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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
Q

T/F: Apical fracture is indication for apico surgery

A

False

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26
Q

What is the best treatment for a re-infected tooth with post/core/crown?

A

Apical curetage w/ retrofill

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27
Q

Non-healing lesion after RCT. Apico surgery and biopsy. Lesion has neutrophils, plasma cells, nonkeratinized stratified epithelium, and fibrous connective tissue. What is it?

A

Granuloma

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28
Q

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?

A
  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
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29
Q

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?

A
  1. Clean tooth and socket with saline.
  2. Gently replant tooth.
  3. Flexible splint for 1 week.
  4. RCT when splint is removed.
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30
Q

T/F: Replantation is indicated only for open apex teeth if the extra-oral dry time is more than 60 minutes.

A

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.

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31
Q

What is the reason for failure of a replanted tooth?

A

External resorption

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32
Q

What is the most important factor for an avulsed tooth?

A

Time

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33
Q

What is the success rate if a tooth is replanted w/in 15 mins? 30 mins?

A 
15mins = 90%
30mins = 50%
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34
Q

T/F: An avulsed tooth should be cleaned with water.

A

FALSE

Saline only.

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35
Q

How long should a replanted tooth be splinted?

A

7-10 days

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36
Q

What is the best solution for an avulsed tooth?

A

Hank’s solution. Milk is next best.

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37
Q

An avulsed tooth w/ closed apex should be immersed in a NaF solution of what pH and for how many minutes?

A

5.5 pH for 5 mins

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38
Q

T/F: An avulsed primary tooth that has <60mins extraoral time should be replanted.

A

False

Do not replant primary teeth.

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39
Q

Which material is the least cytotoxic for perforation repair?

40
Q

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?

A
  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
Q

T/F: In the case of an intrusion, the tooth can often be repositioned, splinted, and no RCT will be needed.

A 
False
Most (96%) intrusion cases lead to necrosis of pulp.
42
Q

What does palpation test for?

A

If inflammation has spread from PDL to periodontium.

43
Q

T/F: Sodium hypochlorite (NaOCl) is used for chelation in endo.

A

False

It dissolves organic tissue in canal.

44
Q

T/F: Chelating agents are good for sclerotic canals.

A

True

Sodium hypochlorite is NOT a chelating agent.

45
Q

What is the purpose of calcium hydroxide during RCT?

A

Intracanal medicament

46
Q

T/F: EDTA is a chelating agent used in endo.

A

True

Removes smear layer and dissolves INorganic material.

47
Q

What percentage of EDTA is used in endo?

48
Q

What is a contraindication for CaOH?

A

Pulp symptomatic for month or longer

49
Q

PAR seen on asymptomatic tooth. When opened the canal is calcified. Treatment?

A

Place EDTA

50
Q

What causes pink tooth mummery?

A

Internal resorption

51
Q

How is internal resorption treated?

52
Q

What type of resorption causes an ankylosed tooth?

A

Replacement resorption

53
Q

What is the treatment of choice for external inflammatory root resorption?

A

Remove necrotic pulp, place calcium hydroxide

54
Q

T/F: Perforating internal resorption is not likely to cause endo failure.

55
Q

What causes grey tooth?

A

Pulp necrosis and blood in dentinal tubules

56
Q

What is the most common cell in a necrotic pulp?

57
Q

What is the most common cause of RCT failure?

A

Inadequately disinfected canal.

*2nd is poorly filled canal

58
Q

What are two main reasons for incomplete removal of bacteria and debris from canals?

A

Failure to irrigate thoroughly. Failure to obtain straight line access.

59
Q

T/F: GP beyond the apex is the most likely cause of RCT failure.

A

False

Least likely

60
Q

T/F: Gutta percha creates a seal with the canal surfaces.

A

False

Needs sealer. Does not have adaptation.

61
Q

2 weeks after crown placement patient reports sensitivity to pressure and cold. Diagnosis?

A

Most likely occlusal trauma. Adjust occlusion.

62
Q

Pt has pain on biting 1 week after RCT, CPC, and crown. Diagnosis?

A

Most likely vertical root fracture.

63
Q

T/F: RCT is proper treatment for vertical root fracture.

A

False

Extraction

64
Q

What is the most common cause of vertical root fracture?

A

Endo - excessive lateral condensation

Vital - physical trauma

65
Q

Which teeth most commonly suffer vertical root fracture?

A

Mandibular posterior

66
Q

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?

A

Isolated pocket depth.

67
Q

When does a transilluminater light up the WHOLE TOOTH?

A

Craze lines

68
Q

What is the most common tooth with cracked tooth syndrome?

A

Mand 2nd molars -> Mand 1st molars -> max premolars

69
Q

What is the best treatment for horizontal root fractures?

A

Reduce and splint

70
Q

What are the most common teeth with crown/root fractures?

A

Mand molars

71
Q

What are advantages of NiTi files over stainless steel?

A

Flexibility and bending memory.

BUT more likely to fracture

72
Q

Which tooth diagnosis is most likely to survive a separated file?

A

Vital pulp w/ no PAR

73
Q

What is the access shape for mand molar?

74
Q

What is access shape for max molar?

75
Q

Why triangular access in max central incisor?

A

Expose pulp horns

76
Q

T/F: EPT is the best test for a tooth w/ a crown.

77
Q

What test differentiates a endo/perio lesion?

A

EPT - tells if pulp is necrotic

78
Q

T/F: EPT is a superior test to thermal testing.

A

False

Thermal testing is superior

79
Q

What treatment sequences gives best prognosis for endo/perio lesion?

A

RCT first. SRP second.

80
Q

How do you distinguish periodontal abscess from apical abscess?

81
Q

Best diagnostic test for acute periradicular periodontitis?

A

Percussion

82
Q

T/F: Pain to lateral percussion indicates an endo problem.

A

False

Perio

83
Q

What is sequence of treatment for acute PA abscess w/ swelling?

A

Incision/drainage and antibiotics -> RCT

84
Q

T/F: Dentin formation is possible after RCT.

85
Q

Taurodontism causes pulp enlargement in which direction?

86
Q

What are the types of nerve fibers found in the pulp?

A

A-beta, A-delta, C

87
Q

Which of the fibers are myelinated and unmyelinated?

A

A fibers = myelinated

C fibers = unmyelinated

88
Q

________ fibers are principally located at the pulp-dentin junction and are responsible for sharp pain.

A

A-delta

Myelinated = faster, sharper pain response

89
Q

_______ fibers are distributed throughout the pulp and respond to high-threshold pain with a dull sensation.

90
Q

T/F: A-delta fibers are larger than C fibers.

91
Q

A ________ is made from a steel wire that is ground to a tapered square or triangular cross section and then twisted.

A

K-file or K-reamer

They are the oldest tools for machining dentin

92
Q

The _______ is a modification of the shape of the K-file, with a non-cutting tip design.

A

K-flex file

93
Q

What is the most recommended internal bleaching chemical?

A

Sodium perborate

94
Q

Describe the benefits of using Zinc Oxide Eugenol as a temporary restoration.

A

provides good seal, antimicrobial

95
Q

What is the predominant organism in an endodontic periapical infection?

A

gram-negative obligate anaerobes

NBDE Pt 2 (12 decks)

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