Intro Material Flashcards
What is the definition of endodontics?
Endodontics is the dental specialty pertaining to the prevention and treatment of apical periodontitis
The scope of endodontics includes…
- differential diagnosis for pain
- vital pulp therapy
- nonsurigical treatment
- surgical removal of tissues
- intentional extraction and replantation
- surgical removal of tooth structure
- internal bleaching
- retreatment of previous teeth
What is included in diagnostic standards?
the ability of the dentist to assimilate the necessary subjective, objective and radiographic information to establish a pulpal or periapical diagnosis, provide appropriate emergency care and referral, and maintain proper patient records and documentation
What is included in treatment planning standards?
case assessment to evaluate the difficulty of treatment and consideration of referral, development of a treatment plan that takes into account the restorability of the tooth, and special consideration for traumatic dental injuries
What requires that clinicians be able to forecast the outcome of initial nonsurgical root canal treatment?
competency in the prognosis of endodontic treatment
Pulp capping (indirect/direct) and pulpotomy are included in what part of endo?
vital pulp therapy
Root-end resection, bicuspidization, hemisection, root resection, root-end filling, and endodontic implants are included in what part of endo?
surgical removal of tooth structure
What is regenerative endodontics?
the incorporation of newer biological therapies that allow us to:
- Revitalize previous necrotic teeth
(dead pulps)
– Re-establish normal tooth sensation
– Continue the root formation of immature teeth with open apices
– Newer materials and protocols
When RCT is performed competently, greater than ___% of treatments will heal
90%
What are the objectives of endodontics?
- correctly diagnose disease as lesion of endodontic origin (LEO)
- perform quality endodontic therapy
- restore & document healed outcome over time via recall
Endo saves ______ teeth per year
17 million
___% of endodontics is performed by a general dentist
75%
The general dentist is the primary care provider and as such must be
highly skilled in…
(1.) Exam
(2.)Diagnosis (DX)
(3.) Case Selection
Why perform a root canal instead of extracting?
we want to avoid the tilting, space loss and super-eruption that follows extraction and lead to periodontal compromise of affected teeth in area
_____________ must be retained as a preventive measure to prevent further dental destruction.
Space and alignment
What are options for this tooth?
- endodontic therapy and coronal restoration
- extract tooth and fixed partial denture
- extract tooth and removable partial denture
- extract tooth and place implant and coronal restoration
What is the AAE (american association of endodontists)?
the reliable source of endodontic information accepted as a dental specialty by ADA and recognized globally as the premier Endodontic organization
What is the AES (american endodontic society)?
- NOT Accepted by ADA or any recognized faction of
organized dentistry in the World. - Not affiliated with any recognized graduate Programs, SODs in US or military.
- standards of care are questionable and open to possible legal liability
- encourage non-recognized, dangerous and often illegal methods and materials
What does the AES support that is illegal or dangerous?
- N2
- RC2B
- Sargenti method
What is the N2: Sargenti technique?
- Non-FDA approved material
- Sloppy technique (not biologically sound)
- Contains para-formaldehyde and other hazardous chemicals that are left in the treated tooth PERMANENTLY
- malpractice insurance companies may ask if you use this material on their application
What is focal infection theory (FIT)?
the notion that a local infection affecting a small area of the body can lead to subsequent infection and/or symptoms in other parts of the body
What is wrong with the focal infection theory (FIT)?
- Seeks to establish RCT teeth as the source of infection within the body & seeks removal of the RCT tooth as a cure for many and sundry (unrelated) diseases and maladies.
- Not based in fact & remains unproven by scientific studies in > 100 years.
Does severe periodontal disease play a role in increased risk of low birth weight babies, cardiovascular disease and diabetes?
“may be true”
What is the “SOAP” format?
- The universally preferred schema of organization & documentation of case histories.
- Think in terms of using this method for all cases
- Required by many insurance companies.
“dont go to court without it!!”
What does SOAP stand for?
S - Subjective
O - Objective
A - Assessment
P - Plan
What is the S of SOAP?
- Subjective (What the patient tells you)
- This is an expansion of the Chief Complaint from your questions and the patient’s answers
What is the O of SOAP?
- Objective (What you observe to be true)
- The results of your clinical examination and testing
What is the A of SOAP?
- Assessment (Diagnosis)
- What your findings indicate to be the problem. This must relate to the chief complaint (CC.)
What is the P of SOAP?
- Plan
- This is how & what you plan to
accomplish in the way of treatment relating to the DX
Before you do anything with a patient you should…
take a proper medical history
What is the order an initial appointment should go?
- Medical History
- Patient Interview (subjective)
- Exam (objective)
- Diagnosis (assessment)
- Treatment Plan (plan)
What is the main objective of the patient interview?
obtain the chief complaint
What does the objective phase of SOAP contain?
A. Now do a brief oral examination with mirror to determine the area(s) of concern.
B. Take diagnostic radiographs of the areas of immediate concern.
C. Your objective is to develop your preliminary Hypothesis of what may be going on
What is the best way to standardize your clinical exam routine?
A. perform an in-depth problem focused examination
B. perform the indicated clinical testing procedures
C. record results in a permanent & organized manner
When does a clinical hypothesis become a diagnosis?
during the assessment stage of SOAP
If you DON’T have a DX, you can do…
NO TREATMENT
All Reasonable Options for the CC are explored and presented to the patient to involve the patient in treatment decisions and to obtain…
informed consent
