max number
Adding 0.1% NaOCl to the lines sig reduced the bacterial load in all treatment groups
In Subbiya’s 2022 paper “Clinical Outcome of Nonsurgical Root Canal Treatment Using a Matched Single-Cone Obturation Technique with a Calcium Hydroxide-based Sealer: A Retrospective Analysis,” what positive and negative prognostic indicators were identified?
Positive prognostic indicators: increased age
Negative prognostic indicators: increase in number of roots, negative pulp sensibility status
In Subbiya’s 2022 paper “Clinical Outcome of Nonsurgical Root Canal Treatment Using a Matched Single-Cone Obturation Technique with a Calcium Hydroxide-based Sealer: A Retrospective Analysis,” what factors did not affect outcome significantly?
Initial periapical index scores
presence of preoperative sinus tract
number of visits
sealer extrusion
In Farhad’s 2022 study “Effect of Citric Acid Versus EDTA on Radiographic Root Development in Regenerative Endodontic Treatment: An Animal Study,” what were the effects of the two solutions on increase in root length and increase in root dentin thickness?
Endodont 2022
No sig difference between the 2 solutions on increase in root length
EDTA showed sig superior increase in root dentin thickness
Authors concluded that use of citric acid vs EDTA not superior on radiographic root development
In Ribeiro’s 2022 study “Impact of Sodium Hypochlorite on Organic Tissue Dissolution in the Periapical Region of Immature Permanent Teeth: An Ex Vivo Study,” which treatment group had the greatest tissue dissolution?
2.5% NaOCl with or without ultrasonic activation
In Ricucci’s 2021 article “Bacterial Invasion of Pulp Blood Vessels in Teeth with Symptomatic Irreversible Pulpitis,” intravascular bacteria were not found in what segments of the canal?
Endo 2021
No intravascular bacteria in the middle and apical segments of canal
Bacterial invasion and colonization of necrotic areas were observed in the pulp of all teeth with caries exposure and symptomatic irreversible pulpitis
In the 2011 study of periapical lesion volumes following RCT vs control, by how much volume was the periapical lucency improved for the treated root canal?
JVD 2012, issue 3. Ordinola-Zapata R, Bramante CM, Duarte MH, et al.The influence of cone-beam computed tomography and periapical radiographic evaluation on the assessment of periapical bone destruction in dog’s teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Aug;112(2):272-9.
50%
In Sanz’s 2021 study “Comparative Biological Properties and Mineralization Potential of 3 Endodontic Materials for Vital Pulp Therapy: Theracal PT, Theracal LC, and Biodentine on Human Dental Pulp Stem Cells,” which material exhibited a sig higher cytotoxicity and reactive oxygen species production?
J Endo 2021
Theracal LC
In the 2013 study investigating if combining an induced blood clot, platelet-rich plasma (PRP), and bone marrow aspirate (BMA) could regenerate pulp in a tooth with periapical inflammation, what was the outcome?
Gmes-Filho JE, Tobias Duarte PC, Ervolino E, et al. Histologic Characterization of Engineered Tissues in the Canal Space of Closed-apex Teeth with Apical Periodontitis. J Endod. 2013 Dec;39(12):1549-56. Epub 2013 Sep 29.
Produced cementum-like or bone-like material, but no pulp
In Ricucci’s 2022 study “Outcome of Direct Pulp Capping Using Calcium Hydroxide: A Long-term Retrospective Study,” what was the main variable that influenced outcome?
J Endo 2023
The quality of the coronal restoration
What are the roles of the following components of an endodontic file?
Flute
Leading edge
Land
Relief
Components of a file: Pathways ch 6
Flute - Collects the dentin
Leading edge - cuts dentin
Land - Prevents screwing in of file, Limits depth of cut, Strengthens file
Relief - inset section of land, Reduce frictional resistance
What is the rake angle, and what functions does it have?
Components of a file: Pathways ch 6
The angle formed by the leading edge and radius of file
Positive cuts
Negative scrapes
What is the helix angle?
Components of a file: Pathways ch 6
The angle the cutting-edge forms with the long axis of file
Defines type of file
The cutting angle is the angle formed by the leading edge of the file and a tangent to the radicular wall in the point of contact. What is the sum of the cutting angle and rake angle?
Components of a file: Pathways ch 6
90 degrees
