Intro to Endo

Question 1

What does the dentine-pulp complex highlight?

Answer 1

The inter-relationship between dentine and pulp

Factors influencing dentine ultimately affect the pulp

Question 2

List the number of canals present:
MAXILLARY
1. Central Incisor
2. Lateral Incisor
3. Canine
4. 1st Premolar
5. 2nd Premolar
6. 1st Molar
7. 2nd Molar

Answer 2

MAXILLARY

1. Central Incisor - 1
2. Lateral Incisor - 1
3. Canine - 1
4. 1st Premolar - 2
5. 2nd Premolar - 1
6. 1st Molar - 4
7. 2nd Molar - 3

Question 3

List the number of canals present:
MANDIBULAR
1. Central Incisor
2. Lateral Incisor
3. Canine
4. 1st Premolar
5. 2nd Premolar
6. 1st Molar
7. 2nd Molar

Answer 3

MANDIBULAR

1. Central Incisor - 1
2. Lateral Incisor - 1
3. Canine - 1
4. 1st Premolar - 1
5. 2nd Premolar - 1
6. 1st Molar - 3
7. 2nd Molar - 3

Question 4

List some pathological/clinical conditions that can lead to endo issues (7)

Answer 4

1. Trauma
2. Tooth surface loss
3. Dental Caries
4. Cracked/fractured teeth
5. Pulpal Pathology
6. Periapical Pathology
7. Root Resorption

Question 5

How does Caries lead to Endodontic Disease?

Answer 5

• Disruption of tooth surface (caries)
• Leads to breakdown of enamel surface
• Progresses into dentine
• At this stage we start to see the true effects of the bacterial invasion
• Products leach into the pulp space –> causing inflammatory changes into the pulp

Question 6

What happens to bacteria once they enter the pulp tissue?

Answer 6

• They are not free floating within the RC space

- They develop biofilms

Question 7

What are the effects of biofilm resistance in the RC space in relation to antimicrobial function? (2)

Answer 7

1. Antimicrobials may fail to penetrate beyond the surface layers of the biofilm
2. Antimicrobials maybe trapped and destroyed by biofilms

Question 8

What does peri-radicular disease lead to?

Answer 8

Significant morbidity

• Tooth loss
• Severe infection

Question 9

What are the clinical objectives of RCT?

Answer 9

1. Removing Canal Contents
   - Remove vital/necrotic tissue
2. Eliminating infection

Question 10

What is the principle of the Dr Schilder paper?

Answer 10

Chemical + mechanical means to disinfect to deride the RC system
To remove bacterial + fungal burden that can cause disease

Question 11

Whats the next step after chemomechanical disinfection?

Answer 11

Obturation

- filling RC space to prevent ingress of bacteria + multiplication of persistent bacteria within the RC system

Question 12

What is the purpose behind an endo-restorative seal?

Answer 12

• Allows healing of periradicular tissues

- The tooth is retained as a functional unit in the dental arch