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3rd yr- CSB- Endodontics > Endodontics treatment on the clinic > Flashcards

Endodontics treatment on the clinic Flashcards

1
Q

Before starting any treatment what must you have taken

A

A thorough history and examination

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2
Q

What should the history include?

A
  1. Complaint of
  2. History of presenting complaint
  3. Previous dental history
  4. Social history
  5. Medical history
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3
Q

What does the examination include

A
  1. Extra oral exam
  2. Intra oral exam
  3. Special tests
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4
Q

Give examples of some special tests

A
  1. Radiographs
  2. Sensitivity/ vitality tests
  3. Study models
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5
Q

After taking a good history and exam what should you be able to form

A

A diagnosis

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6
Q

Give examples of some Endodontics related diagnoses we can come to

A
  1. Reversible pulpitis
  2. Irreversible pulpitis
  3. Acute periodical inflammation
  4. Chronic periapical inflammation
  5. Chronic suppurative periapical inflammation
  6. Acute periapical abscess/celulitis
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7
Q

Which fibres are often affected in reversible pulpitis

A

A delta fibres

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8
Q

Which fibres are affected by irreversible pulpits

A

C fibres

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9
Q

What questions about the pulp should you ask yourself before making a treatment plan

A

Can the pulp be saved?

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10
Q

What is periapical inflammation

A

When infection spreads beyond the apex of the tooth into the periradicular tissues

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11
Q

What are the symptoms of acute periapaical inflammation

A

Short sharp pain with a spontaneous onset but short duration

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12
Q

What are the symptoms of chronic periapaical inflammation

A

Usually asymptotic

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13
Q

What can happen when you treat chronic periapical inflammation

A

Sometimes treatment may allow an increased level of oxygen to enter the previously closed tooth
The bacteria may then become aerobic causing the tooth to flare (phoenix abscess)
Patient will not be happy as tooth is now symptomatic when it wasn’t before

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14
Q

What is a phoenix abscess?

A

It is acute exacerbation of a chronic periapical lesion. It can occur immediately following root canal treatment if bacteria is left in the canal

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15
Q

What is the difference between cellulitis and an abscess

A

Cellulitis is a diffuse inflammatory process characterised by oedema, redness pain and interference of function
An abscess is a localised collection of pus

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16
Q

Gove examples of vital Endodontics treatment

A

Pulp capping
Direct pulp cap
Pulpotomy
Pulpectamy

17
Q

How do we cap a pulp

A

We leave a small layer of dentine over the pulp and avoid exposing it to bacteria

18
Q

How do we place a direct pulp cap

A

In a clean environment under rubber dam we place a layer of material (non setting calcium hydroxide or RMGIC) over the pulp before placing our restoration on top

19
Q

What is the first thing you aim to treat with any patient

A

Treat any pain they have come in with

20
Q

What is the aim of emergency treatment

A

To relieve symptoms

21
Q

Give examples of emergency treatment we can carry out to help Endo patients

A
  1. Seal dentinal tubules if they have reversible pulpitis
  2. Access clean and drain if they have symptomatic irreversible pulpitis
  3. Prescribe antibiotics if they have SYSTEMIC symptoms and spreading infection
22
Q

Where does Endodontics treatment fall in a full treatment place

A

After placing definitive restorations but before the designing of fixed or removable dentures

23
Q

Before starting any treatment what must you gain from the patient

A

Consent (also let patient know of cost and prognosis in general practice)

24
Q

Give some tooth factor you must consider before starting Endodontics treatment

A
  1. Confirm if the tooth is restorable. If it is not restorable there is no point trying to save it when a crown can not be placed on top
  2. Also consider if you can get a rubber dam onto and around the tooth
25
Q

How must we assess the restorability of a tooth

A

You CAN NOT rely solely on clinical and radiographic exam so you must remove any restorations on the tooth to be able to accurately assess restorability

26
Q

What can happen if you down remove any restorations on the tooth and just start accessing through the restoration

A

You will not know the status of the tooth tissue under the restoration (it may be infected with secondary caries)
This means there could be a bacteria reservoir under the restoration that could lead to Endodontics failure

27
Q

List the equipment needed for Endodontics treatment

A
  1. Patient protection
  2. La and topical
  3. Rubber dam kit
  4. Oro seal
  5. floss and wedgets
  6. Cons kit with hand pieces
  7. Endo kit
  8. Irrigant and syringe
  9. Hand files
  10. Protaper golds and k files
  11. Apex locater
  12. Paper points, GP
  13. Non setting calcium hydroxide
  14. Finger spreader
  15. Tubiseal and mixing pad
  16. Any restoration material needed
28
Q

Talk through the standard timeline for an Endodontics treatment plan

A
  1. History, examination, diagnosis and emergency treatment
  2. Confirm restorability, place provision restoration and finalise treatment plan
  3. Prevention, period and caries management before treatment
  4. Access and working length determination
  5. Prepare the canals
  6. Obturate the canals
29
Q

Talk through the stages we follow when preparing a canal

A
  1. Access
  2. Coronal flare using gates gladdens or SX
  3. Determine working length
  4. Prepare using pro tapers of k files
30
Q

How do we create a corona flare

A

Can either use:
SX (more conservative)
OR
Gates gliddens (removes more tooth tissue)

31
Q

When do we obturate the canals

A
  1. No symptoms
  2. No odour
  3. When we have thoroughly cleaned the canal
32
Q

Name the 4 radiographs we usually take during RCT

A
  1. Pre op
  2. Working length
  3. Master point
  4. Post op
33
Q

List the main complaints defence bodies receive from patients undergoing RCT

A
  1. Poor communication
  2. Unsatisfactory treatment
  3. Failure to make appropriate diagnosis
  4. Incorrect/ unnecessary treatment
  5. Fee dispute
  6. Post treatment complication
34
Q

How can you reduce the risk of being sued

A
  1. Provide treatment to the best of your ability
  2. Explain the treatment to your patient
  3. Keep carful records
35
Q

What must your records include

A
  1. Patients complaint, symptoms and history
  2. Clinical signs and special tests
  3. Diagnosis and treatment plan
  4. LA type and amount used
  5. Working length and reference points
  6. Instrumentation and preparation
  7. Type of root filling material and sealer used
  8. Number of radiographs
  9. Type of restoration material used
  10. Any complications
36
Q

State the claim that if a patient makes is usually indefensible

A

If the dentist fails to protect the oropharynx from ingestion of foreign bodies such as inhalation or swallowing of an Endodontics instrument it is likely that any resultant claim with be indefensible

3rd yr- CSB- Endodontics (5 decks)

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