Endodontics

Question 1

what is a subjective examination

Answer 1

an examination that includes evaluation of symptoms or problems described by the patient
- chief complaint
- character and duration of pain
- painful stimuli
- sensitivity to biting and pressure

Question 2

what is an objective examination

Answer 2

an examination made by endodontist who evaluates the status of the tooth and surrounding tissues
- extent of decay
- periodontal conditions surrounding tooth
- presence of extensive resto
- tooth mobility
- swelling or discolouration
- pulp exposure

Question 3

what is a percussion test

Answer 3

dentist taps the incisal or occlusal surface of the tooth with end of mouth mirror handle and is held parallel to the long axis of tooth

Question 4

what is a palpation test

Answer 4

dentist applies firm pressure to the mucosa above the apex of the root to notice any sensitivity or swelling

Question 5

what is a control tooth and why is it used

Answer 5

a healthy tooth used to compare questionable teeth of similar size and structure during pulp vitality testing

Question 6

what type of radiograph is needed in endodontics

Answer 6

good quality radiographs

Question 7

what are the symptoms of pulpal nerve damage

Answer 7

1. pain when occluding
2. pain during mastication
3. sensitivity to hot or cold beverages
4. noticeable facial swelling
5. fever
6. tenderness of the surrounding gums
7. crack or discoloured teeth

Question 8

what is a chief complaint

Answer 8

description of symptoms, problems, conditions by patient

Question 9

what is reversible pulpitis

Answer 9

occurs when the pulp is irritated and the patient is experiencing pain to thermal stimuli
- eliminating irritant and placing sedative material may save the pulp

Question 10

what is irreversible pulpitis

Answer 10

displays symptoms of lingering pain
- root canal therapy and extraction is only treatment option

Question 11

what kind of bur would be used in the initial entry of a tooth for a root canal procedure

Answer 11

round bur or inverted cone

Question 12

what are k-type files used for

Answer 12

for initial entry and cleaning of the canal

Question 13

what is a Hedstrom file used for

Answer 13

used for final enlargement of canal and provides greater cutting efficiency

Question 14

what is a Reamer filed used for

Answer 14

removes dentin structures and smooths and increases size of canal

Question 15

what is a broach and when is it used

Answer 15

a thin, flexible, tapered metal hand instrument with projections
- removes vital, inflamed hemorrhagic pulp tissue from the canal

Question 16

what is biochemical cleaning

Answer 16

an irrigation solution that acts as a disinfectant to destroy bacteria in the canal and to wash away debris

Question 17

what is electric pulp testin and how does it work

Answer 17

a test used in endo diagnosis to determine whether a pulp is vital or nonvital
- delivers small electrical stimulus to pulp

Question 18

how is a heat test performed

Answer 18

small pea-sized piece of gutta percha is heated or end of an instrument, and placed on facial surface of teeth

Question 19

what is a direct pulp cap

Answer 19

a procedure that is indicated when the pulp has been partially exposed
- calcium hydroxide is placed

Question 20

what is an indirect pulp cap

Answer 20

a temporary procedure where most of the carious dentin in deep cavity is not removed
- liner or temp resto is placed and cavity is reopened after a period of time and remaining carious dentin is removed

Question 21

describe the procedural steps in electric pulp vitality testing

Answer 21

1. describe procedure to pt, and explain they may feel tingling or warmth
2. identify teeth to be tested, isolated and dried
3. set the dial at zero
4. place thin layer of toothpaste on tip of tester
5. test control tooth first and place tip on cervical third of facial surface
6. gradually increase level of current until it is felt, and document level
7. repeat procedure on suspect tooth
8. document

Question 22

what is a gates glidden bur used for

Answer 22

to enlarge the walls of the pulp chamber

Question 23

what is a pesso file

Answer 23

used when tooth requires a post prep

Question 24

how would you know the difference between the pesso file and gates glidden bur

Answer 24

the pesso file is used to elongate the canal opening, the gates glidden bur is used to enlarge the walls
- gates glidden bur is smaller

Question 25

what does a rubber stop prevent

Answer 25

prevents perforation (going past apex)

Question 26

what are paper points and how are they used

Answer 26

paper points are sterile absorbent pieces of paper rolled into narrow poinrs - held with locking pliers and inserted into canal to absorb irrigation solution

Question 27

can air be blown into the canal? why?

Answer 27

no, because it will put bacteria and debris into the blood stream and tooth

Question 28

what is the chemical commonly known as household bleach

Answer 28

sodium hypochlorite

Question 29

what is parachlorophenol used for

Answer 29

it is an antibacterial agent used to prevent infections in root canals

Question 30

what is the name of the solution used as an intracanal medicament for pulpotomies on primary teeth

Answer 30

calcium hydroxide

Question 31

what is a fistula

Answer 31

canal

Question 32

what does obturation refer to

Answer 32

the process of filling a root canal

Question 33

what is debridement

Answer 33

to remove or clean out the pulpal canal

Question 34

for anterior tooth, access to the canal for an endo procedure would be through which surface

Answer 34

lingual surface

Question 35

for posterior tooth, access to the canal for an endo procedure would be through which surface

Answer 35

occlusal surface

Question 36

what is a trial point cone

Answer 36

an appropriately sized gutta-percha point that is cut to a predetermined length used to obturate the pulpal canal

Question 37

what is a master cone

Answer 37

trial point that is now being used for permanent placement

Question 38

what is the lentulo spiral instrument used for

Answer 38

used to properly distribute root canal sealer and cement evenly throughout the root canal

Question 39

what is gutta percha and what is it used for

Answer 39

material taken from a palaquium gutta tree that is used to obturate the pulpal canal

Question 40

what is the estimated working length and reference point

Answer 40

estimated working length - knowing the length of the completed canal prep and root canal filling reference point - measuring from the highest point on the incisal or occlusal surface to determine length of canal

Question 41

what is a glick number 1 used for

Answer 41

used for placement of temporary restorations and removal of excess gutta percha

Question 42

what does the endodontic spoon excavator do

Answer 42

removes coronal pulp tissue

Question 43

what are pluggers

Answer 43

has a flat tip, used to condense

Question 44

what is a lentulo spiral

Answer 44

spins root canal sealer in canal

Question 45

what is an endodontic explorer

Answer 45

used in locating the canals

Question 46

what is a spreader and what does it do

Answer 46

has a pointed tip and is used to apply lateral pressure during condensation

Question 47

what is a pesso file used for

Answer 47

used in preparation for a post

Question 47

what is a barbed broach and what does it do

Answer 47

has fish like hook projections that removes vital, hemorrhagic pulp tissue from the canal

Question 48

what do the gates-glidden burs do

Answer 48

used to enlarge the walls of the pulp chamber

Question 49

what does the electronic apex locator do

Answer 49

used to prevent perforation of the apex

Question 50

what is a retrograde restoration

Answer 50

done when the apical seal is not adequate - a small filling prep is made at the apex and is sealed with filling materials

Question 51

what is an apicoectomy

Answer 51

surgical removal of the apical portion of root

Question 52

what must be done to the master cone tip before it is placed permanently into the canal

Answer 52

must be coated with a sealerw

Question 53

what is the difference between hemisection and a root amputation

Answer 53

hemisection - procedure where the root and crown and are cut lengthwise (usually for mand) root amputation - used to remove on or more roots without removing the crown

Question 54

what are the 5 types of radiographs used for endodontic treatment

Answer 54

initial radiograph - taken during diagnostic stages before treatment working length time - taken once the pulp has been opened and is used to determine the length og the canal final instrumentation image - taken with the final size files in all canals receiving treatment root canal completion image - taken of the completed canal filled after the toth has been temporized and the dental dam removed recall image - radiographic image is taken at post-treatment evaluations

Question 55

what is pulpitis

Answer 55

indicates that pulpal tissue have become inflamed

Question 56

what is a periradicular abscess

Answer 56

an inflammatory reaction to pulpal infection

Question 57

acute periradicular abscess

Answer 57

an inflammatory response with pain, tenderness of the tooth to pressure, pus and swelling of the tissue from necrosis

Question 58

periodontal abscess

Answer 58

an inflammatory reaction that is frequently cause by bacteria entrapped in the perio sulcus

Question 59

periradicular cyst

Answer 59

develops at or near the root of a necrotic tooth, an inflammatry response to pulpal infection and necrosis of the pulp

Question 60

pulp fibrosis

Answer 60

decrease of living cells within the pulp, causing fibrous tissue to take over the pulpal canal

Question 61

necrosis

Answer 61

used to describe a tooth that does not respond to a sensory stimulus

Question 62

perforation

Answer 62

making a hole beyond the apex of tooth

Question 63

what are the 4 typs of irrigation solutions that can be used

Answer 63

sodium hypochlorite - antimicrobial and solvent on necrotic pulp edta - removal of inorganic portion of smear layer and dentin debris chlorhexidine - antibacterial with lower cytotoxicity and no foul smell or taste hydrogen peroxide - colourless liquid with disinfectant and bleaching properties