Microbiological aspects of endodontics Flashcards
Failure of endodontics is due to:
- Failure to remove sufficient bacteria from the root canal
- Re-invasion of the root canal by bacteria at later time
List ways bacteria can enter the pulp:
- Direct exposure - crown fracture, caries
- Exposure of dentine - deep cavity prep, leaky restoration
- Exposure of accessory canals and apical foramen - extensive recession
Most endodontic microbial flora are?
Most are obligate anaerobes. No single microorganism
List the summary of steps in endo and ways to reduce endodontic microbial flora
- Aseptic procedures
- Tooth preparation prior to endodontic treatment
- Rubber dam isolation
- Cleaning and shaping root canals
- Irrigation
- Medication
- Temporary restoration
- Obturation
- Restoration
When is medicaments applied?
Applied after mechanical instrumentation but before obturation (between appointments)
Purpose of medicament?
- Eliminate remaining microbes
- Prevent re-colonization of canal between appointments
- Reduce periapical inflammation
- Promote periapical healing
- Control inflammatory root resorption
List types of medicaments
- chemical antiseptics (e.g. Ca(OH)2)
- Antibiotic preparations (e.g. Ledermix or odontopaste)
List application options
- Lentulo -> spiraled slow-speed applicator
- K file
- Injection with needle
Describe Ledermix paste (medicament)
- Rapid relief of pain with acute pulpal and periodontal inflammation
- Active compounds: anti-inflammatory cortisone derivative; broad-range antibiotic
- Non-setting
- Cons: discolours teeth
Describe odontopaste (medicament)
- zinc oxide-based root canal paste
- Active compounds: anti-inflammatory cortisone derivative; antibiotic
- Does NOT stain teeth
Cons of odontopaste
- Does NOT eliminate all bacteria
- Cannot be mixed with 50:50 ratio with Ca(OH)2. Only 0.5% Ca(OH)2 is allowed
Describe properties of calcium hydroxide (Ca(OH)2)
- pH 12.5
- Anti-bacterial due to high alkalinity
- Non-setting
