endodontology part 2 Flashcards

1
Q

what are the steps of root canal treatment

A

access
chemo mechanical preparation
medication- temporisation with ca(oH2) and pledget
obturation with GP
restore- on post teeth with cusp coverage restoration
on anterior- composite restoration usually

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2
Q

why do we use ca(oh2) during temporisation

A

as it is very alkaline- has a pH of 12 and therefore kills any bacteria that was left in the canal
prevents bacteria getting back in

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3
Q

give examples of steroid based dressings

A

odontopaste

ledermix

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4
Q

why are steroid based dressings not used

A

as steroids require a blood supply to work and you have removed the pulp

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5
Q

when is the only time we will used ledermix

A

on lower molar teeth- hard to anaesthetise and the steroid dressing will make it easier to anaesthetise next time

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6
Q

what are the options after we have located and accessed the tooth

A

hand preparation and using the rotary instruments to shape the canals

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7
Q

what are we trying to achieve when we shape the canals

A

a continuous smooth tapered to the apex

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8
Q

why is a tapered shape ideal for the canals

A

facilitates both irrigation and the obturation of the canal

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9
Q

what is chemo-mechanical preparation of the canals

A

it is when we use chemicals such as sodium hypochlorite/chlorhexidine to clean out the canals as well as rotary instruments and hand files to remove the necrotic pulp

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10
Q

where is most bacteria found in the tooth

A

the coronal part of the tooth therefore we have to remove the pulp roof adequately

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11
Q

what is coronal flare

A

the flaring of the coronal third of the tooth using gates gligdens and widening the part of the tooth

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12
Q

what technique do we use for hand instrumentation

A

step down technique

stem winding- doesn’t change the shape of the canal

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13
Q

what is the step down technique

A

using the smallest

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14
Q

what is the balance force technique

A

engage the file into the dentine and dentine whilst applying apical peressure which breaks a bit of dentine off
creates stress in the files and therefore breaks so it is NOT AS IDEAL TECHNIQUE

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15
Q

what is stem winding

A

you place the file into the canal and rotate the file slowly to remove debris
takes more time but less procedural errors

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16
Q

what is the anti curvature filing technique

A

file away from the curvature of the root canal- as the curvature is usually the thinner part and therefore you will just file out of the root (strip perforation)

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17
Q

what are the types of files

A
stainless steel/nickel titanium(newer) 
K type( K file, K flex, K flexo) 
H type (hedström)
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18
Q

how are k flexo files made

A

they have a rhombiodal cross section shape and they are made by twisting them

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19
Q

what is the issue with hedstrom files

A

as the flutes are mechanically cut into the file it does suffer from micro cracks which leads to the file usually cracking in the tooth

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20
Q

what re components of the file

A

handle- will stamp the size
file length
silicone stop- helps with the reference point

21
Q

if a file size is 35 what size is the tip

22
Q

what are usual file lengths

23
Q

what is the cutting length of the file

A

19mm- MIGHT GET ASKED IN EXAM ***

24
Q

which file should we use

A

the shortest file that can do the job as there is more tactile sensation

25
what can differ in the tips
they can be cutting or non cutting
26
which k files are non cutting
k flexo
27
which files have cutting tips
hedström files
28
what do the files have
2% taper- meaning for every 1mm back from the tip the diameter increases by 0.02mm MIGHT ASK IN EXAM***
29
who first described the step-down preparation
goerig in 1982
30
what is the double flare
coronal flare and then the apical flare and blending back to create a taper
31
what prep shall we do first
the coronal flare- do not force files into the canal
32
how can we tell the size of the gates glidden
by the number of bands on the non working end
33
what is the working end of a GG2 the same size as
a size 70 file- 0.7mm
34
what is the working end of a GG3 the same size as
a size 90 file
35
what is the working end of a GG4 the same size as
110 file
36
how do gates gliddens work
use with a brushing motion and cut on the out stroke
37
how do we finish apical preparation
determine the working length | using an apex locator and a radiograph using a size 10/15 length
38
what is the working length
the length from the coronal aspect of the tooth to the apical constriction
39
what is the apical constriction
where the apex of the tooth narrows it is a few mm away from the apical foramen
40
what is the step down technique
use the smallest file eg 10 and using the stem winding technique rotate until loose then use eg the size 15 file and work till loose and then the size 20 file until loose if a file does not fit DO NOT FORCE it just go back to the size smaller file and continue to rotate
41
what is cold lateral compaction
GP into the root canal and the finger spreader along the side and push the GP to the side of the canal keep going till you cannot fit anymore GP in the canal
42
how do we cut the GP
using a heater instrument and cut the GP to the CEJ
43
what is the master apical file
the largest file that is used to the full working length
44
what is the master apical file dependant on
the size of the curvature and the original size of the canal
45
how do we obturate
use a master apical file to see the full size of the working length and then get GP of the same size dry the canal with paper points and ensure it goes to working length till you can feel a tug back
46
how does the cold lateral compression technique work
using a finger spreader and GP to fill the canal and use accessory cones to fill the canals
47
what do we do once we have all the GP in the canals
take a radiograph called the mid fill radiograph- to check if you've got GP in the right place
48
what is thermoplasticised techniques
using a hot instrument to melt the GP so it flows into lateral canals as well as vertical canal
49
where do we cut back the GP to in a posterior tooth
the oriface