Handbook Flashcards
When should pulp capping be considered?
Only in vital, symptomatic free teeth with no history of pulpitis
What is used as a pulp capping agent?
Calcium hydroxide (Dycal)
MTA
Biodentine
What can be used to provide an appropriate peripheral seal around the tooth?
Opal dam
What are the suggested clamps to use for anterior teeth?
C or E
What are the suggested clamps to use for premolars?
E or EW
What are the suggested clamps to use for molars?
A, AW, FW or K
What is the shape of the access cavity for incisors?
Rounded triangle shape
What is the shape of the access cavity for canines?
Oval shape
What does mechanical shaping of the root canals allow?
Creates a space that allows the irrigation needle to deliver irrigant into the apical third of the canal
What is the preferred irrigant?
What are the main properties of this?
What is it used for?
Sodium hypochlorite 2.5-5.25%
Dissolves organic material and is bactericidal
Disinfection
What is used as the penultimate irrigant?
How long for?
What does this do?
EDTA 17% placed into the canal for 1 minute
Removes the smear later
In the final irrigation prior to obturation what is recommended?
A 10 minute soak with sodium hypochlorite
What is the % of chlorhexidine digluconate used for at the start of a RCT treatment?
0.2%
Used to check dam integrity/disinfect tooth surface
What movement should be performed with K files?
Why?
What must be performed in between each K file use?
Watch winding
Limits the risk of unwinding and fracture
Irrigation with sodium hypochlorite - to prevent blocking the canal with organic or inorganic debris
When should the working length calculation be carried out?
One the estimated working length has been reached with a size 10 K file - attach the apex locator to the apical contriction/patency
What is the minimum size K file that can be used for a radiographic working length?
Size 15 to ensure visibility
What does the modified double flare technique do?
Allows production of a continuously tapering funnel-shaped preparation
Involves development of an initial coronal flare followed by an apical flare
What is used in the modified double flare technique?
Gates glidden drills and stainless-steel K files
How is a coronal flare created?
Using a gates glidden bur
Each bur advances slightly further into the root canal
Largest gates-glidden is used first and then the smaller size 1-2mm further until you reach gates glidden 2
What movements are involved in modified reciprocation? (RECIPROC)
Modified reciprocation is a reciprocating movement of the file with 2 different angles of rotation
–150 degrees counterclockwise
–30 degrees clockwise
This creates a step-wise rotary motion
At what length would you use a reciproc to initially?
2/3 of the estimated working length
What additional step is performed for non-vital teeth with symptoms or mucosal swelling?
(inter-visit)
Intracanal medicament to complete disinfection
Non setting calcium hydroxide paste in the prepared root canal with a temporary coronal seal of cotton wool + GIC should then be placed
What is cold lateral compaction?
Obturation technique
Placing a single cone of gutta-percha (GP) with a sealer in the prepared root canal and adding secondary GP cones that are compacted together with the use of a spreader
What are the treatment options for a previously root treated tooth?
Root canal treatment
Extraction
Monitor (annually with a radiograph and 6 months clinically)
What is the indication for internal bleaching?
Tooth has been root canal treated and discoloured
The obturation should be of appropriate clinical quality and the tooth asymptomatic
What bleaching agent is used for internal bleaching?
Carbamide peroxide- 16%
What is the technique for internal bleaching?
Record shade
Prophylaxis- clean/scale and polish tooth
Dental dam
Remove restoration from access cavity
Remove GP from pulp chamber and 1mm below the ACJ
Place 1mm RMGIC over GP to seal canal
Remove any very dark dentine
Etch surface with 37% phosphoric acid
Place 16% carbamide peroxide gel in cavity
Cotton wool pellet over this
Seal with GIC
Review and repeat as required at weekly intervals
What is ledermix used for?
Placed over an inflamed or hyperaemic pulp to reduce inflammation in a tooth to be root treated
What is used as the root canal obturation sealer?
AH plus
How much apical obturation material should remain after post preparation?
3-5mm
How do you protect the root canal filling from coronal leakage?
Removal of all gutta-percha from the pulp chamber and placement of a resin-modified glass ionomer lining over the obturated root canal entrances and pulp chamber floor
What is critical to long term success of root filled tooth?
Cuspal coverage onlays should be considered as the first choice for the definitive restoration
The coronal/crown preparation should always be undertaken first. This helps to establish the quality and quantity of remaining dentine, the presence or absence of a suitable ferrule and the necessity for post placement
What is considered a sufficient ferrule?
1-2mm of remaining sound dentine on more than 75% of the tooth circumference
What choice of post should be used when no ferrule can be achieved?
A cast/prefabricated metal post and core should be used
What is the preferred choice of post when a sufficient ferrule is present?
A fibre post
Name 3 constituents of GP other than GP.
Zinc oxide
Plasticisers
Waxes
Radio-pacifiers
