Endodontics - should you treat this case? Flashcards

1
Q

What questions should you ask yourself before performing endo?

A

Is treatment indicated?

Is maintaining the patients tooth in their best interests?

(carry out a patient evaluation)

Should I treat this tooth or should a specialist?

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2
Q

What factors are involved in a patient evaluation?

A

Medical status - recent CV problems? diabetes? Cancer treatment?

Psychological status

Social factors

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3
Q

(medical)

At what stage of pregnancy should ONLY emergency treatment be carried out?

A

1st trimester

Other endo procedures can be carried out 2nd and 3rd.

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4
Q

(medical)

In terms of cardiovascular disease, what is a strong contraindicator to endodontic treatment?

A

MI in the past 6 months

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5
Q

(medical)

When carrying out endo treatment on a patient with CV disease what kind of protocol must you adapt?

A

A stress reducing protocol

i.e.
Shorter appointments
Sedation
Anxiety & pain control

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6
Q

(medical)

What must you consider when treating a patient who has underwent/ currently receiving chemotherapy/radiotherapy?

A

Poor healing

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7
Q

(medical)

What kind of endodontic disease can compromise a diabetic - even if well controlled?

A

Acute endodontic infection

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8
Q

(medical)

What must you consider in a patient with diabetes?

A

Poorer healing/poorer outcomes - must be monitored closely.

Have to minimise stress.

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9
Q

(medical)

What kind of patient takes biphosphates?

A

An individual with osteoporosis

All of these patients are considered a high risk.

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10
Q

(medical)

What is the aim(s) in terms of endodontic treatment with patients taking biphosphonates?

A

Preventative care

Non-surgical tretament

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11
Q

(medical)

What must you always be cautious of in a patient taking biphosphonates?

A

BRONJ

Osteonecrosis of the jaw.

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12
Q

(dental)

If a tooth requiring endo treatment has a poor periodontal status what is the appropriate treatment?

A

Extraction

- endo treatment cannot be performed since the tooth is likely to be mobile.

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13
Q

(dental)

If the tooth is unrestorable, should it be endodontically treated?

A

no - some exceptions

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14
Q

(dental)

Can you carry out endodontic treatment without appropriate isolation of the tooth?

A

No

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15
Q

List some factors that would influence the prognosis of endodontic therapy (6)

A

Separation of instruments during instrumentation

If a perforation occurs during instrumentation

If there are ledges

Calcification of the pulp chamber - makes it difficult to locate the pulp chamber on a radiograph.

Resorption - Can occur externally or internally

Development anomalies/difficult anatomy

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16
Q

What must be covered in consent for endodontic treatment?

A

Ensure consent is obtained for each step of the treatment plan.

Options available

The prognosis and why that is the case.

The risks/complications

Ensure they know that they will require a restoration once the endo treatment has been carried out.

Let them ask any questions

17
Q

What is the success rate for a tooth with irreversible pulpitis and NO periradicular radiolucency?

A

90% over 10 years

18
Q

What is the success rate for a tooth with a necrotic pulp?

A

80% over 10 years

19
Q

What are the possible complications of endodontic treatment?

A

Perforation

Separated instruments

Post-operative pain

Extrusion of various solutions. (NaOCl etc)

20
Q

Describe the minimal level of difficulty for an endodontic case.

A

Preop indicates routine complexity - normal
(contributing factors only in the minimal difficulty category)

Likely that a predicatble outcome can be attained

21
Q

Describe the moderate level of difficulty for an endodontic case.

A

Preop indicates complexity
(1 or more contributing factors in moderate difficulty category)

Predicatble outcome would be challenging for an experienced and competent practitioner

22
Q

Describe the high level of difficulty for an endodontic case.

A

Preop indicates exceptional complexity
(several contributing factors in moderate difficulty category and at least 1 in the high difficulty category)

Predicatble outcome would be challenging for an experienced and competent practitioner