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BDS3 Past Papers > Endodontics > Flashcards

Endodontics Flashcards

1
Q

what to assess in tooth before endo

A

TTP
swelling
increased mobility
buccal sulcus
amount of tooth structure left
restorability

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2
Q

clinical investigations other than radiography to assist in diagnosis

A

sensibility tests;
- EPT = current used to stimulate sensory nerves at pulp-dentine junction

  • thermal cold test = endofrost on cotton wool
  • TTP = end of mirror tapped on occlusal surface of tooth
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3
Q

sensitivity to hot and cold indicates what

A

reversible pulpitis

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4
Q

painful to pressure when eating indicates what

A

apical periodontitis

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5
Q

name the design principles outlined by Herbert Schilder

A

create a continuously tapering funnel shape

maintain apical foramen in original position

keep apical opening as small as possible

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6
Q

objectives of irrigant use in RCT

A

disinfection of root canal space
removal of smear layer
enhancement of biofilm disruption
dissolve pulp remnants
flushing out debris

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7
Q

what is the ideal primary endodontic irrigant
and what concentration range is it most effective

A

NaOCl sodium hypochlorite
3-5% [3]

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8
Q

name factors important for the function of NaOCl primary endodontic irrigant

A

concentration
volume
contact
mechanical agitation
exchange
antimicrobial efficcy
biocompatability

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9
Q

reasons for carrying out obturation of the prepared root canal

A

prevent microorganisms and fluid along RC
block apical foramina, dentinal tubules and accessory canals
prevent reinfection
fluid tight seal apically

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10
Q

briefly describe the steps involved in obturating the RC in an upper central incisor

A
  • ensure debris washed away
  • dry RC with paper points
  • use master cone matches size/shape of prepared canal
  • lightly butter in sealer
  • use spreaders to place into canal, laterally compacting to walls and ensuring straight and not bent
  • if needed, add accessory points
  • heated instrument to burn off excess GP
  • obturation verification
  • final restoration
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11
Q

number of canals found in upper first molar

A

3
can be 4 [MB2]

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12
Q

during instrumentation of canal, where is considered the ideal end point of shaping/obturation

A

apical third of the root
2mm away from the apex

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13
Q

what is the term for maintaining communication between the pulpal space and periradicular tissues

A

apical foramen

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14
Q

what is working length in endodontics

A

distance from reference point on tooth surface to the point at which RC preparation should end

at least 2mm away from apex

ensure no overpreparation/instrumentation which can lead to perforation and damage to apical tissues

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15
Q

two common intra-operative radiographs which can be utilised during endodontic tx to aid working length determination

A

working length PA, endofile inserted

initial radiograph PA

master cone PA

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16
Q

potential causes of a corrected working length changing during the course of endodontic shaping

A

over instrumentation
underpeparation
curvature of canals
apical transportation
file deviation
instrument fracture
debris obstruction

17
Q

what pat of the root canal filling is the most important in ensuring long term success

A

coronal seal

ensuring success and preventing infection

18
Q

why is non setting NaOH an ideal inter-appt medicament

A

antimicrobial
12.5 alkali pH kills bacteria
tissue dissolution
reduces inflammatory response/calming
biocompatible

19
Q

components of GP

A

*20% Gutta-percha
* 65% Zinc Oxide
* 10% Radiopacifiers
* 5% Plasticizers

20
Q

reasons for using a sealer when using cold lateral compaction

A

seals space between dentinal wall and core
seals dentinal tubules
adhesion
prevents microleakage
fills voids and irregularities
lubricates during obturation

21
Q

name problems with NaOCl

A

unable to remove smear layer along [need EDTA 17%] and mechanical aggitation
tissue irritaiton - oral mucosa/periapical tissues

dissolves collagen fibres in dentine
effect on organic material, dissolution of mineral components so becomes weaker

22
Q

4 irritant complications [NaOCl]

A

apical extrusion leading to tissue necrosis
allergic reactions
ophthalmic injuries
fabric discolouration

23
Q

A 60-year-old patient presents complaining of generalised bleeding gums. There are CPITN scores of 4 in each sextant, with 78% sites showing bleeding on probing. A panoramic radiograph shows generalised horizontal bone loss, with 50% alveolar bone loss at the worst sites. The medical history is clear and the dentition is only lightly restored.

  1. what diagnosis
  2. what stage and grade
  3. what factor to determine from social history
A

generalised periodontitis

Stage III Grade B

smoking

24
Q
  1. A 35-year-old patient presents complaining of mobility of tooth 34, which he feels is becoming worse. On examination, tooth 34 demonstrates Grade II mobility. There is no attachment loss but there is evidence of moderate toothwear affecting a number of teeth, likely attributable to attrition. Radiographic examination reveals generalised widening of the periodontal ligament space of tooth 34 and the tooth responds positively to sensibility testing
  2. What is the most likely diagnosis
  3. how would you manage this pt
A

occlusal trauma

correction of occlusal relations
occlusal adjustment
restorations
orthodontics
control of plaque induced inflammaiton
orthodontics
splint

25
Q

A patient presents with a 7 mm pocket that is discharging pus, on the mid-buccal aspect of tooth 26. The tooth is non-vital and there is very little pathological periodontal pocketing elsewhere in the patient’s mouth.

  1. what is the diagnosis
  2. give two anatomical factors that may be responsible for the location of the discharging pocket
  3. what tx would you perform
A
  1. periodontal abscess
  2. root morphology
    proximity to sinus
    root canal anatomy
    proximity to apical foramen
  3. excision and drainage of abscess
    RCT on tooth
    PMPR
    antibiotics if systemic
26
Q

A patient presents complaining of a constant throbbing pain from the right side of her mandible. This has kept her awake at night. On examination, you establish that tooth 46 is grossly carious and is tender to percussion.

  1. diagnosis
  2. further investigations
  3. best tx options for relief of pain
A

periapical periodontitis

PA radiographs, sensibility testing

analgesics
RCT, XLA

BDS3 Past Papers (13 decks)

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