Introduction to Endodontics Flashcards
Endodontics is the branch of dentistry concerned with the morphology, physiology, and pathology of the ____ and ____
Human dental pulp and periradicular tissues
What does the endodontics specialty encompass?
- Biology of the normal pulp
- Etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions
Endodontics includes diagnosis and treatment of oral pains of what origin?
Pulpal and/or periradicular
What are examples of vital pulp therapy?
Pulp capping, pulpotomy
True or false: endodontics includes nonsurgical treatment of root canal systems
True
Endodontics includes ____ of root canal systems
Obturation
Endodontics includes surgical removal of:
Pathological tissues resulting from pulpal pathosis
What is replantation?
Intentional or of avulsed teeth
Endodontics can include surgical removal of tooth structure, such as:
- Root end resection (apicoectomy)
- Retrofill procedure (MTA)
- Root resection
- Hemisection
True or false: Endodontics includes bleaching of discolored dentin and enamel
True
Endodontics can include ____ of failed endodontically treated teeth (conventional or surgical)
Retreatment
What procedures are related to coronal restorations?
Post and core buildups
True or false: implants are associated with endodontics
True
An ____ is a dentist with two or more years of advanced training in the scope of endodontics from an advanced education program accredited by the ADA commission of dental accreditation and who limits his or her practice to endodontics
Endodontist
Why is it important to learn to perform endodontics well?
- 70% of the nearly 15 million endodontic treatments in the US are performed by general dentists
- Only 30% of endodontic procedures are performed by endodontists
What are the objectives of endodontic therapy?
- Reduce pulpal irritants to a point that healing and repair can occur
- Relieve pain and discomfort
- Prepare the tooth the be restores to proper form and function
- Preserve the natural dentitition
What are the basic phases of endodontic therapy?
- Diagnosis (2 parts)
- Preparation of the canal system
- Obturation and sealing of the canals
What are the 2 parts to diagnosis?
- Pulpal
- Periapical
What is involved with preparation of the canal system?
- Cleaning (mainly by irrigation with sodium hypochlorite solution)
- Shaping (accomplished with files)
____ is a clinical diagnostic category in which the pulp is symptom-free and normally responsive to pulp testing
Normal pulp
____ is a clinical diagnosis based on subjective and objective findings indicating that the inflammation should resolve and the pulp return to normal
Reversible pulpitis
____ is a clinical diagnosis based on subjective and objective findings indicating that the vital inflamed pulp is incapable of healing
Symptomatic irreversible pulpitis
What are additional descriptors of symptomatic irreversible pulpitis?
- Lingering thermal pain
- Spontaneous pain
- Referred pain
____ is a clinical diagnosis based on subjective and objective findings indicating that the vital inflamed pulp is incapable of healing
Asymptomatic irreversible pulpitis
What are additional descriptors of asymptomatic irreversible pulpitis?
- No clinical symptoms but inflammation produced by caries
- Caries excavation
- Trauma
____ is a clinical diagnostic category indicating that the tooth has been endodontically treated and the canals are obturated with various filling materials other than intracanal medicaments
Previously treated
____ is a clinical diagnostic category indicating that the tooth has been previously treated by partial endodontic therapy (pulpotomy, pulpectomy)
Previously initiated therapy
What are normal apical tissues?
- Teeth with normal periradicular tissues that are not sensitive to percussion or palpation testing
- Lamina dura surrounding the root is intact, PDL space is uniform
____ is inflammation usually of the apical periodontium producing clinical symptoms including a painful response to biting and/or percussion or palpation
Symptomatic apical periodontitis
Symptomatic apical periodontitis may or may not be associated with:
An apical radiolucent area
____ is inflammation and destruction of apical periodontium that is of pulpal origin, appears as an apical radiolucent area, and does not produce clinical symptoms
Asymptomatic apical periodontitis
____ is an inflammatory reaction to pulpal infection and necrosis characterized by rapid onset, spontaneous pain, and tenderness of the tooth to pressure, pus formation, and swelling of associated tissues
Acute apical abscess
____ is an inflammatory reaction to pulpal infection and necrosis characterized y gradual onset, little or no discomfort, and the intermittent discharge of pus through an associated sinus tract
Chronic apical abscess
What is condensing osteitis?
Diffuse radiopaque lesion representing a localized bony reaction to a low-grade inflammatory stimulus, usually seen at apex of tooth
Considerations/case selection for endodontic treatment
Degree of ____
Pulpal damage (reversible, irreversible, or necrotic)
Considerations/case selection for endodontic treatment
Considerations/case selection for endodontic treatment
____ lesion
Periapical (pulpal origin?)
Considerations/case selection for endodontic treatment
Strategic value and ____ of tooth
Restorability
Considerations/case selection for endodontic treatment
Degree of ____ support
Periodontal
Root/crown ratio, mobility, pocket depths
Considerations/case selection for endodontic treatment
Patient must have sufficient information made available in order to:
Choose or reject endodontic treatment (informed consent)
What is informed consent?
An agreement by the patient to have treatment rendered by the provider after the risks of the treatment, the results of no treatment, the alternatives to treatment and all prognoses have been explained
Informed consent is an ____ process
Active
Not merely having patient sign his or her name to a document
When the pulp is irreparably damaged, the only choices are:
- Endodontic treatment
- Extraction/replacement
- No treatment
What are some non-surgical or conventional endodontic treatment procedures?
- Vital pulp therapy
- Irreversibly or non-vital (necrotic) pulp therapy
Vital pulp therapy is performed for:
Reversible pulpitis
What materials are used for vital pulp therapy?
Calcium silicate materials (MTA, BC Putty)
What are some examples of vital pulp therapy procedures?
- Direct pulp therapy (MTA pulp cap)
- Pulpotomy (MTA covering orifices of canals)
- Regeneration/revascularization (necrotic open apex)
What are some examples of irreversible or nonvital pulp therapy?
- Pulpectomy
- RCT
- Management of resorptive defect
- Apexification/apical barrier with MTA (immature teeth)
- Revascularization of necrotic teeth
Surgical endodontics involves what kinds of procedures?
- Incision and drainage (I&D)
- Periapical surgery
- Root resection/amputation
- Hemisection
- Intentional replantation
What procedures are associated with periapical surgery?
- Apical curettage (removal of periapical granuloma or cyst)
- Root end resection (apicoectomy)
- Apical retrofill (MTA or BC Putty used)
- Perforation repair (MTA used)
What is the ultimate goal of endodontics?
Healing
Healing required what 2 things?
- Proper diagnosis with pre-op radiograph
- Healing evident in post-op radiograph (1 year) following tx
