Janes' Wiggs Chapter 15 and 16 - Endodontics Flashcards

Question

According to Wiggs Chapter 15 (endodontics) What are group IV endodontic instruments?

Answer 1

Engine driven instruments with 3d adaptation. self adjusting file is only current one. Included a picture because it's so cool

Answer 2

Enging driven reciprocatin instruments. Think endo pulse, jack-hammer, woodpecker or...

Answer 3

Ultrasonic instruments

Answer 4

Ledging, gouging, zipping stripping, and translation are all caused by straight–stiff files working in curved canals and trying to regain their straight shape

Answer 5

Barbed broach for removing pulp tissue whole Insert, twist 180 and remove Will grab tooth walls and ruin everything/break - very fragile

Answer 6

Gates glidden drill enlarge access and flare coronal portion of access sized in iso sizes, but go in increments of 20 starting at 50. so smallest is iso 50, largest is iso 150

Answer 7

Reamers and files are both meade the same way, from a triangle, square or rhomboid blank. Twisted to create a spiral - Files are twisted more than reamers (more flutes per mm) •Reamers have \<1/10- \<1/4 spirals per mm They are more aggressive at cutting, but poorer carrying Used in a clockwise turning fashion •Files have ¼ to \>1/2 spirals per mm Tend to carry better and give better tactile sense, but don't cut as aggressively •Used in a push-pull or in a ¼ turn and pull fashion

Answer 8

H-File Made by machine cutting a round blank to remove a triangular spiral and thus leaving a continuous spiral with a thin core

Answer 9

K file Square makes a cutting circle in 1/4 turn (90 deg turn will bring a new cutting face the position where adjacent one started) Triangle makes a cutting circle in 1/3 of a turn (need to rotate a triangle 120 deg to bring another cutting flute into position of the adjacent one Rhombus needs to turn 180 degrees because it's asymmetrical, need to go halfway around to brig a new flute to the position of the adjacent cutting flute (which is on the opposite side)

Answer 10

K file is Stiffer, has a lower cutting ability, and is less prone to breakage H file is less stiff, more aggressive cutting, and more prone to breakage

Answer 11

Will thread into dentin when rotated, and dethreading it will stress or break the metal. Baically an H file is a long, skinny screw

Answer 12

standard taper is 0.02. means for every mm of length of the file, it gets 0.02 mm wider.

Answer 13

White Yellow Red Blue Green Black Begins at 15, and goes by 5's until 60 then by 10's for every colour. N.B. Lightspeed does have a 65 file, it is also blue, like the 60. 70's are green

Answer 14

it is the fraction of a milimetre in width at the tip of the file ie. 50 ie 0.5 mm 15 is 0.15 mm 100 is 1.0 mm

Answer 15

Blunt tips - will only follow a canal, won't cut a new one radial lands - spaced between cutting edges that are at the periphery of the file, but non cutting negative rake angle - promotes scraping rather than cutting

Answer 16

For ribbon shaped canals, and for making a good coronal flare (used in a push pull manner only and more aggressive cutting.

Answer 17

lateral compaction, have a pointy end

Answer 18

Vertical compaction, have a flat end

Answer 19

made from the sap of the "palaquim" tree (*Palaquim gutta*)

Answer 20

alpha phase - sticky, pliable and will flow under pressure beta phase - cones are beta phase, more rigid Heat will transform from beta to alpha, cooling and condensing will shift it back (VERY slow cooling will allow it to remain alpha, but this doesn't usually happen with normal compacting and cooling)

Answer 21

18–22% gutta‐percha 59–76% zinc oxide remainder being a combination of radiodense materials and plasticizers Cohen's lists: Gutta-percha (19%–22%) Zinc oxide (59%–79%) Heavy metal salts (1%–17%) Wax or resin (1%–4%)

Answer 22

Standard cones correspond to ISO sizes Conventional cones manufactured to be similar in taper to spreaders for use as accessory cones

Answer 23

* lubricate the root canal, * dissolve organic pulp and necrotic debris, * soften dentin, * destroy bacteria, * flush debris from the canal * remove the smear layer

Answer 24

Lubricates softens dentin dissolves inorganic debris bactericidal

Answer 25

not effective in removing the biofilm or dissolving necrotic organic tissue

Answer 26

dissolve inorganic material, dissolve organic tissue, biocompatible, antibacterial, non‐toxic, penetrate dentinal tubules, easy to use Bleach (NaOCL) either full strength (6%) or half strength (3%)

Answer 27

•Instruments are passively placed in the canal and rotated 90° clockwise to engage canal wall dentin and then rotated counterclockwise as axial force is applied to the instrument Helps K-Files remain centred with fewer complications

Answer 28

* Place fitted master cone in the canal with the sealant * Pre-fit a spreader, and after master cone in place, jam the spreader in to 1-2 mm short of apex. * Don’t split the root, and place an accessory cone. * Repeat until 2/3 of canal is obturqated

Answer 29

* Heat and roll together 2-3 large GP cones and place while warm. * May help in very large canals which are challenging to instrument * Can re-soften the tip for better adaptation with heat, eucalyptol or chloroform dip for 3-5 seconds * Used in very large, immature canals.

Answer 30

* Usually used with warm compaction * Use a heated instrument (red-hot) to heat the GP core after in place with sealer. Withdraw the heated instrument and use a plugger to vertically compact the warm material * Repeat with additional pieces of GP until filled

Answer 31

* Measure plugger 5-7 mm short of the apex. * Place a GP cone and sealer, and then put a plugger that can be heated. * Push it to 2-3 mm from the measured point, and allow it to cool while maintaining the force * Heat it again prior to withdrawl * Fill remainder of canal with sealer and GP

Answer 32

* Plug made for use with lightspeed * Place to 2-3mm from the apex for a test fit. * Apply sealer with a lentulo and spread with a paper point. * Place the plug, and check with a rad, unthread the carrier * Place a GP cone and more sealer * Remove excess with a heated plugger, and then vertically compact

Answer 33

* Basically Guttaflow * polydimethylsiloxane containing small particles of gutta‐percha * No additional sealer * Fill canals by injection, or lentulo * Can use with a master GP cone, or above techniques for large canals

Answer 34

* Sealer applied * Heated GP placed into canal and compacted while warm * Will have shrinkage due to cooling, * Compacting it while warm will compensate for the shrinkage

Answer 35

* Use a slowspeed handpiece at 10,000-12,000RPM and a compacting instrument * Feed instrument in beside the GP * As it rotates, heat is generated, and blades force the GP apically and laterally * Feed in additional points as it’s withdrawn * Not usually used in vet endodontics

Answer 36

Over or under extended refers to the vertical dimension of the fill. filled beyone the apex is termed over extended filled short of the apex is underextended

Answer 37

It refers to the fill in any dimension. overall quality of the obturation.

Answer 38

some sealers (eugenol) will inhibit the polymerization of composites

Answer 39

•If struggling to find a canal, expose the whole floor of the chamber in the region and then put a drop of bleach of hydrogen peroxide – will bubble over the canal

Answer 40

to establish an unrestricted passageway from the crown and through the pulpal cavity to the apical terminus of the endodontic canal

Answer 41

Chelating agents such as ethylene‐diamine‐tetra‐aceticacid (EDTA) can be used to aid in the dissolution of inorganic calcification within the canal

Answer 42

Damage to the floor of the pulp chamber, but not through to the PDL

Answer 43

ledging or transportation

Answer 44

prevention: prebend stiff files, use flexible files, don't use too much apical presssure management: prebend a file at 45 deg and use with tip towards the trus canal, springiness should help direct it into place. continue with bent files until filing complete

Answer 45

Zipping or elliptication

Answer 46

Enlarge the whole canal to remove the elbow adjacent to the apical vault

Answer 47

Stripping/lateral perforation

Answer 48

* Caused by overzealous instrumentation in the mid root area. * Prevent with judicious filing and anti-curvature pressure Treat perforation with MTA. If it won't stop bleeding, use an intracanal medicament CaOH for 2-3 weeks

Answer 49

Backup technique is used to create a new apical stop.

Answer 50

Vital pulp therapy apexification/apexigenesis (regenerative endodontics?)

Answer 51

The goal is to stimulate root end closure (or a hard tissue barrier to serve as a closed root end), so that eventually a standard endodontic procedure may be carried out.

Answer 52

6-24 months

Answer 53

•EDTA is helpful because it may help to release growth factors involved in odontogenesis from dentin

Answer 54

* Primary - Elimination of symptoms * Secondary - Increased root wall thickness, increased root length * Tertiary - Positive vitality testing

Answer 55

stem cells growth/differentiation factors scaffolding

Answer 56

periapical cyst (those pesky rests of mallasez) apicoectomy, curettage, and histopathology indicated

Answer 57

internal root apex inaccessibility external root end complications

Answer 58

Four categories of apical surgical intervention are: periradicular drainage, periapical curettage, apical resection or apicoectomy, and retrograde obturation or filling.

Answer 59

* Removal of a diseased apex * Allow access for retrograde filling.

Answer 60

A flat resection

Answer 61

Class I preparation

Answer 62

Slot of Matzuri

Answer 63

Zinc oxide cements or MTA