Final Flashcards
1
Q
Pulpal irritants
A
microbial
mechanical
chemical
2
Q
Microbial irritants
A
obligate anaerobes dominate intraradicular infeciton
gram negatives are most common bacteria in edno infection
3
Q
Main source of microbial irritaion to dental pulp and periradicular tissues
A
Dental caries
4
Q
Is direct pulp exposureto microrgansims a prereq for pulpal response and inflammation?
A
no
5
Q
Asepsis
A
goal in vital case to prevent infection
6
Q
Antisepsis
A
goal in nonvital case to remove all organism
7
Q
Primary RCT infections are
A
polymicrobial, dominated by obligatory anaerobic bacteria
8
Q
gram negative anaerobic rods
A
most frequenct bacterium
9
Q
Which bugs are easily taken out during RCT
A
obligate anaerobes
10
Q
Wht kind of bugs can survive chemo mechanical RCT? and Which ones are freq isolated form failed RCT
A
Facultative bacteria and E. Faecalis
11
Q
Mechanical irritatnts
A
deep cavity prep, lack of cooling, impact trauama, occlusal trauma, deep perio curretage, ortho movement
12
Q
Chemical irritants
A
dentin cleaning, sterilizing, desensitixing agents, temp and permnanet filling materials
13
Q
A fiber
C Fiber
A
A fiber are mylinated thus fast and fat , C fiber slow (small)
A fiber is sharp pricking feeling, C fiber is burning aching less bearable feeling.
14
Q
Cell poor and rich zone
A
alphabet P before R
then closest to top fibroblast & nerve fiber/ venule & arteriole
15
Q
cell free zone
A
cell free zone of weil
free of cels, traversed by blood capillaries and unmyelinated nerve fibers.
adjacent to odontoblastic layer
16
Q
Celll rich zone
A
subodontoblastic area, alot of fibroblasts and immune cells , dendiritic cells etc.
17
Q
SAP
A
First extension of pulpal inflammation into periradicular tissues
Irritants—inflammatory mediators from irreversible pulpitis
*there is inflammation but no swelling
Spontaneous pain
Acute pain to biting or percussion
Hot, cold, electric sensitivity (pulpitis)
May or may not respond to Pulp Vitality Tests
May or may not have PA radiolucency (yet)
Widened (thickened) PDL
Histology—PMNs and macrophages
May have liquefaction necrosis
18
Q
SAP irritants
A
Irreversible Pulpitis Bacterial toxins from necrotic pulp Chemicals—Irrigants or disinfecting agents Hyperocclusion—Restorations or bridges Overinstrumentation Overextension of obturation material
19
Q
SAP tx
A
remove irritant if vital, the rct, if necrotic rct
if its due to hyperocclusion wait a couple of days
20
Q
ASSYMPTOMATIC APICAL PERIODONTITIS
A
Caused by Pulpal Necrosis
Sequel to SAP
Chronic
Generally assymptomatic
Little or no pain
No response to Pulp Vitality Tests
Slightly sensitive to palpation
Widened PDL to Extensive lesion (starting lesion at least)
Granuloma—PMNS, Mast Cells, Macrophages,(no epithelium)
Apical Cyst—Stratified squamus epithelium surrounded by CT containing all cellular components found in granuloma (Granuloma that contains a cavity lined with epithelium—Epithelial Cell Rests of Malessev or Hertwigs root sheath)
59%–granuloma, 22%–cysts, 12%–scars, 7%–?
Tx by RCT or extraction
21
Q
Condensing osteitis
A
Variant of AAP
Increase in trabecular bone (response to persistant irritation in pulp)
Mostly mandibular posterior teeth
May or not be painful
no special tx, goes away following rct
22
Q
osteosclerosis
A
Hardeninng of the bone is osteosclerosis
Idiopathic (no known cause) kinda looks like condensing ostities
You can solicit pain on condenseing osteitis, on ostesclerosis nothing.
23
Q
Acute apical abces
A
Localized or diffuse liquefaction lesion of pulpal origin Destroys periapical tissues Disintegrating PMNs Necrotic pulp Abcess within a granuloma
Rapid onset of acute spontaneous pain to percussion and biting and palpation!!!
Moderate to severe discomfort and swelling—intra and sometimes extraoral
Purulence (pus), sinus tract (more common in chronic)
Surrounding the abscess is granulomatous tissue (an abscess within a granuloma)
Lymphadenophy—submandibular and cervical
Periapical Radiolucency
No response to Pulp Vitality Tests
Varying degree of mobility
Frequently febrile
24
Q
AAA is freq
A
febrile,
do RCT or I and D
25
Chronic apical abcess
Inflammatory lesion of pulpal origin
Long standing lesion
Same histology as AAA
```
Generally assymptomatic
Not sensitive to biting
May feel different to percussion
No response to pulp vitality tests
Apical radiolucency
Mucosal or facial sinus tract
```
26
RCT overview
Hyperplastic Pulpitis—Pulp Polyp….RCT
Irreversble Pulpitis—Symptomatic or Assymptomatic … RCT
Necrotic Pulp… RCT
Symptomatic Apical Periodontitis—SAP .. RCT. UNLESSED CAUSED BY HYPEROCCLUS
Assymptomatic Apical Periodontitis—AAP ..RCT BECAUSE NECROTIC
Acute Apical Abcess—AAA.. RCT/febrile
Chronic Apical Abcess—CAA …RCT
Condensing Osteitis..RCT
27
Pathways of pulpal disease
Dentinal Tubules—exposed tubules always put pulp at risk
Direct Pulp Exposure- most obvious route
Caries—most common cause
Iatrogenic—restorative procedure
Trauma—crack
28
perio disease
Two-way street—microbes in subgingival biofilms could reach the pulp by the same pathway that intracanal microbes reach the periodontium
Pulpal necrosis only occurs if periodontal disease (pocket) reaches the apical foramen due to damage of blood vessels that penetrate the apical foramen
29
Anachoresis/Chemotaxis
Microbes transported in blood to areas of tissue damage
Traumatized teeth become infected thru this pathway
Enamel cracks
30
pulp reactions
3 reactions protect the pulp against caries (decrease in dentin permeability, tertiary dentin formation, inflammatory and immune responses)
Pulp is the only connective tissue in the body with the ability to protect itself from certain external irritants
Swelling—cardinal sign of inflammation (pulp has limitation on volume) also, almost no collateral circulation
31
Viscious Cycle in Response to Trauma
Increased blood flow leads to vasodilation and an increased capillary pressure, which leads to increase capillary filtration which leads to increased tissue pressure resulting in pulpal pain!
This increased pressure outside the vessels compresses the thin-walled venous vessels which leads to a decreased blood flow and increased filtration, strangulating the pulpal vessels
Occurs only at site of injury—can remain localized for some time especially if irritant is removed
If injurious irritant is strong and long lasting, the inflammation will spread throughout the pulp (from periphery to central to root to periapical tissues = pulpal necrosis
32
INFLAMATORY PROCESS
PMNs, macrophages, plasma cells
Mast cells not found in normal/healthy pulps appear and release histamine initiating immune response
33
Pulp polyp
Rare!
Successive breakdown of pulp stops
Opening of pulp cavity occurs
Instead of necrosis, pulp tissue proliferates
Hyperplastic pulpitis
Generally young teeth
Generally assymptomatic
Surface epithelium forms from oral epithelial cell implantation
34
pulpal necrosis
Caused by bacteria and bacterial products or loss of blood supply
Infectious agents cause liquifaction necrosis
Blood loss causes ischemia/coagulation necrosis (trauma)
35
Chief complaint
Medical History
Dental History
First Information Obtained
Volunteered by Patient
36
Periapical testing is more...
| Thermal is more..
percussion, pulpal
37
Cold ice water on face to relieve pain what is dx?
irreversible pulpitis or pulpal necrosis
38
Guy with ice was making the pulp shrinking, keeping pressure downa nd vessels form expanding.
Probably a necrotic pulp because hes coming in with a hot pulp
39
Hot and tender indicates
necrosis
40
really tender indicates
pulpitis
41
swelling in face is tell tale sign of
acute alveolar abcess
42
Dental history
point to offending tooth, when did symptom first start, how bad does it hurt, what produces or reduces symtpoms, how long to dypmtoms last?
43
classify pulp diseases
```
Reversible Pulpitis
Irreversible Pulpitis
Pulpal Necrosis
Previously Initiated Pulpal Therapy
Normal
```
44
Reversible pulpitis
Stimulation uncomfortable but reverses quickly
Caries, exposed dentin (most), recent dental treatment, defective restorations, trauma
RCT generally not needed
Eliminate cause/Viscious Cycle?
45
irreversible pulpitis
Symptomatic—Intermittent or spontaneous pain
Stimulation results in heightened and prolonged response
Minimal or no radiographic changes
Pulp will eventually become necrotic
Asymptomatic—Caries possibly into pulp space (best time to treat)(pulp polyp)
RCT needed
46
pulpal necrosis
Only classification describing histological status of pulp (or lack there of)
Subsequent/after to Irreversible pulpitis (Symptomatic or assymptomatic)
Following complete pulpal necrosis, symptoms usually subside until disease extends into PA tissues
Cold test—no response** so if doesnt respond to cold you know you are necrotic!
Heat—sometimes exacerbates pain due to expansion of gases or fluids
RCT needed
47
Cc: hurts a little with cold, don’t want it to get worse
How long it start? Just this past summer
Clinical history? No trauama, no exposre, no prev rct, restoration is there 6 months ago (a little deep)
No swelling, sinus tract or mobility, perio pribe is WNL, no caries, or fracture, restoration is there
Pain wise little pain with cold only, does it linger? (gone is 6 sec)
reversible pulpitis!!
48
Tooth really tender to cold
| Chipped off part of it 6 months ago (allows bacteria to release toxin in tubuleS)
Irreversible pulpitis
49
No pain
Large filling
Little puffiness and tender up abce
Mobile
necrotic
50
1—IRREVERSIBLE PULPITIS—NORMAL PERIAPEX
Extreme temperature exposure results in intense and prolonged pain (dull, throbbing)
Treatment—removal of as much pulpal tissue as time allows (pulpectomy/pulpotomy) or clean and shape
Cotton pellet (as good as anything)
Relieve occlusion
51
2—IRREVERSIBLE PULPITIS—(SAP)
Extremely percussion sensitive
Treatment—complete pulpectomy or clean and shape
Cotton/cavit
Relieve occlusion
52
3—NECROTIC PULP—(SAP) (NO SWELLING)
```
Extremely percussion sensitive
Treatment—complete pulpectomy or clean and shape
Establish drainage if possible
Copious irrigation
CaOH medicament if room after drying
Cotton/cavit (old school—leave open)
Relieve occlusion
Antibiotics/Pain Management
```
53
4—NECROTIC PULP (SWELLING) WITH DRAINAGE
```
Treatment—complete pulpectomy or clean and shape (apical penetration)
Copious irrigation
CaOH after drying
Cotton/cavit
Relieve occlusion
Antibiotics/Pain Management
```
54
5—NECROTIC PULP (FLUCTUANT SWELLING) NO DRAINAGE
```
Treatment—Complete pulpectomy or clean and shape (apical penetration)
Copious irrigation
CaOH after drying
Mucosal I & D
Cotton/cavit
Antibiotics/Pain Management
```
55
6—NECROTIC PULP (DIFFUSE SWELLING) WITH DRAINAGE
```
Treatment—complete pulpectomy or clean and shape
Copious irrigation
CaOH after drying
Cotton/cavit
Antibiotics/Pain Management
Reduce occlusion
```
56
7—NECROTIC PULP (DIFFUSE SWELLING) NO DRAINAGE
```
Treatment—complete pulpectomy or clean and shape (apical patency)
Copious irrigation
Cotton/cavit
Extra oral/intra oral drainage
Antibiotics/Pain Management
```
57
Zone of fish
Purulence comes first then hemorrage
B is at center of defect, full of pus
On edges is battle of liquefaction
58
Intraoraly you do an I and D it heals so fast in a week
| 3 months though _____ the healing is so slow extraorally
externallly
59
ENAMEL FRACTURES
Enamel only
Chipping
No pulpal treatment (1-2% pulpal necrosis will occur)
A blow to take enamel off may be enough to get your pulp necrosed!
60
CROWN FRACTURES WITHOUT PULP EXPOSURE
Uncomplicated—involves enamel and dentine
1-7% pulpal necrosis will occur
Treatment—exposed dentine protection immediately (CaOH cement or other hard dental liner—VitraBond) then restore if less than ½ mm of dentine
Reattachment of separated tooth fragment with bonding agents
Crown is fractured, no pulp
But involveds enamel and dentin
4x greater than enamel chip for trauama.
Pulpal protection needs to happen so put caoh cement or other dentaliner vitra bond to help
Some dentin is sensitive
You traumatized the tooth, tx is to protect exposed dentine
Uncomplicated is invlvedenamel and dentine, 7% chance of pulp necrosis
You gotta protect pulp when etching
61
CROWN FRACTURES WITH PULP EXPOSURE
Complicated—involves enamel, dentine and pulp (13% of all dental injuries)
100% necrosis if left untreated
Factors—extent of fx, stage of root development, length of time since fx and restorative tx plan
Immature roots need pulp to develop
Treatment—pulp capping (CaOH) 1st 30 hours
partial pulpotomy
full pulpotomy (Salvages some root)
pulpectomy (RCT)
62
TREATMENT FOR EXPOSED PULP
As time increases depth of pulpal therapy increases
Inflammation decreases success for vital pulp therapy
Mature tooth—pulpectomy (complete RCT therapy) affords most predictable success
Immature tooth—vital pulp therapy should always be attempted
After pulpal therapy—bacteria-tight seal is most important
Cvek Pulpotomy—shallow (2mm), day of injury—greater than 80% is successful relative to day of injusry.
MTA—High pH, bacteria-tight seal, hardens, can act as base for permanent restoration (needs moisture to cure-two appointments), grey can’t be used in anterior teeth, expensive
CaOH—can be mixed with saline or anesthesia (thick paste)
ZOE or glass ionomer to seal
``
63
Cvek Partial Pulpotomy
```
Cut slot prep for the exposure
Cut across
Make the preparation
Don’t run anything inside
Iriigate and drry, place MTA over top, the glass inomer acid etch
```
Single hole, teeny hole, don’t need to reveolve a lot o pulpt tissue
Pulp horn
Mm of dentin in there
Clean it out
Get to dry, put paper points in there, but flat end in there.
Then put calcium hydroxide in there. – stimulates a antibacterial response!
Lay glass ionomer over that and tooth heals
64
CROWN-ROOT FRACTURE
Enamel, dentine and root cementum (may or may not involve pulp
Usually oblique (Involve both crown and root)
Periodontal rather than endodontic challenge
Restorable?
Root extrusion
65
ROOT FRACTURE
Cementum, dentine and pulp
Horizontal—only seen on xray if beam goes directly through fx (transverse or oblique)
Treatment—splint (cervical or middle 1/3), usually no immediate treatment for apical 1/3
Reposition and stabilize
66
LUXATION INJURIES
Concussion—no displacement, no mobility, percussion sensitive, no treatment
Subluxation—no displacement but mobile and percussion sensitive with possible sulcular bleeding, no treatment
Extrusive—displacement coronally, mobile, xray shows displacement, pulp test non-vital, treatment (reposition, splint 2-4 weeks, RCT later if needed)
Lateral—displacement (mdbl), treatment (reposition, splint 2-4 weeks, RCT later if needed)
Intrussive—dispacement apically, no mobility, may re-erupt spontaneously if immature apex, ortho extrusion if mature apex, high incidence of ankylosis, RCT (put some caoh in there to hopefully stop ankylosis)
67
AVULSION LUXATION
Complete displacement from socket
reimplantation and splint
Duration, storage medium, apical maturity key factors
68
Splingting extra oral time less than 60 minutes
Closed apex—saline, milk, saliva, xray, irrigate socket (coagulum), reimplant and splint 2 weeks (flexible), antibiotics (doxy or pen), RCT one week (CaOH—2 weeks)
Open apex—saline to clean, Doxycycline—5 min, minocycline (Arestin), reimplant and splint (flexible), antibiotics, follow for vitality (2, 6, 12 mos)
69
if tooth has been out extraorally for more than 60 minutes
Closed Apex—Soak in 2% NaF 5-20 minutes, RCT in NaF soaked gauze in hand (just do the Root canal in hand), Replant and splint 4 weeks (ankylosis—high)
Open Apex—May not reimplant due to very high incidence of ankylosis (RCT out of mouth)
70
apexogenesis
Vital pulp therapy to encourage continued physiologic development and formation of the root end. Objective—maintain pulp vitality
Cvek Pulpotomy—vital, reversible pulpitis
Cervical Pulpotomy—deeper exposure
Control bleeding—moist cotton pellet
Rinse—NaOCl (diluted-1.25%)
MTA or CaOH (hard)
Temporize
71
APEXIFICATION
Pulp vitality not attainable—calcific barrier induction across open apex with pulpal necrosis and no lesion
Larger opening, larger instruments
Copious irrigation w/NaOCl 1.25% (anything to aid—sonic, etc)
WL short of apex, gentle, circumferential filing
CaOH paste (lentulo spiral?)
Long term temporary seal
3 month follow-up—possible replace CaOH
MTA for permanent artificial barrier (will seal of apex like guttapercha)
9-24 months for barrier formation (becoming more popular)
Barrier—Osteoid or cementoid (distinct from, but continuous with cementum, dentin and predentin)
Regendo (tx of choice with nonvital necrotic tooth)
72
Difference is that apexificaiton is created here
In apexogensis we want root to continue to grown naturally
CaOH is promoting inflammation and stimulates osteoid bridge formation at the end of the root
None of these tx actually strengthen the root though
MTA takes a long time to gorm and artifical barier os osteoid and cementoid
Regendo: tx of choice with nonvital necrotic tooth
.
73
Deep dentin is more porous that superficial dentin or not?
| What do young well perfused pulps have?
Deep dentin is more porous than superficial dentin, the teeth that are more of a risk at deep carious lesions are pulps of primary teeth and immature permanent teeth
You don’t get sensory innervation to the pulp until later stages of root formation
Young pulps have a big reparing capacity.
74
Tooth morphology
Primary teeth are smaller in all dimensions
Primary crowns are wider M-D relative to crown length
Primary teeth have narrower and longer roots relative to crown length and width
Facial and lingual cervical thirds of the crowns of anterior primary teeth are more prominent (more cervical bulge)
Primary teeth are more constricted at the DEJ
Facial and lingual surfaces of primary molars converge (narrowr occlusal table) occlusally==narrower in B-L
Roots are more slender and longer
Roots flare out nearer the cervical area and at the apex (since permanent teeth coming in between)
Enamel is thinner
Dentin is thinner
Pulp chambers are comparatively larger
Pulp horns are higher
75
pulp tests
Standard pulp provocation tests of limited value
Unreliable electrical pulp testing (11% open apices vs 79% closed apices)
Thermal testing may be more reliable (particularly CO2 ice)
76
pulp therapy for vital tooth
Indirect Pulp Therapy—avoid pulp exposure
Hall Technique—stainless steel crown only (no caries removal)
Direct Pulp Capping—carious exposures no, small mechanical or traumatic exposures yes
Pulpotomy—formacresol, glutaraldehyde, ferric sulfate, MTA, electrosurgical, laser
77
if tooth is non vital the n pulp therapy like this
```
Rubber dam mandatory
WL 2-3mm short of radiographic length
NiTi instruments recommended
Absolutely no perforation—thin walls
Obturation—Zoe, Iodoform paste, CaOH, (must be resorbable)
```
78
apexogenesis
You don’t get a lot of wall thickening iwht apexogenesis, we want a natural bridge formation to eventually doa normal RCT
79
apexification
immature tooth with necrotic pulp: gotta either put MTA at the apex or complete but porous calcific barrier at apex
80
regendo
stimulate apical end with blood, blood clot invades, eventually goes coronoally towards MTA seal, then root forms and wall thickens!
81
Regendo requirements 3
Stem Cells—Pulpal mesenchymal stem cells located in perivascular region and cell-rich zone of Hohl (stem cells of apical papilla—SCAP)
Growth Factors(Morphogens)—Molecular signals that induce cellular differentiation
Scaffold—Provides 3 dimensional, physical microenvironment
82
what we need for regendo to work
Pulp necrosis
Immature root apex (young patient)
Pulp space not to be utilized for restorative purposes(post)
Coronal seal (you need enough cervical tooth structure to get the seal)
83
Regendo technique
Visit 1(W/right case)—Anesthetize, isolate, access, necrotic tissue debridement (minimal instrumentation), WL, copious irrigation (1-2% NaOCl then 0.12-2% CHX), dry, medicament (CaOH or triple AB paste), cotton/cavit
Triple antibiotic paste—1:1:1 mixture of ciprofloxacin/metronidazole/minocycline (typically stop minocycline since it stains!)
Visit 2—4 weeks have passed —Repeat visit 1 if no resolution of infection has occurred, Anesthetize—3% mepivacaine w/o vasoconstrictor (promote blood clot formation), isolate, access, copious irrigation (1-2% NaOCl then 17% EDTA) to remove all antimicrobial medicament, dry, #10 or 15 file out apex to stimulate bleeding, collagen matrix (Colla-Plug) to serve as matrix for white MTA seal, permanent restoration
12-18 month recall
84
healed, nonhealed, healing, and functional definitions
Healed—functional, asymptomatic teeth with no or minimal periradicular pathosis
Nonhealed—nonfunctional, symptomatic teeth with or without periradicular pathosis
Healing—teeth with periradicular pathosis that are asymptomatic and functional, or teeth with or without periradicular pathosis that are symptomatic but for which the intended function is not altered
Functional—a treated tooth or root that is serving its intended purpose in the dentition
85
NaOcl accidents
A little bit of both. NaOCL aciddents, too far injected past apical foramen.
Before irrigate canal make sure syringe isnt plugged up!
86
What do posts do
the just serve to retain core of the tooth, they dont stregnthen a root but actually weaken it.
87
influence of endo therapy includes
Loss of Moisture—9%
Irrigation Materials—NaOCl, EDTA, etc interact with dentin and deplete calcium and fragilize dentin
Aging—reduces fracture resistance
Aggressive Coronal Access and Instrumentation—results in excessive tooth structure loss
Loss of Coronal Seal—reinfection leading to additional Endodontic treatment
88
Requirements for a good restoration
Preserve Remaining Tooth Structure
Protect Remaining Tooth Structure
Provide Coronal Seal
Satisfy Function and Esthetics
89
foundation restorations
composite without post
or ceramic post
etc.
90
A POST AND CORE IS
A POST & CORE is a dental restoration used to sufficiently build-up tooth structure for future restoration, i.e. crown when there is not enough tooth structure to properly retain the crown.
91
Post
The POST is placed within the body of the root of a tooth that has already been treated with RCT
92
Core
The CORE is the part of the restoration that shows out in the mouth that helps anchor a cap or crown
93
Post (Dowel)
Post (Dowel)—metal or other rigid restorative material placed in the radicular portion of a non-vital (root canal) tooth. A dowel usually made of metal is fitted into a prepared canal of a natural tooth. When combined with an artificial crown or core, it provides retention and resistance for the restoration.
94
Core
Core—refers to properly shaped substructure, which replaces missing coronal tooth structure and retains the final restoration. The core is designed to resemble or become the crown preparation or crown itself.
95
Post properties
max protection to root, adequare retention with root, max retention of core and corwn, max protecton of crown, estethics, high radiographic visibility
96
Posts purpose, risk
Purpose—retain a core in a tooth with extensive loss of coronal tooth structure
Risks—procedural accidents (perforations, root fractures, treatment failures)
Indications—only used when other options are not available to retain a core
Posts DO NOT strengthen roots
97
Anterior teeth and posts
Little or no benefit in a structurally sound anterior tooth
Increases chance for a non-restorable failure
Prior to crown placement when coronal tooth structure is thin and small pulp chambers can’t provide sufficient retention and resistance
98
Molars and posts
```
Cuspal coverage, but most don’t require post
Pulp chamber and canals provide provide adequate retention for core buildup
Largest canals (palatal of maxillary and distal of mandibular)
```
99
What teeth req more posts than molars?
Require posts more often than molars (bulkier and smaller pulp chambers)
Delicate root morphology requires special care during post space.
premolars.
100
What is post retention influenced by?
Retention is influenced by post length, diameter, taper, luting cement, and passive or active
Increasing length and diameter increases retention
Active posts more retentive than passive posts
Parallel posts more retentive than tapered posts
***Diameter is least important factor
Resistance is influenced by remaining tooth structure, post length and rigidity, antirotation features and presence of FERRULE
101
whats the easiest post type to retrieve
whast the worst
metal
ceramic or zirconia is impossible
102
what kind of posts are there
active- threaded and engage dentin wall more retentive
passive: retained stricyly by luting agent less retentive
parallel more retentive thatn tapered, less stress
tapered requires les dentin removal increase wedge effect
103
How long should post be
dont go farther than 4mm , leave at least 4 mm of gutta percha
*and as long as clinical crown will be!
104
post diameter
although doesnt matter a ton it should NOT exceed 1/3 root diameter
105
what is ideal coronal seal material for post
amalgam or glass ionomer
106
Post serves one purpose
RETAIN CORE
107
Length of post and gutta percha that needs to remain
as long as clinical crown, 4 mm
108
Parallel serrated
is what we use in clinic/best
109
Metal
is easiest to retrieve for post, ceramic sucks, fiber is easier.
