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Mod 5 exam > Endodontics (including DM) > Flashcards

Endodontics (including DM) Flashcards

1
Q

Roots and canals: maxillary first molar

A

4 canals (93% JOE 1999) – TWO MB canals.

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2
Q

Roots and canals: Maxillary second molar 56.9%

A

3 roots, 3 canals

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3
Q

Roots and canals: Maxillary second molar 22.7%

A

3 roots, 4 canals

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4
Q

Roots and canals: Maxillary second molar 9%

A

3 roots, 3 canals ( initially but MB and DB combine)

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5
Q

Roots and canals: Maxillary second molar 6.9%

A

2 roots, 2 canals

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6
Q

Roots and canals: Maxillary second molar 3.1%

A

1 root, 1 canal

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7
Q

Roots and canals: Maxillary second molar 1.4%

A

4 roots, 4 canals (2 sit palatally)

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8
Q

Roots and canals: Mandibular first molar - distal root 70%

A

70% = 1 canal

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9
Q

Roots and canals: Mandibular first molar - distal root 15%

A

15% = 2 canals (joining)

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10
Q

Roots and canals: Mandibular first molar - distal root 5%

A

5% = 2 canals

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11
Q

Roots and canals: Mandibular first molar - mesial root 59%

A

59% = 2 canals

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12
Q

Roots and canals: Mandibular first molar - mesial root 28%

A

28% =2 canals (joining with single foramen)

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13
Q

Roots and canals: Mandibular first molar - mesial root 12%

A

12% = 1 canal

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14
Q

Roots and canals: Mandibular first molar - mesial root 1%

A

1% = 3 canals

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15
Q

Roots and canals: Mandibular second molar - mesial root 38%

A

38% = 2 canals (joining)

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16
Q

Roots and canals: Mandibular second molar - mesial root 35%

A

35% = 2 canals

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17
Q

Roots and canals: Mandibular second molar - mesial root 27%

A

27% = 1 canal

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18
Q

Roots and canals: Mandibular second molar - distal root 92%

A

92% = 1 canal

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19
Q

Roots and canals: Mandibular second molar - distal root 5%

A

5% = 2 canals

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20
Q

Roots and canals: Mandibular second molar - distal root 3%

A

3% = 2 canals (joining)

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21
Q

How many failed RCTs are as a result of missed canals?

A

42%

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22
Q

Upper premolars number of canals?

A

Usually has 2 but can sometimes have 3

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23
Q

Maxillary first molar roots

A
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24
Q

Maxillary second molar roots

A
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25
Q

Maxillary premolars roots

A
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26
Q

Mandibular first molars roots

A
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27
Q

Mandibular premolar roots

A
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28
Q

Infection: primary endo/secondary perio lesion

A
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29
Q

Infection: primary perio/secondary endo lesion

A
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30
Q

Infection: true combined lesion

A
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31
Q

Distance from buccal cusp to roof of pulp chamber?

A

6mm

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32
Q

Height of pulp chamber

A
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33
Q

Distance from plural floor to furcation

A
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34
Q

Accessory canals in first mandibular molars: 23%?

A

23% have a lateral canal from the coronal third of a major root canal to the furcation region

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35
Q

Accessory canals in first mandibular molars: 13%?

A

13% have a single furcation canal extends from the pulp chamber to the intraradicular region

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36
Q

Accessory canals in first mandibular molars: 10%?

A

10% have both lateral and furcation canals

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37
Q

REMEMBER? Accessory canals in first mandibular molars

A

Side, middle, double

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38
Q

Ferrule effect

A

o we WANT the ferrule effect
o 1.5-2mm of dentine
o “tube” of dentine
o Supportive help tooth bear occlusal load

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39
Q

Posts?

A

Not desirable (only for when there is barely any tooth left)

40
Q

Success % of RCTs if the obturation is within the normal 0-2mm area

A

94%

41
Q

Success % of RCTs if the obturation is too short

A

68%

42
Q

Success % of RCTs if the obturation is too long

A

76%

43
Q

Hulsmann criteria

A

For irrigant extrusion - HULSM acronym!

H - haemorrhage
U - undeniable symptoms (acute pain, swelling, redness)
L - loss of sensation (numbness, weakness of facial nerve)
S - secondary infection, sinusitis, cellulitis
M - massive face (swelling) infraorbital region or mouth angle

44
Q

Antibiotics dosage: amoxicillin

A

500mg x 3 (for 5 days)

45
Q

Antibiotics dosage: penoxymethylpenicillin

A

1 x 250mg 4 times daily (increase to 500mg for severe infections) – 5 days

46
Q

Antibiotics dosage: metronidazole

A

1 x 400mg capsules 3 times daily – 5 days

47
Q

Traditionally used sealers in RCTs

A

Calcium hydroxide materials
Zinc oxide eugenol materials
Glass ionomer cements

48
Q

New advancements in sealers in RCTs

A

Bioactive calcium silicate cement Mineral Trioxide Aggregate (MTA) - are being favoured now e.g. biodentine due to their biocompatibility and they don’t shrink on setting, they also utilise the moisture in the canal by being hydrophilic - this helps them set.

49
Q

Pain immediately after RCT not to worry about?

A

toxicity of some sealers on setting

50
Q

Assessing success of obturation? COVP

A

C - coronal restoration adequate
O - obturation within 2mm of apex
V - voids absent
P - periapical lesion absent

51
Q

What type of seal is necessary for a successful RCT?

A

Hermetic seal (Hermes could fly in the air) – sealed against the escape or entry of air.
Fluid tight or bacteria tight seal – more appropriate than hermetic seal as root canals are evaluated for leakage of fluid.

52
Q

What situations could mean only 1 appointment needed for the RCT? ONE

A

o Only minor symptoms
o Not wet - blood/pus etc
o Everything goes (necrotic pulp/irreversible pulpitis etc)

53
Q

What situations could mean only 1 appointment needed for the RCT? TWO

A

o Technically difficulties (anatomical complexities/patient or dentist is tired)
o Wet canal (persistent exudate in RC)
o Ouch – symptoms are acute

54
Q

% composition GP cone

A

o 60 – zinc oxide
o 20 – gutta percha
o 10 – radioopacifiers
o 5 – plasticisers
o 5 - Other; waxes, colouring agents, antioxidants, and metallic salts.

55
Q

Periapical diagnosis:  Non TTP, no palpation findings
 Normal radiographically

A

Normal periapical tissues

56
Q

Periapical diagnosis:  Tooth is TTP, +/- palpation findings
 Loss of lamina dura, PDL widening radiographically

A

o Symptomatic periapical periodontitis (irreversible/necrotic pulp)

57
Q

Periapical diagnosis:  Non TTP, no palpation findings
 Radiolucency around the apex of tooth radiographically

A

o Asymptomatic periapical periodontitis

58
Q

Periapical diagnosis:  VERY TTP, sinus/pus palpation findings
 PDL maybe normal or slightly widened, distinct radiolucency where chronic lesion present.
* TREATMENT  drainage!! Then RCT or extract.

A

Acute periapical abscess

59
Q

Periapical diagnosis:  Usually asymptomatic - Non TTP, sinus palpation findings
 Radiolucent area on bone radiographically

A

o Chronic periapical abscess

60
Q

Sodium hypochlorite

A

o antimicrobial
o can dissolve necrotic tissue
o No evidence suggests using NaOCl >1%.
o DDH we use 2%!!
o ~20ml of solution per canal.
o Disadvantages: unpleasant taste, highly toxic, inability to remove smear layer when used alone.

61
Q

Management of Sodium hypochlorite extrusion

A

o Tell patient
o Help manage symptoms: analgesics, cold packs, antibiotics, refer to OS.

62
Q

When irrigating where should your needle be bent?

A
  • NEEDLE – place a bend 2-3mm short of the WL, to prevent going to far into the canal.
63
Q

Citric acid function

A
  • Citric acid (17% EDTA) – removal of smear layer
    o Dissolves smear layer (particles are soluble in the acid).
64
Q

Balanced force technique

A
  • Balanced force technique – required for size 50 files diameter canals.
    o Engaging: clockwise 60 degrees turn
    o Cutting stroke: anticlockwise 120 degrees turn
    o Removing: clockwise 60 degrees turn
65
Q

Two ways a file can fracture in the canal

A

o Sheer/torsional fracture: an instrument will fail by torsion when the ultimate shear strength is exceeded – instrument has bound to the canal wall. Clinician’s fault.
o Flexural fracture/cyclical fatigue: instrument is subjected to tension and compression cycles at point of maximum flexure, continuous rotation in curved canals. Not clinicians fault.

66
Q

Management of fractured endodontic instruments

A

o Locate (radiographically and by tactile sensation)
o Earlier is worse. Inadequate cleaning of area.
o Overcome (Bypass fractured instrument)
o Proceed? Consider symptoms and prognosis.
o Attempt removal? Is this feasible based on location.
o Radiolucency periradicularly = prognosis worse.
o Document and discuss with patient.

“LEOPARD”

67
Q

Apical patency

A

the ability to pass a small Flexofile passively through the apical constriction without widening it (Buchanan 1989).

68
Q

Micro/macro glide path

A
  • MICRO glide path: established with hand instruments (size 08 and 10 k-files to WL)
  • MACRO glide path: enhanced micro glide path with rotary instrument (Proglider)
69
Q

Canal medication

A

Non-setting calcium hydroxide base (for inter-dental appointments) - anti-inflammatory.

70
Q

Antibiotic/steriod paste for the canal

A

Odontopaste (zinc-oxide based).

71
Q

Antimicrobial extra for the canal?

A

10min soak in Iodine-containing pastes
 Bactericidal, fungicidal and virucidal and sporicidal.
 Contra-indications: iodine hypersensitivity, pregnant and breast-feeding woman.

72
Q

Crown Down Sequence

A

Crown Down Sequence – instrumentation technique for challenging anatomy:
o “Prepare from the crown all the way down”
o Focus on preparing the upper 1/3 of the canal and then work down to preparing the apical 1/3 of the canal.
o Prevents instrument binding or transportation during cleaning and shaping.

73
Q

Pulp innervation fibres

A

90% A delta myelinated fibres, rest are A beta fibres and unmyelinated C fibres.

74
Q

What material is better for direct pulp capping?

A

International endodontic journal 2021 = MTA (mineral trioxide aggregate) e.g. Biodentine are better for direct pulp capping than calcium hydroxide.

75
Q

Reactionary dentinogenesis

A

Reactionary dentinogenesis: odontoblasts from pulp are recruited to lay down dentine as a result of a carious lesion.

76
Q

Reparative dentinogenesis

A

Reparative dentinogenesis: pulp (odontoblast cells) is directly damaged and so odontoblast-like cell is used to make reparative dentine which is of poorer quality that the reactionary dentine.

77
Q

Direct pulp capping classes

A

o Class I  trauma or iatrogenic damage
o Class II  infection

78
Q

Pulpitis and the treatment you do for each

A

o Initial or mild pulpitis – indirect pulp capping
o Moderate pulpitis – coronal pulpotomy (partial/full)
o Severe pulpitis – coronal pulpotomy/RCT/Extraction

79
Q

High risk of IE? VIC

A

o Valve prosthesis
o IE previously
o Congenital heart disease (cyanotic)

**some exclusions

80
Q

Pulp becomes inflamed when bacteria is ___mm away

A

0.5mm

81
Q

Clamp bow for maxillary teeth

A

facing down

82
Q

Clamp bow for mandibular teeth

A

facing up

83
Q

Partial pulpotomy = ___mm removed

A

2-3mm

84
Q

Definition: Stress

A

Resistance force per unit area of a material against deformation when an external force is applied (mm2)

85
Q

Definition: Tensile strength

A

Capacity of a material to withstand load trying to elongate the material.

86
Q

Definition: yield strength

A

Stress the material can withstand without being deformed permanently.

87
Q

Definiton: strain

A

o Change of original dimension when the material is under stress.

88
Q

Defintion: elastic limit

A

o The greatest stress the elastic solid can withstand without being deformed permanently.

The elastic limit is the maximum stress that a material can undergo without experiencing permanent deformation. It is the highest stress a material can withstand and still return to its original shape when the applied stress is removed.

89
Q

Definiton: plastic deformation

A

o Permanent deformation that pertains when the load is removed that exceeds a materials elastic limit.

90
Q

Defintion: Plastic limit

A

o Breaking point of a material

91
Q

Key properties of NiTi

A

o Super elasticity
o Shape memory

92
Q

K files made from ?

A

 Made from raw ss wire which is ground to 0.02 taper and shaped (triangle/square)
 This is then twister in a COUNTER clockwise rotation to achieve the file.

93
Q

Why is SS a good material in endo?

A

 Stiffer than NiTi
 Corrosion resistant (due to Cr and Ni)]

94
Q

Memory shape

A

Memory shape means that you can heat the file to get it back to the curved shape it was once in (tailored to the canal).

95
Q

High modulus of elasticity

A

A material with a high modulus of elasticity is stiff and resists deformation under applied stress.
It means the material requires a large amount of stress to produce a small amount of strain.
Examples of materials with high modulus of elasticity include metals like steel and ceramics.

96
Q

Low Modulus of Elasticity:

A

A material with a low modulus of elasticity is more flexible and deforms easily under applied stress.
It means the material undergoes a significant amount of strain even with a relatively small amount of stress.
Examples of materials with low modulus of elasticity include rubber and some polymers.

Mod 5 exam (5 decks)

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