Endodontics. Flashcards
Definition of Endodontics.
This is a branch of dentistry that deals with the cause, diagnosis, treatment and prevention of infection to the pulp and its sequelae.
Reasons for endodontic tx?
Gross caries, pain, swelling, ulceration, tenderness to hot/cold, an abscess.
Consultation for endodontic tx?
History of complaint, checking medical history, examination (ttp, cold test, etp), radiograph, diagnosis, tx plan.
Endodontic stages.
Isolation, Access, Extirpation, Debridebment, Disinfection, Obturation.
Isolation-
Isolating the tooth which is going to be treated. This is done for protection of the airways, moisture control, and visibility for the operator.
Access.
Accessing the root canal by removing the decay and reaching the necrotic pulp.
Extirpation.
Physically removing the necrotic pulp from the canal. This is done with k-files and barbed broaches.
Debridement.
This stage is the mechanical removal of the infection in the canal. This can be done using rotary systems or hand files.
Disinfection.
This is the chemical removal of infection from the canal. using irrigants such as Sodium Hypochlorite and EDTA.
Obturation.
At this stage the canal is dried and filled with gutta-percha.
Hand Files- Pro/Cons.
Pro- watch winding rotation, flexible, tactile.
Con- single use, easily fractured, increased hand fatigue.
Rotary system- Pro/Cons.
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.
Use of Sodium Hypochlorite.
It is a good irrigant due to its microbacterial properties and it has disolving capabilities.
Use of EDTA.
Chemically softens the root canal and the smear layer.
How can the crown be restored after RCT?
Amalgam, Composite, GI, Inlay, Onlay, Crown.
What is the tx plan if RCT fails?
Re-do RCT, apicectomy, extraction.
Post-op instructions.
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.
Apicectomy
A surgical procedure to remove infected area in the apex, to fill the apical end of the root and the prevent re-infection.
Set up for apicectomy
Surgical tray, surgical pack, surgical handpiece and bur, sutures
what are the steps to an apicectomy procedure
- 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
Post operative instructions
- 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
