intra canal meds, temp and bleaching Flashcards
rubber dam needed?
always
single vs multivisit RCTs
Many studies show no statistical difference in
outcomes between RCT completed in a single
visit vs. RCT completed in multiple visits.
is single visit RCT acceptable?
Single visit RCT is acceptable as a
modern evidenced-based standard
in general ; most predictable with
vital teeth and no P/R pathoses.
what prevents single visit RCTs in the clinic here?
time
multi visit possible advantage
multi visit may be superior in reducing the microbio challenge
AT UMKC-SoD, Teeth with Peri-Radicular Pathosis or
Necrotic Pulp will be treated at least how long with CaOH before obturation?
at least one week with intra-canal medication with
Ca(OH)2 before Obturation.
DST should heal.
Between RCT visits or at any time the canal is not
protected by adequate rubber dam isolation, the
canal must be?
Between RCT visits or at any time the canal is not
protected by adequate rubber dam isolation, the
canal must be protected from salivary contamination
(micro-organisms) by some type of temporary filling
Anytime obturation is not yet accomplished, this is an indication for:
Anytime obturation is
not yet accomplished,
this is an indication for
intra-canal medication.
Any Time that a Temporary
Restoration is placed, it is a
good idea to:
Any Time that a Temporary Restoration is placed, it is a good idea to Medicate & Seal with Proper Interim Temporization
Calcium Hydroxide
- CaOH is currently the singular most popular
intra-canal medication to use for disinfection of
canal between RCT visits
CaOH
– Far less toxic than?
– environment for most micro-organisms?
– Bone healing encouraged?
– Antimicrobial activity time frame?
– Helps to dry?
– Safety and removal?
– DO NOT CONFUSE WITH? why?
Calcium Hydroxide
– Far less toxic than previous intra-canal medications
– Unfavorable environment for most micro-organisms (pH 12.4)
– Bone healing encouraged in a basic vs. acidic environment
– Antimicrobial activity extends over extended periods (up to 3 mos.)
– Helps to dry a “weepy” canal
– Safe & easily removed by irrigation at subsequent appointment
– DO NOT CONFUSE WITH BC SEALER
– (You will never get set BC SEALER OUT of the canal(s
Calcium Hydroxide: Interim Placement
- CaOH tip is placed about 2mm short of WL (do NOT allow to BIND) and the CaOH is expressed as the syringe is retracted from the canal.
Objective: fill the canal in its entirety to Cervical Line - Clear excess CaOH from chamber
- Place sterile cotton pellet in chamber to prevent clogging of the canal with temporary filling material
- Temporary filling is placed following the cotton pellet
If you have a mandibular PM or Molar with
open apices, how should you proceed with CaOH
If you have a
mandibular PM or Molar with
open apices, it is possible to
force CaOH out the apex & into
the Mandibular Canal possibly
causing Paresthesia
and Severe and lasting Pain to
the jaw and Face.
Temporization Between Visits
- Sterile cotton in chamber over CaOH
- Place Cavit, IRM, Amalgam or Composite over cotton:
Cavit
Comes from the tube or jar ready to place in the
tooth. No mixing. (1-2 week duration of seal – seals better than IRM but deteriorates rapidly)
Best used only for 1 surface acces
IRM
1-4 week duration of seal = stronger = use when 2
surfaces or more are missing
Composite, Amalgam, Temporary Crown indicated when?
when considerable tooth structure is compromised or a greater delay to next treatment visit is anticipated