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Endodontic Guidelines > Guide to Clinical Endodontics > Flashcards

Guide to Clinical Endodontics Flashcards

1
Q

why do we need to examine and diagnose endodontic problems

A

to determine diagnosis and treatment need
determine cases too complex for level of training
determine if wise to consult with others

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2
Q

what is apexogenesis

A

vital pulp therapy performed to allow continued physiological development and formation of the root
remove portion of pulp and apply medicament

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3
Q

what are the indications for apexogenesis

A

deep caries - pulp exposure
no pretreatment symptoms
controlled bleeding

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4
Q

what are the aims of apexogenesis

A

prevent adverse clinical signs
prevent breakdown of periradicular tissues
obtain radiographs of root development

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5
Q

what is a pulpotomy

A

surgical removal of coronal portion of vital pulp tissue and biological material placed in pulp chamber and restored

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6
Q

when is a pulpotomy indicated

A

exposed vital pulps
irreversible pulpitis of primary teeth
emergency treatment for permanent if cannot start RCT
for permanent teeth with immature roots before RCT can happen

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7
Q

what are the aims of a pulpotomy

A

prevent adverse clinical signs
get radiograph of root for endo treatment
prevent breakdown of periradicular tissues
prevent resorption or canal calcification

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8
Q

what is pulpal debridement (pulpectomy/extirpation)

A

surgical removal of entire pulp tissue

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9
Q

what are the indications for pulpectomy

A

relief for acute pain before conventional RCT when RCT cannot be accomplished at that appointment

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10
Q

what is the aim of a pulpectomy

A

relief of acute pain until complete treatment can happen

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11
Q

what is indirect pulp capping

A

2 visits 6 months apart
remove caries but leave some over pulp and place CaOH and restore
next visit remove all caries and CaOH and then restore

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12
Q

what are the indications for indirect pulp capping

A

deep caries - pulp exposure
no pretreatment subjective symptoms
no periradicular pathology

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13
Q

what are the aims of indirect pulp capping

A

prevent clinical signs
obtain radiographs for root development
prevent breakdown of periradicular tissues
prevent resorption or canal calcification

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14
Q

what is direct pulp capping

A

material placed onto surface of vital pulp at exposure site and restored

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15
Q

what are the indications for direct pulp capping

A

mechanical exposure of pulp
controlled bleeding
material can be in direct contact with pulp
exposure when tooth is under dam
coronal seal can be maintained

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16
Q

what are the aims of direct pulp capping

A

prevent clinical signs
develop contact of biocompatible radiopaque capping material with pulpal tissue
maintain normal responsiveness to electrical and thermal pulp tests
prevent breakdown of periradicular supporting tissues

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17
Q

what are the benefits of using dental dam for endodontics

A

minimise risk of contamination of root canal by indigenous oral bacteria
aid visualisation by providing clean operating field
prevent aspiration/ingestion of materials

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18
Q

when would RCT be indicated on primary teeth

A

irreversible pulpitis or necrosis with no permanent successor
necrosis with/without periradicular disease
treatment will not damage permanent successor

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19
Q

what do you obturate with when there is a permanent successor present

A

a material which will resorb at similar rate to tooth (not GP)

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20
Q

if there is no permanent successor present what do you obturate primary teeth with

A

GP and sealer

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21
Q

what are the aims of RCT in primary teeth

A

alleviate symptoms
create well obturated canal
prevent breakdown of periradicular tissues
allow resorption of root structures and material when successor erupts

22
Q

what are the indications for RCT for permanent teeth

A

irreversible pulpitis
necrotic pulp
compromising pulp due to dental procedures
placement of a post
fractured teeth with pulpal involvement
thermal hypersensitivity

23
Q

what is pulp regeneration

A

remove pulp
place antimicrobial in canal and temporise
bring patient back
open canal and irrigate
overinstrumentation to induce bleeding
clot in canal
place MTA (3-4mm)
close canal permanently
reassess root development

24
Q

what are the indications for pulp regeneration

A

incomplete root development and incomplete apical closure
when you cant use apexogenesis due to necrotic pulp

25
Q

what are the aims of pulpal regeneration

A

treat apical periodontitis
induce radiograph of apical closure without breakdown of supporting tissues
retain dentition during craniofacial development
promote root development

26
Q

what is apexification

A

clean and shape canal and pack with biologically appropriate material to create an apical barrier

27
Q

what is the indication for recalcification

A

treating external and internal resorptive defects perforating to external surface

28
Q

what is the aim of recalcification

A

encourage biological root repair

29
Q

what is the procedure for recalcification

A

clean and shape canals and pack with material promoting resorptive repair

30
Q

what are the indications for re-root treatment

A

continued periradicular pathosis
defiecient RCF quality
persistent symptoms
restorative procedures requiring re-RCT

31
Q

what are the aims of re-root treatment

A

alleviate symptoms
create well obturated canal
maintain health of periradicular tissues

32
Q

what is incise and drain

A

make a surgical opening in soft tissue to release exudate or decompress area of swelling

33
Q

what are the indications for incise and drain

A

if pathway is needed to soft tissue with swelling to provide necessary drainage
when pain due to accumulation of exudate in soft tissues
when need to collect samples

34
Q

what are the aims of incise and drain

A

alleviate symptoms
reduce localised soft tissue swellings
promote repair of soft tissues
prevent damage to teeth or anatomical structures

35
Q

what do you do for an enamel fracture

A

smooth or resin bond or bond fragment back

36
Q

what do you do for uncomplicated crown fracture

A

repair with bonded resin or bonding fragment back
composite bandage

37
Q

what do you do for complicated fracture of immature tooth

A

pulp capping or partial pulpotomy

38
Q

what do you do for complicated fracture of mature tooth

A

if doesnt need a crown then vital pulp therapy
if needs a crown then RCT

39
Q

what is the treatment for crown-root fracture of immature tooth

A

pulp capping then wait until mature to do RCT

40
Q

what is the treatment for crown-root fracture of mature teeth

A

RCT

41
Q

what is the definitive care of avulsion with less than one hour of dry time

A

for immature - apexification then RCT
for mature - RCT within 7-10 days of reimplantation

42
Q

what is the definitive care of avulsion with more than one hour dry time

A

RCT

43
Q

what teeth are not suitable for re-implantation after avulsion

A

teeth with immature apices and extra-oral dry time greater than one hour
primary teeth

44
Q

what is the emergency care for alveolar fracture involving teeth

A

reduction of alveolar segment and splint for 4-6 weeks

45
Q

what is the definitive care for alveolar fracture involving teeth

A

RCT after evaluating pulpal status of teeth

46
Q

what are the indications for a post

A

remaining coronal tooth structure is inadequate for retention of restoration
sufficient root length to accommodate the post
adequate ferrule

47
Q

what are the aims of placing a post

A

retain core
place along long axis of tooth
avoid perforations or root fractures
preserve apical seal
eliminate space between post and surrounding tooth structure
place post in root structure that is supported by bone
minimise contamination of root canal system

48
Q

what is the indications for a core

A

replacing coronal tooth structure
enhanced retention and resistance to displacement is necessary

49
Q

what are the aims of a core

A

provide retention for final restoration
occupy entire pulp chamber
core does not perforate pulp chamber floor
eliminate space between core and root canal filling material

50
Q

what type of restoration should be on a posterior tooth after RCT

A

full cuspal coverage

51
Q

when is it indicated to remove a post/post and core

A

loss of retention
recurrent caries
fracture of post/core
access for RCT is necessary

52
Q

what are the aims of post and core removal

A

minimise damage to tooth/adjacent teeth
alleviate symptoms
remove entire post
avoid root fractures or perforations

Endodontic Guidelines (2 decks)

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