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endo II > lecture 5: case selection and recall responsibilites > Flashcards

lecture 5: case selection and recall responsibilites Flashcards

1
Q

can you treat it?

A

no - it has calcified canals

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2
Q

what is the sigle most important factor affecting RCT success

A

case selection

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3
Q

can we treat this

A

probs not has canal sclerosis.

so makes it hard to do.

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4
Q

can we tx this

A

probs not, difficult to tx bc of canal sclerosis

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5
Q

is the tooth strategic and functional?

is the tooth restorable?

is it periodontally sound?

is the investment justified by the benefits?

A

subsequent considerations

is the tooth restorable is an impt question.

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6
Q

what do we see here?

A

there should be 4 canals, ther is a missing MB2

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7
Q

what do we see here?

A

periapical lesion

probs from a missed 4th canal in the molar

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8
Q

can we tx this?

A

if there is no antagonist then will not do pt justice to restore it.

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9
Q

can we tx this?

A

the tooth itself is not restorable, too much decay

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10
Q

can we tx this

A

no, it is missing at least 2mm of sound dentin that is needed to do a RCT.

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11
Q

can we tx this?

A

no, it is not periodontally sound

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12
Q

what is the case difficulty assessment form

A

it helps you determine the difficulty level, so you have a reasonable basis to decide if you should accept or refer the case

made by the AAE

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13
Q

the AAE endodontic case difficulty assessment form includes what

A

Colum Categories are:

  1. minimal 2. moderate 3. high risk.
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14
Q

re-treatment and procedural indicidents are always what category of aae difficulty assessment form

A

high risk

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15
Q

can we tx this?

A

yes, it meets the subsequent considerations.

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16
Q

at umkc, AAE case difficulty is:

category 1

category 2

category 3

A

category 1: undergrad

category 2: endo honors/advanced endo

category 3: advanced endo

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17
Q

at umkc undergrads can do what:

A

category 1 cases include:

  • no 2M or 3M
  • no M until 2-3 successful ant done
  • nothing through a crown
  • approved by endo faculty for all undergrad
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18
Q

can we tx this

A

no

if we cannot see the chamber then we will not be able to find canals

this happens after many years of trauma.

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19
Q

can we tx this

A

no

its is invasive resportion or perforating internal resorption

need to take CBCT and othe tech to do so.

20
Q

can we tx this

A

no

its is invasive resportion or perforating internal resorption

need to take CBCT and othe tech to do so.

21
Q

can we tx this

A

no

its is invasive resportion or perforating internal resorption

need to take CBCT and othe tech to do so.

22
Q

can we tx this

A

probs not, you would predict potential problems and see that these teeth have aberrant anatomy

it is a “nightmare”

23
Q

can we tx this

A

us probs not, refer, you would predict potential problems and see that these teeth have aberrant anatomy

here it splits into different roots

24
Q

what is wrong here

A

they missed the second canal in this md PM

24% of pts have this second canal

25
Q

whats wrong here

A

they missed the second canal in this md PM

24% of pts have this second canal

26
Q

can we tx this

A

it is very difficult

tipped, malposed or malformed teeth are all very difficult

27
Q

can we tx this

A

tipped, malposed or malformed teeth are all very difficult

28
Q

can we tx this

A

GD, probs not, refer out

why? because this tooth is LONG, a long tooth may be 2x the work AND time of a normal length tooth.

teeth with long roots are anything over 23mm

need special instruments

29
Q

can we tx this

A

difficult because it is a 4th canal mand molar

C-shaped canals are also very difficult (seen in 2nd MX M)

and radix = an additional root

30
Q

can we tx?

A

probs not, this is a high cervical break, which means there is a 45 degree bend, even if the root isnt that curved, it still makes it difficult to tx.

31
Q

can we tx this?

A

probs not, refer, becaues there is LOTS of curvature happening here.

Seen in the apical 1/3, middle 1/3 AND the roots are really long.

32
Q

what 4 things should we routinely refer:

A
  1. procedural incidents (instrument separation, most or all perforations, if you cannot find a canal)
  2. Surgery cases
  3. Re-tx cases
  4. Insoluble paste RCT (different than GP, hard to break through)
33
Q

can we tx this?

A

there is an OPEN APEX so, no.

why? bc you cannot seat GP with an open apex. You would have to do a different technique and would need microscopes.

Refer.

34
Q

when should you refer?

A

ANYTIME before or during the dx or tx.

35
Q

how often should you recall endo procedures?

A

6, 12, and 24 months after tx.

this is your professional responsibility, ethical and moral obligation and legal mandate.

36
Q

when should you recall procedures?

A
  • immediately if the pt reports adverse S/S
  • minimum recalls intervals months to a year later (6, 12, 24)
37
Q

if pt has adverse s/s after RCT tx what should you do?

A

recall immediately

S/S include:

  • infection, pain, or continued sensitivity.
  • DST.
38
Q

what is the purpose of endo recall?

A
  • assess the status of tx tooth
  • healed/healing (will see if it is function or diseased) want to pay attention that the lesion is getting smaller.
  • determine the need for additional tx
  • document recall procedures
39
Q

how much success do you have on endo:

A

well over 90% (assuming intelligent case selection)

and assuming competent and careful technique.

40
Q

can we tx this

A

yes. as pre-doc too.

has big pulp chamber, 2 root canals.

41
Q

can we tx this?

A

yes. even as predocs.

42
Q

can we tx this.

A

yes, as endo honors?

why? see a fast break.

43
Q

can we tx this?

A

probs not, refer.

there are pulp stones, the roots are really long and thin.

44
Q

what is the #1 rule for refferal:

A

refer when it is in the BEST interest of your pt.

but also, do the math, sometimes can loose money and incurliabiltiy, so better off just to refer.

45
Q

is the case selection a form of infomed consent to the pt, and what things does it include?

A

yes.

the patient has to understand all the complexities of what happens after the RCT, the cost of RCT and all the related services too like a crown.

The pt has to know everything that can go well or wrong during RCT too.

46
Q

guidelines for a reffer for AGD:

A
  • name and contact info for the pt
  • appointment time
  • reason for the referral
  • general background which may affect the case
  • med and dental info
  • med consultations and specific probs
  • prev. dental history
  • and XRAYS

it is a 2 way communcation between endodontist and GD.

endo II (7 decks)

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