Endodontics.

Question 1

Definition of Endodontics.

Answer 1

This is a branch of dentistry that deals with the cause, diagnosis, treatment and prevention of infection to the pulp and its sequelae.

Question 2

Reasons for endodontic tx?

Answer 2

Gross caries, pain, swelling, ulceration, tenderness to hot/cold, an abscess.

Question 3

Consultation for endodontic tx?

Answer 3

History of complaint, checking medical history, examination (ttp, cold test, etp), radiograph, diagnosis, tx plan.

Question 4

Endodontic stages.

Answer 4

Isolation, Access, Extirpation, Debridebment, Disinfection, Obturation.

Question 5

Isolation-

Answer 5

Isolating the tooth which is going to be treated. This is done for protection of the airways, moisture control, and visibility for the operator.

Question 6

Access.

Answer 6

Accessing the root canal by removing the decay and reaching the necrotic pulp.

Question 7

Extirpation.

Answer 7

Physically removing the necrotic pulp from the canal. This is done with k-files and barbed broaches.

Question 8

Debridement.

Answer 8

This stage is the mechanical removal of the infection in the canal. This can be done using rotary systems or hand files.

Question 9

Disinfection.

Answer 9

This is the chemical removal of infection from the canal. using irrigants such as Sodium Hypochlorite and EDTA.

Question 10

Obturation.

Answer 10

At this stage the canal is dried and filled with gutta-percha.

Question 11

Hand Files- Pro/Cons.

Answer 11

Pro- watch winding rotation, flexible, tactile.

Con- single use, easily fractured, increased hand fatigue.

Question 12

Rotary system- Pro/Cons.

Answer 12

Pro- more time efficient, less hand and wrist fatigue, once autoclaved can be re-used.
Cons- expensive, need experience before use, no increase in success of treatment.

Question 13

Use of Sodium Hypochlorite.

Answer 13

It is a good irrigant due to its microbacterial properties and it has disolving capabilities.

Question 14

Use of EDTA.

Answer 14

Chemically softens the root canal and the smear layer.

Question 15

How can the crown be restored after RCT?

Answer 15

Amalgam, Composite, GI, Inlay, Onlay, Crown.

Question 16

What is the tx plan if RCT fails?

Answer 16

Re-do RCT, apicectomy, extraction.

Question 17

Post-op instructions.

Answer 17

Avoid hard food for a couple of days, use painkillers if pain persists, apply ice pack to reduce pain and swelling, the area will be senstitive for a couple of days, a follow up appointment will be made for 3 months time.

Question 18

Apicectomy

Answer 18

A surgical procedure to remove infected area in the apex, to fill the apical end of the root and the prevent re-infection.

Question 19

Set up for apicectomy

Answer 19

Surgical tray, surgical pack, surgical handpiece and bur, sutures

Question 20

what are the steps to an apicectomy procedure

Answer 20

• LA
• Raise the flap
• Remove the apex and clean with saline
• Dry the area with gauze
• Fill with mineral trioxide aggregate (MTA) = helps reduce bacterial migration
• Suture
• Instructions given

Question 21

Post operative instructions

Answer 21

• Take painkillers that you normally use for headaches
• Use an ice pack to reduce face swelling
• Luke warm and salty water rinse a day after the surgery
• Brush the rest of the teeth normally and avoid brushing the surgical area.
• Soft diet
• Return a week after for suture removal
• 6 month follow up