ENDODONTICS

Question 1

a. Provisional diagnosis, would paracetamol relieve the pain (2M)

Answer 1

May reduce pain but not as effective as NSAIDs because paracetamol only has analgesic and antipyretic effect but it doesn’t have any anti-inflammatory effect so pulp inflammation cannot be contained.

Question 2

b. Vertucci Canal configurations of 15 (2M)

Answer 2

Question 3

c. Risk associated with root canal treatment of 15 (3M)

Answer 3

 Possibility of furcal perforation because some second premolars may also have two roots

 Removing too much dentine in the crown area may cause buccal or lingual perforation

 Calcification may prevent access to the orifice hence may destroy the floor in the process

Anson: Big table included page 56

Question 4

d. What is smear layer? How to remove it? (3M)

Answer 4

Smear layer

1. Comprising both organic and inorganic components which is largely composed of particulate dentine debris created by endodontic instruments during root canal preparation; it also contains pulpal remnants and microorganisms.

How to remove?

• The key method of smear layer removal involves 17% EDTA as a chelating agent together with sodium hypochlorite to dissolve the organic component.

Question 5

A middle aged man requesting treatment for his upper front teeth, with history of allergy to antibiotics Periapical radiograph: apical radiolucency at 11
Intra-oral photographs:

• 11MB fractured (Class IV), restored with pin retained composite resin, white spot lesion and caries on

11B

• 21B Class V composite discolored, with stained margin
  a. What are the factors affecting the success rate of root canal treatment? (5)

Answer 5