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NBDE Pt 2 > High Yield Endo > Flashcards

High Yield Endo Flashcards

1
Q

Which teeth do you perform pulp eval on?

A

Teeth, neighboring teeth, contralateral teeth

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2
Q

T/F: An apical radiolucency present for a long time w/ no symptoms or sinus tract is associated with a necrotic pulp.

A

False

Asymptomatic chronic periodontitis

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3
Q

What is the best option for a super-erupted molar with irreversible pulpitis?

A

RCT and crown

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4
Q

What is indicated from a radiolucency at furcation of a primary first molar in a 5 y.o.?

A

Necrotic pulp - secondary tooth should not be causing resorption yet in a 5 y.o.

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5
Q

Prolonged, unstimulated night pain suggests which pulpal condition?

A

Pulp necrosis

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6
Q

Any periapical abscess indicates which pulpal condition?

A

Necrotic

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7
Q

Can a periapical radiolucency at the apex of a primary tooth be a normal finding?

A

Yes. If perm tooth is erupting. If in furcation of primary molar - most likely necrotic

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8
Q

Necrotic primary tooth can lead to what problem with the permanent tooth?

A

Can disturb ameloblastic layer of permanent successor or spread infection

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9
Q

What is the most common medication for pulpectomy/pulpotomy?

A

Formocresol

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10
Q

T/F: Calcium hydroxide is contraindicated in pulpotomy in a child.

A

True

Can lead to resorption of primary teeth.

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11
Q

Describe the though process on pulpectomy/pulpotomy/extraction in primary teeth.

A
  1. No furcation RL - pulpotomy
  2. Furcation RL on 1st primary molar - ext
  3. Furcation RL on 2nd primary molar - pulpectomy if restorable and no root resorption
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12
Q

What is the best testing method for newly erupted primary teeth?

A

Percussion

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13
Q

T/F: EPT is a good test for traumatic teeth.

A

False

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14
Q

What is the least reliable test on primary teeth?

A

EPT

Percussion is most reliable

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15
Q

What is the most difficult pulpal diagnosis and tooth location to anesthetize?

A

Irreversible pulpitis and mandibular

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16
Q

Tooth not responsive to cold, not responsive to percussion, tender to palpation.

A

Necrotic w/ chronic apical periodontitis

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17
Q

T/F: Mesial inclination of a molar is a good reason to refer to endo.

A

False

Dilaceration, calcification, inability to obtain anesthesia - all good reasons

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18
Q

What is the best treatment for a vital pulp exposure of 1st perm maxillary molar in 7 y.o.?

A

Pulpotomy

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19
Q

7 y.o. fractured central incisor 3 hours ago. 2mm exposure and bleeding pulp. Treatment?

A

Pulpotomy w/ calcium hydroxide

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20
Q

Why do pulpotomy only on exposures in permanent molars on children?

A

Give time for apexogenesis (apex closure)

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21
Q

What is apexification?

A

Creating an apical barrier on an immature permanent tooth. Done w/ dense calcium hydroxide paste or MTA

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22
Q

What is apexogenesis?

A

Vital pulp therapy to allow for natural physiologic closure of apex. Frequent recalls and replacement of medicament. RCT when apex is closed.

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23
Q

Which method (apexification/apexogenesis) is indicated in non-vital teeth?

A

Non-vital - apexification

Vital - apexogenesis

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24
Q

What are indications for apicoectomy?

A
  1. Persistent pathology following RCT
  2. Lesion enlarges after RCT
  3. Overextended treatment interfering w/ healing
  4. Apical portion can not be instrumented
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25
T/F: Apical fracture is indication for apico surgery
False
26
What is the best treatment for a re-infected tooth with post/core/crown?
Apical curetage w/ retrofill
27
Non-healing lesion after RCT. Apico surgery and biopsy. Lesion has neutrophils, plasma cells, nonkeratinized stratified epithelium, and fibrous connective tissue. What is it?
Granuloma
28
A 7 y.o. patient comes in after a fall. His mom brings in his avulsed #8. The fall took place less than 1 hour ago. What is the appropriate treatment?
1. Clean tooth and socket with saline 2. Gently replant tooth. 3. Flexible splint for 1 week 4. Continued evals to check for revascularization. 5. If no revascularization -> apexification and RCT
29
A 27 y.o. patient comes into the office after a softball accident. He brings in #8 in a cup of saliva. What is the appropriate treatment?
1. Clean tooth and socket with saline. 2. Gently replant tooth. 3. Flexible splint for 1 week. 4. RCT when splint is removed.
30
T/F: Replantation is indicated only for open apex teeth if the extra-oral dry time is more than 60 minutes.
False No matter the tooth, if it has been out of the mouth, and not in an appropriate storage media for >60 minutes it should not be replanted.
31
What is the reason for failure of a replanted tooth?
External resorption
32
What is the most important factor for an avulsed tooth?
Time
33
What is the success rate if a tooth is replanted w/in 15 mins? 30 mins?
``` 15mins = 90% 30mins = 50% ```
34
T/F: An avulsed tooth should be cleaned with water.
FALSE Saline only.
35
How long should a replanted tooth be splinted?
7-10 days
36
What is the best solution for an avulsed tooth?
Hank's solution. Milk is next best.
37
An avulsed tooth w/ closed apex should be immersed in a NaF solution of what pH and for how many minutes?
5.5 pH for 5 mins
38
T/F: An avulsed primary tooth that has <60mins extraoral time should be replanted.
False Do not replant primary teeth.
39
Which material is the least cytotoxic for perforation repair?
MTA
40
34 y.o. patient comes in after a car accident. He has already been treated in the E.R. for other injuries. Radiograph shows horizontal root fracture in coronal third of #9. What is the appropriate treatment?
1. Reposition tooth 2. Stabilize w/ rigid splint for 3-4 months. 3. Remove splint and monitor pulpal status. 4. If necrotic at 1 year - RCT. **If fracture in apical third, could splint for 4-6 weeks.
41
T/F: In the case of an intrusion, the tooth can often be repositioned, splinted, and no RCT will be needed.
``` False Most (96%) intrusion cases lead to necrosis of pulp. ```
42
What does palpation test for?
If inflammation has spread from PDL to periodontium.
43
T/F: Sodium hypochlorite (NaOCl) is used for chelation in endo.
False | It dissolves organic tissue in canal.
44
T/F: Chelating agents are good for sclerotic canals.
True Sodium hypochlorite is NOT a chelating agent.
45
What is the purpose of calcium hydroxide during RCT?
Intracanal medicament
46
T/F: EDTA is a chelating agent used in endo.
True | Removes smear layer and dissolves INorganic material.
47
What percentage of EDTA is used in endo?
17%
48
What is a contraindication for CaOH?
Pulp symptomatic for month or longer
49
PAR seen on asymptomatic tooth. When opened the canal is calcified. Treatment?
Place EDTA
50
What causes pink tooth mummery?
Internal resorption
51
How is internal resorption treated?
RCT
52
What type of resorption causes an ankylosed tooth?
Replacement resorption
53
What is the treatment of choice for external inflammatory root resorption?
Remove necrotic pulp, place calcium hydroxide
54
T/F: Perforating internal resorption is not likely to cause endo failure.
True
55
What causes grey tooth?
Pulp necrosis and blood in dentinal tubules
56
What is the most common cell in a necrotic pulp?
PMN
57
What is the most common cause of RCT failure?
Inadequately disinfected canal. *2nd is poorly filled canal
58
What are two main reasons for incomplete removal of bacteria and debris from canals?
Failure to irrigate thoroughly. Failure to obtain straight line access.
59
T/F: GP beyond the apex is the most likely cause of RCT failure.
False Least likely
60
T/F: Gutta percha creates a seal with the canal surfaces.
False Needs sealer. Does not have adaptation.
61
2 weeks after crown placement patient reports sensitivity to pressure and cold. Diagnosis?
Most likely occlusal trauma. Adjust occlusion.
62
Pt has pain on biting 1 week after RCT, CPC, and crown. Diagnosis?
Most likely vertical root fracture.
63
T/F: RCT is proper treatment for vertical root fracture.
False Extraction
64
What is the most common cause of vertical root fracture?
Endo - excessive lateral condensation | Vital - physical trauma
65
Which teeth most commonly suffer vertical root fracture?
Mandibular posterior
66
Patient is complaining of pain on a lower premolar which had a post/core, and crown placed 2 months ago. What diagnostic finding will be most indicative of a vertical root fracture?
Isolated pocket depth.
67
When does a transilluminater light up the WHOLE TOOTH?
Craze lines
68
What is the most common tooth with cracked tooth syndrome?
Mand 2nd molars -> Mand 1st molars -> max premolars
69
What is the best treatment for horizontal root fractures?
Reduce and splint
70
What are the most common teeth with crown/root fractures?
Mand molars
71
What are advantages of NiTi files over stainless steel?
Flexibility and bending memory. | BUT more likely to fracture
72
Which tooth diagnosis is most likely to survive a separated file?
Vital pulp w/ no PAR
73
What is the access shape for mand molar?
Trapezoid
74
What is access shape for max molar?
Triangle
75
Why triangular access in max central incisor?
Expose pulp horns
76
T/F: EPT is the best test for a tooth w/ a crown.
False ICE
77
What test differentiates a endo/perio lesion?
EPT - tells if pulp is necrotic
78
T/F: EPT is a superior test to thermal testing.
False Thermal testing is superior
79
What treatment sequences gives best prognosis for endo/perio lesion?
RCT first. SRP second.
80
How do you distinguish periodontal abscess from apical abscess?
Pulp test
81
Best diagnostic test for acute periradicular periodontitis?
Percussion
82
T/F: Pain to lateral percussion indicates an endo problem.
False Perio
83
What is sequence of treatment for acute PA abscess w/ swelling?
Incision/drainage and antibiotics -> RCT
84
T/F: Dentin formation is possible after RCT.
False
85
Taurodontism causes pulp enlargement in which direction?
Apically
86
What are the types of nerve fibers found in the pulp?
A-beta, A-delta, C
87
Which of the fibers are myelinated and unmyelinated?
A fibers = myelinated | C fibers = unmyelinated
88
________ fibers are principally located at the pulp-dentin junction and are responsible for sharp pain.
A-delta Myelinated = faster, sharper pain response
89
_______ fibers are distributed throughout the pulp and respond to high-threshold pain with a dull sensation.
C fibers
90
T/F: A-delta fibers are larger than C fibers.
True
91
A ________ is made from a steel wire that is ground to a tapered square or triangular cross section and then twisted.
K-file or K-reamer They are the oldest tools for machining dentin
92
The _______ is a modification of the shape of the K-file, with a non-cutting tip design.
K-flex file
93
What is the most recommended internal bleaching chemical?
Sodium perborate
94
Describe the benefits of using Zinc Oxide Eugenol as a temporary restoration.
provides good seal, antimicrobial
95
What is the predominant organism in an endodontic periapical infection?
gram-negative obligate anaerobes

NBDE Pt 2 (12 decks)

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