Endodontics /(docmicks) Flashcards

1
Q

Dental pulp is made up of

A

Loose connective tissue

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2
Q

‼️📌BE

Surveillance cell of the pulp

A

Histiocytes

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3
Q

Cells of the Pulp

A
  1. Fibroblast
  2. Odontoblast
  3. Odontoclast
  4. Histiocytes / Wandering cells
  5. Undifferentiated mesenchymal cells/ Progenitor cell
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4
Q

most numerous, secretes collagen fibers

A

Fibroblasts

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5
Q

produces dentin, found the periphery of the pulp

A

Odontoblast

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6
Q

cell resorbing dentin

A

Odontoclast

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7
Q

macrophages

A

Histiocytes or wandering cells

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8
Q

reservoir of stem cells

A

Undifferentiated mesenchymal cell

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9
Q

Pulp becomes more fibrous when aging

A

True

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10
Q

Internal root resorption

Deciduous

A

Observe, asymptomatic
Painful extraction
Pulpal therapy

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11
Q

Internal root resorption

Permanent

A

Exo

RCT

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12
Q

When do we declare definitive diagnosis

A

After access preparation

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13
Q

test to determine if the tooth is vital or non vital

A

Vitality test

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14
Q

to determine the pulp is responsive or non responsive
NOT ACCURATE in determining PULPAL VITALITY
Commonly used secondary test
Commonly to produce FALSE - NEGATIVE & FALSE POSITIVE results

A

Electric Pulp Test

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15
Q

to differentiate reversible & irreversible pulpitis

Most common test

A

Thermal Test

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16
Q

Cold test

A

air blasts
ice
difluorochloromethane / Endo ice
Ethyl chloride or CO2 stick

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17
Q

gutta percha or hot water

A

Heat test

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18
Q

used when other tests are inconclusive
Sensitive: Vital
Non sensitive- non vital
Last resort

A

Test Cavity

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19
Q

Most accurate test to determine the pulpal vitality

A

Laser Doppler Test

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20
Q

for diffuse or vague pain

A

Anesthetic test

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21
Q

to determine necrotic pulp or fractured teeth using fiberoptic light source

A

Transillumination

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22
Q

Symptomatic (provoked pain - lasts for <2seconds after removal of the stimulus
Has exposed dentin no pulp exposure
+ vitality test

A

Reversible Pulpitis / Hyperemia

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23
Q

Symptomatic (spontaneous pain)
Pan id accentuated by stimulus or lying down
paindful stimulus results to lingerimg pain that pasts for more than 30sec
Has large tooth defect or carious lesion (possibly with pulpal exposure)
+ vitality test

A

Symptomatic Irreversible Pulpitis

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24
Q

Asymptomatic
Large tooth defect or carious lesion (possibly with pulpal exposure)
+ vitality test
Most difficult to diagnose

A

Asymptomatic Irreversible Pulpitis

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25
Q

Asymptomatic
(-) vitality test
has large tooth defect or carious lesion

A

Pulp necrosis

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26
Q

Rx. No changes (intact lamina dura)

(-) percussion / palpation

A

Normal Apical Tissues

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27
Q

Rx. With or without widening of periodental space

(+) PP

A

SAP/ Acute Apical Periodontitis

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28
Q

RX. Widening of Periodontal Space

(-) PP

A

Chronic Apical Periordontitis / Asymptomatic Apical Periodontitis

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29
Q
Rx. With or without widening of Periodontal space
spontaneous pain
evidence pf pus
Malaise fever 
Lymphadenopathy/ Lymphadenitis
(+) percussion
A

Acute Apical Abscess

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30
Q
Widening of periodontal space
If + to percussiom patient has little discomfort
Evidence of pus
chronic fistula
(+) / (-)
A

Chronic Apical Abscess

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31
Q

Increase radioapacity of adjacent bone tissues
(+) (-)
due to low grade infection
good immunity

A

Condensing Osteitis

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32
Q

1st

2nd

A

Endo

Perio

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33
Q

‼️‼️REMEMBER‼️

How can you differentiate Acute Apical Abscess from Lateral Periodontal Abscess

A

Vitality Testing

Probing

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34
Q

Chronic Focal Sclerosing Osteomyelitis

A

Condensing Osteitis

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35
Q

Inflammatiom of the periosteum adjacent to the area of an infected tootj with periapical lesion is called

A

Proliferative Periostitis / Garre’s Osteitis

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36
Q

Exophytic overgrowth of pulpal tissue with a present epithelial surface

A

Pulp Polyp ( Chronic Hyperplastic Pulpitis)

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37
Q

Starts apically & progresses coronal
associate with endodonticallt tx tooth
J-shape or teardrop rdl area
Cause : Iatrogenic

A

Vertical Root Fracture

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38
Q

Tx for monorooted

A

Extraction

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39
Q

Multirooted

A

Root Amputation

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40
Q

If extend coronally

A

Hemisection

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41
Q

‼️📌

splitting of mand. molar & removal of affected root

A

Hemisection

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42
Q

removal portion of a root without involving the crown

A

Root Amputation

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43
Q

Types of Horizontal Fracture

A
  1. Coronal root fracture
  2. Middle root fracture
  3. Apical root fracture
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44
Q

Tx. stabilize & observe
Poor prognosis
If there is pulp necrosis - RCT
Optional: removal of coronal portion - if there is continuation of fracture

A

Coronal root fracture

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45
Q

Tx. Usually stabilization & observe
Pulpal necrosis- RCT
Optional: Apicoectomy

A

Middle Root Fracture

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46
Q

best prognosis
Tx. Usually observe
Pulp is usually vital & fracture line heals
If there is pulpal necrosis - RCT
Optional: Apicoectomy- there is continuation of fracture

A

Apical Root Fracture

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47
Q

Ideally leave the MTA

A

6mos. / 1-2mos.

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48
Q

preserve pulp vitality under deep lesion

A

Indirect pulp capping

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49
Q

To preseve pulpal vitality after pinpoint mechanical exposure of asymptomatic pulp in a clean dry field

A

Direct Pulp capping

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50
Q

Procedure pulp capping

A

CaOH2/ MTA - Base- Final Restoration

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51
Q

removal of coronal pulp , presevation of radicular pulp

A

Pulpotomy / Partial Pulpectomy

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52
Q

Indications of Pulpotomy

A
  1. Vital tooth with PROVOKED PAIN
  2. 1.8mm of dentin thickness between PULP & CARIOUS LESION
  3. Root Length is NOT <2/3 of total length (for deciduous)
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53
Q

Type of Medicament Used : Partial Pulpotomy
Indication for Deciduous
Contraindicated in young permanent tooth
* Gold standard for Deciduous pulpotomy

A

Formocresol

54
Q

Partial Pulpotomy
Indicated for Permanent tooth
Contraindicated : Deciduous- why?

A

CaOH

Lead to internal root resorption/ Pink tooth of Mummery

55
Q

*‼️📌 what do you call partial pulpotomy

A

Cvek Pulpotomy

56
Q

removal of entire pulp

A

Pulpectomy

57
Q

Indications Pulpectomy

Deciduous only

A
  • Infected pulp with Spontaneous pain/ Nocturnal pain
  • Non-vital pulp with Periradicular lesion
  • Root length is NOT <2/3 of total length (for deciduous)
58
Q

Obturation material for pulpectomy of deciduous?

A

ZOE , CaOH - Vitapex

59
Q

RCT

,

A
  1. access prep
  2. Biomechanical preparatipm
  3. Obturation
60
Q

Incisors

A

Ovoid/ Triangular

61
Q

Canines & PM

A

Ovoid

62
Q

Maxillary Molars

A

Triangular / Rhomboidal

63
Q

Mandibular Molars

A

Trapezoidal

64
Q
All incisors 
All PM (except Max. 1st PM)
A

1

65
Q

Max. 1st PM

A

2

66
Q

Max. 2nd molar

Mand. 1st & 2nd molar

A

3

67
Q

Max. 1st Molar

A

4 orifice

68
Q

Most common ant. tooth associated with 2 orifices

A

Mand.Lateral Incisors

69
Q

The Canal orifice that is most difficult to locate?

A

MB2 Of Max. 1st Molar

70
Q

Posterior tooth with highest endodontic failure rate?

A

Max. 1st Molar

71
Q

MB2 of Maxillary 1st molar is usually located

A

Palatal in relation MB1

72
Q

what is the goal of access prep

A

Straigjt Line Access

73
Q

Types of Apex

A
  1. Anatomical Apex
  2. Apical Foramen
  3. Apical Constriction
74
Q

most apical end of root

A

Anatomical apex

75
Q

0.5mm from anatomical apex

A

Apical Foramen

76
Q

0.5mm from the apical foramen in the region of DCH

Natural stop during RCT

A

Apical Constriction

77
Q

‼️📌BE

If you want to expose lingual orifice of 2nd Mand. Lateral Incisor you must reduce

A

Lingual side

78
Q

📌‼️BE

DB orifice approach it must be opposite

A

ML
DB-ML
MB-DL

79
Q

Proper approach orifice

A

Avoid inserting multiple files

80
Q

Ideally, the apical point where canal preparation is to end, is loacted in

A

Apical Constriction- 0.5mm - 1.0mm

81
Q

detach pulp

A

Smooth Broaches

82
Q

remove pulp

A

Barbed broach

83
Q

push & pull motion in clockwise-counterclockwise motion

A

Files

84
Q

for shaving dentin
removal of old fillng
half turn twist (clockwise) & pull

A

Reamers

85
Q

cuts only during pulling

A

Hedstrom

86
Q

6

A

Pink

87
Q

8

A

Gray

88
Q

10

A

Purple

89
Q

15-45-90

A

White

90
Q

20-50-100

A

Yellow

91
Q

25/55/110

A

Red

92
Q

30/60/120

A

Blue

93
Q

35/70/130

A

Green

94
Q

40/80/140

A

Black

95
Q

12

A

Orange

96
Q

irrigating solution

bactericidal, dissolves pulpal contents, softens dentin

A
Sodium Hypochlorite (0.5% - 5.25%
ideal 5.25%
97
Q

Irrigating solution

A
Hydrogen Peroxide (3%)- Bleaching agent
NSS (0.9% NaCl)
98
Q

Chelating Agent. Remove smear layer

A

EDTA

99
Q

Irrigating solution, Bactericidal

A

Chlorhexidine (0.12%)

100
Q

Disinfection of root canal (medicament)

A
Ca (OH) 2
Camphor monochlorophenol (CMCP)
101
Q

‼️📌BE
Root perforation
best prognosis
difficult to repair

A

Apex

102
Q

Poorest prognosis in root perforation

easy to repair

A

CEJ

103
Q

CaOH

A

3-14 days

7 days

104
Q

filling the canal in all dimensions

A

Obturation

105
Q

NaOCI by product

A

Para- chloroaniline- brownish pigment clog the root canal cavity

106
Q

Main materials used for Obturation

A

Gutta percha- common

107
Q

Principal component of Gutta Percha

A

Zinc Oxide

108
Q

conventional

- not good filing properties

A

Silver Cones

109
Q

to fill discrepancies , act as a lubricant to fill accessory canals

A

Sealers

110
Q

main component sealers

A

Zinc Oxide

111
Q

Most common sealer

A

ZOE

112
Q

Solution used to soften gutta percha during tx

A

Chloroform, xylene (xylol), eucalyptol

113
Q

Most predominant bacteria in an infected root canal cavity

A

Streptococcus & Enterococcus

114
Q

After obturation the microorganisms at the periapex are eliminated by

A

Natural defenses of the body

115
Q

Recall the px afte root canal tx should be

A

6mos.

116
Q

‼️📌BE

Open Apex- Funnel Wide Shaped

A

Blunderbuss Apex

117
Q

chemically induced apical closure

Non vital young permanent with open apex

A

Apexification

118
Q

Procedure of Apexification

A

Canal filled with CaOhH or MTA (gold standard)

After apical closure or formation of calcific barrier or apical stop , proceed to RCT

119
Q

physiologic development of apex after successful vital pulp therapy (preservation of the pulp)

A

Apexogenesis- DPC, IPC, Pulpotomy

120
Q

for discolored teeth after RCT

A

Endodontic Bleaching

121
Q

localized, fluctuant intraoral swelling due to abscess

A

I& D

122
Q

Periapical Microsurgery

Procedure

A
  1. Flap
  2. Trephination
  3. Apicoectomy
  4. Retrograde filling
123
Q

semilunar flap/ triangular flap/ trapezoidal flap

A

Flap- Periapical Microsurgery

124
Q

drilling a hole in a bone )surgical window)

A

Trephination

125
Q

Retrograde filling
best
prevent excessive amalgam expansion

A

MTA

Zinc Free Amalgam

126
Q

root end surgery

A

Apicoectomy

127
Q
250 F (121c) for 20-30 mins
15 psi
A

Autoclave

128
Q
‼️📌
320 F (160 C' for 1 hour
A

Dry Heat

129
Q

not used as primary sterilization method

A

Chairside Sterilization

130
Q

uses 1mm metal cup glass beads , 450 F (232 C) for 10 sec.

A

Glass Bead

131
Q

uses table salt

A

Salt sterilizers

132
Q

Heat- Sensitive Materials

A
Quaternary Ammonium Compounds-- Best solution
Alcohol
NSS
chlorhexidine
NaOCI