Midterm Review Flashcards
Periodontal Probing - Subjective or Objective?
Objective
*Experiencing sensitivity to ice on an affected tooth - Subjective or Objective?
Subjective
Assessing radiographs of an area of concern - Subjective or Objective?
Objective
Experiencing pain upon chewing, even on a piece of bread - Subjective or Objective?
Subjective
Tooth disclorations - Subjective or Objective?
Objective
Sensitivity when drinking hot coffee
- Subjective or Objective?
Subjective
Experiencing pressure pain when the gingiva is pushed on - Subjective or Objective?
Subjective
What instrument will the dentist require to locate opening of the canals?
Endodontic explorer
What instrument will the dentist require to remove remaining pulp tissue?
Endodontic long shank spoon excavator
What material will the dentist require to dry inside the canals?
Sterile absorbent paper points
What material will the dentist require to fill pulp chamber after obturation?
Gutta-Percha
What instrument will the dentist require to heat and inject gutta percha inside the canal?
Gutta-percha warming unit
What instrument will the dentist require to condense gutta percha laterally in the canal?
Endodontic Spreader
What instrument will the dentist require to condense gutta percha vertically in the canal?
Endodontic Plugger
What instrument will the dentist require to condense, sever (cut) and carry material into the tooth?
Glick instrument
After high and slow speed handpiece had been used and canals had been located. What instrument will the dentist require to clean and shape inner canal walls?
K Type File Manual and/or Rotary Endodontic Handpiece
What instrument will the dentist require to remove pulp tissue from canals?
Broach (fishhook like)
What instrument will the dentist require to remove dentin, smooth and enlarge the canals?
Reamer file (similar to K type file but cutting edges are further apart)
What instrument will the dentist require to clean, smooth and/or perform final enlargement of the canal’s inner walls?
Hedstrom File (spiral edges)
What instrument will the dentist require to enlarge or open the walls of the pulp chamber?
Gates Glidden Bur/Drill
What instrument will the dentist require to prepare tooth for a post placement?
Peso File
What instrument will the dentist require to insert endodontic sealer inside the canal(s)?
Lentulo Spiral
What instrument will the dentist require to attach rotary files?
Rotary Endodontic Handpiece
Files that clean canals?
K Type file
Hedstrom file
File hat shape canals?
K Type file
File that removes pulp tissue?
Broach
Files that smooth canals?
-Reamer
-Hedstrom file
Files that enlarge canals?
-Reamer
-Hedstrom
-Gates Glidden Bur/Drill
What instruments/materials will the dentist require to flush out bacteria and debris from the canals?
Endodontic Irrigating Syring, Sodium Hypochlorite or Chlorhexidine or EDTA
What instrument will the dentist require to keep dental files in proper order?
Endodontic Stand
What instrument will the dentist require to measure files in millimeters?
Endodontic ruler
What instrument will the dentist require to set up desired length of the files?
endodontic stoppers
What instrument will the dentist require to electronically measure the entire length of the canal?
Apex locator
Name the procedure in which only the coronal portion of the pulp is removed.
A pulpotomy is the removal of the coronal portion of the pulp, and the treatment of the remaining radicular pulp.
What are the supernumerary teeth found at the midline called?
Mesiodens
Name the procedure commonly used to facilitate closure of a diastema caused by thick frenulum tissue between the centrals.
Frenectomy
Reasons for retaining primary teeth
For proper nutrition intake
For jaw and face development
For sound and speech development
To retain space for permanent teeth
For esthetic reasons
A Class III fracture is..
When the fracture involves the enamel, dentin and extends to the pulp
According to Erikson, what basic conflict is present for a two year old child?
Autonomy vs. Shame
What is a child’s level of intelletual capacity and development called?
Mental age
Reasons why stainless steel crowns are used as a restorative material in pedodontics.
-They can be prepared and placed at a single appointment
-They are sufficiently durable to last until the primary teeth are replaced by the permanent
-They are almost always well tolerated by the ginigiva of young patients
-They are much less expensive than cast restorations
List 3 types of tests used to determine pulp vitality.
Radiographs
Percussion & Palpation
Thermal Testing
Electrical Pulp Testing
Describe diagnostic conclusions for endodontic therapy.
Early Pulpal Disease
Irreversible Pulpitis
Necrotic Pulp
Describe surgical endodontics and explain why it is performed.
Surgical endodontic procedures (apical curettage, apicoectomy, retrograte restoration, root amputation) are performed when conventional root canal treatments are not successful or they are not an option. Common reasons for surgical endodontics are..
- when there has been a failure of the RCT
-when surgery is required into the apex and perapical tissue
-to perform biopsy
_____ is the surgical removal of infectious material surrounding the apex of a root.
Apical Curettage
A(n) _______ is a healthy tooth used as a standard to compare questionable teeth of a similar size and structure during pulp vitality testing.
control tooth
A(n) _____ is localized area of pus that originates from an infection.
abscess
______ is an examination technique that involves tapping on the incisal or occlusal surface of a tooth to determine vitality.
Percussion
______ is a plastic type of filling material used in root canal therapy.
gutta-percha
A(n) _____ is the placement of calcium hydroxide over a not completely exposed pulp.
indirect pulp cap
_____ means not living.
non-vital
____ is a term used to remove or clean out the pulpal canal.
Debridement
_____ is a technique to touch or feel for abnormalities of the soft tissue.
Palpation
____ is the procedure whereby the dental pulp is removed, and the canal is filled with a permanent dental material.
root canal therapy
A(n) ____ is the application of calcium hydroxide to a cavity prepartion in which the dental pulp is fully or partially exposed.
direct pulp cap
To break through and extend beyond the apex of the root is ______.
perforation
Nerves, blood vessels, and tissue that surround the root of the tooth are called _____.
Periradicular
A(n) __________ is the removal of a vital pulp from the coronal portion of the tooth.
pulpotomy
_______ is inflammation of the dental pulp.
pulpitis
A small restoration placed at the apex of a root is _____.
Retrograde restoration
A dentist who specializes in the prevention, diagnosis, and treatment of the dental pulp and periradicular tissues is a(n) ______.
Endodontist
____ occurs when there is pulpal inflammation, but the pulp may be salvageable.
reversible pulpitis/early pulp disease
Periradicular tissues are ________.
Tissues that surround the root of a tooth
What dental emergency can result if bacteria reach the nerves and blood vessels of a tooth?
Abscess
Is pain subjective or objective component of a diagnosis?
Subjective
Tooth #5 (1.4) is being considered for possible root canal therapy. Which tooth would be used as a control tooth?
12 (2.4)
*same tooth in opposite quadrant
When the dentist taps on a tooth, what diagnostic test is being performed?
Percussion
What type of radiograph would be exposed through-out root canal therapy?
Periapical
The diagnosis of inflamed pulp tissues is..
pulpitis
Another term for necrotic is ______
non-vital
The dental material selected for a pulp cap is ________________.
calcium hydroxide
What portion of the pulp would the dentist remove in a pulpotomy?
Coronal Portion
What instrument has tiny projections and is used to remove pulp tissue?
Broach
What type of file would be selected for the final enlargement of a pulpal canal?
Hedstrom File
A rubber stop is placed o a file to ______
prevent perforation and to maintain the correct measurement of the canal
To obturate means to _____
fill a pulpal canal (debride is to remove pulp)
the irrigation solution recommended during root canal therapy is ______
diluted sodium hypochlorite (bleach)
the dental material commonly selected for obturation of a canal is…
gutta-percha
The type of moisture control recommended by the ADA for root canal therapy is ..
dental dam
What surface of a posterior tooth would the dentist enter with a rotary bur when opening a canal for RCT?
Occlusal
____________ is a surgical procedure that involves the removal of the apex of the root.
Apicoectomy
What is the difference between a root canal & a pulpectomy?
A pulpectomy is complete removal of pulp from the crown and roots. The tooth is then filled with material that can be reabsorbed by the body. It’s usually performed on baby teeth. A root canal starts with a pulpectomy, but the tooth gets a permanent filling or crown.
A tooth that has been torn away or dislodged by force is said to be ___________.
avulsed
_____ occurs when teeth are displaced from their position in the mouth.
extrusion
When a tooth has been pushed ito the socket as a result of injury, it is __________.
intrusion
The ______ is a type of matrix used for primary teeth.
T-band
The specialty of dentristry concerned with infants through adolescent and special needs patients is _____________.
pediatric dentistry
_____ is a concept of layout used in pediatric dental practices.
Open bay
A(n) _________ is a dental procedure in which the coronal portion of the dental pulp is removed.
Pulpotomy
How long will a pediatric dentist continue his or her education after dental school?
2 to 3 years
What is unique about the treatment areas of a pediatric practice?
Many are designed with the open-bay concept
What is a device that can be used to gently restrain pediatric patients?
Protective stabilization
When should children first see a dentist for regular examinations?
When their first tooth erupts
How often are radiographs recommended to be taken in a child with a high risk of decay?
every six months
What procedure is recommended to protect the pits and fissures of posterior teeth?
Sealants
For pediatrics, fluoride varnish is applied as
direct gel
At what phase of orhtodontics would a pediatric dentist intercede in getting a patient to stop sucking his or her thumb?
Preventive
What endodontic procedure is performed on a primary molar?
Pulpotomy
Would a child be refered to a prosthodontist for the placement of a stainless steel crown?
No
In children, which teeth are most commonly injured?
Maxillary Anterior
When a tooth is avulsed, it has ____
come out
How would the dentist stabilize a tooth after an avulsion?
with a temporary splint
Which tisses surround the root of the tooth
Periradicular
For which set of patients does a pediatric dentist focus on providing oral healthcare?
Infants, children & adolescents
how is mental age determined?
The childs level intellectual capacity and development
What are the guidelines for establishing trust between the child and the dentist?
Tell, show, do
Pediatric dentists recommend the first appointment for a child should take place by ___ years of age.
1
How often is it recommended that radiographic imaging be performed for children at high risk for tooth decay?
6 months
How will a dentist restore a severely decayed and endodontically treated primary tooth?
stainless steel crowns
The success rate for replantation of permanent teeth is highest when the tooth is replanted within _____ minutes of the avulsion.
30 minutes
Which government acgency should be contacted in cases of suspected child abuse?
Child Protective Services
Which services would NOT be routlinely provided in a pediatric dental office?
Third molar extractions
Which of the following is incorrect regarding the design of most pediatric offices?
Children are separated in individual operation rooms.
Until what age is it easier to have the parent be with the child for the dental examination?
2 years
which guideline should not be used routinely when treating children?
tell the child that it will not hurt
Which type of restraint should be avoided for children with behaviour problems?
Having the parent physically hold them
Which statement is incorrect regarding stainless steel crowns
They have high quality cervical margins
TRUE IS..
-They may be used to restore a fractured tooth
-they are durable enough to last until perm teeth erupt
-they are indicated when there is a severely decayed tooth
If the pulp of the newly erupted permanent tooth has been exposed, this procedure promotes healing of the pulp?
Direct pulp cap with calcium hydroxide
would pain be an objective or subjective component of a diagnosis?
Subjective
When a dentist taps on a tooth, what diagnositic test is being performed?
Percussion
True or False - DAs can perform cold tests?
t
How many radiograph images may be taken through the course of root canal therapy?
5 PAs (including the 6 month post operative check)
4 PAs during the actual procedure
What diagnosis is given when pulpal tissues are inflamed?
Pulpitis
What treatment is used to atempt to save the pulp and encourage the formation of dentin at the site of the injury?
Pulp capping
What procedure removes a root from a multirooted tooth?
root amputation
Give another term for necrotic or necrosis
NON VITAL
What dental material is commonly selected for pulp capping?
Calcium hydroxide
What portion of the pulp is removed for a pulpotomy?
Coronal portion only
What dental instrument has tiny projections and can be used to remove pulp tissue?
Barbed broach
What is the term for a tooth that has been completely knocked out of the mouth?
avulsed
Used for initial debridement. Flexible file will be requested when the canals are curved, stiff file will be requested when canals are straight.
K-Type File
What is Hedstrom File used for?
Used for final enlargment of the canals
What is the Reamer file used for?
Used to remove dentin, smooth and enlarge the canal
What is the Broach Files used for?
Used to remove pulp tissue from canals as well as cleftover otton pellet or cement residue.
What is Gate-Glidden burs/drills used for?
Used to enlarge the walls of the pulp chamber
What is the Pesso file used for?
Used to prepare area for post placement
What can cause Pulpal nerve damage?
Physical irritation:
-mild sensitivity to complete nerve death or infection of surrounding tissues
-extensive decay moving into the pulp
-abscess can also form
Trauma:
-blow to a tooth or the jaw causes damage to surrounding tissues, which damages to nerve tissues and blood vessles
What is the most common cause of pulpal damage?
cavities
Trauma can cause pulpal damage via:
-broken teeth
-chipped teeth
-cracked teeth
-fractured teeth
-attrition
-erosion
-if a filling is too high
-grinding & clenching
What are common signs and symptoms of pulpal damage?
-Pain when occluding, chewing
-Sensitivity to hot or cold beverages
- Swelling of the face
What is Percussion - what does it determine?
tapping the incisal or occlusal surface of the tooth with the handle of a mouth mirror and comparing it to a “control” tooth - used to assess the extent of inflammation into the periapical tissues
What is Palpation - what does it determine?
applying firm pressure with the index finger to the mucosa near the apex of the tooth and to a “control” area - used to assess the extent of inflammation into the periapical tissues
how is a Cold Pulpal Test done?
Dry ice or ethyl chloride on a cotton applicator are used to apply a cold stimulus to a non-restored tooth and a “control” tooth
How is a heat test done?
Heated instrument or gutta percha
What does electric pulp testing determine?
Is used to identify if a tooth is vital or not
How does normal pulp react to hot/cold test?
reacts to hot and cold with a sudden reaction which disappears as soon as the stimulus is removed
How does early pulpal disease react to hot/cold test?
reacts with a sharp pain in the tooth that lingers as a throbbing pain once the stimulus is removed this is called pulpitis and depending on the circumstance, the pulp may recover
How does irreversible pulpitis react to hot/cold test?
reacts as a sharp severe pain which remains as a intolerable throbbing once the stimulus is removed – the pulp will not recover if this is the reaction as the vitality of the pulp decrease heat may create pain. Cold may relieve it the pulp will not recover at this stage
How does necrotic pulp react to hot/cold test?
no sensation at all within the pulp when either hot or cold stimulus is applied
endo treatment or extraction
How to treate reversible pulpitis?
eliminate irritant & placing sedative material can save the pulp
Can you treat irreversible pulpitis?
Pulp cannot and will not heal
Treat with RCT or extraction
Symptoms of chronic periradicular abscess?
Asymptomatic
some discharge of pus
Symptoms of periradicular abscess?
pain, tenderness to pressure, pus formation, swelling
Periodontal abscess vs Periapical Abscess?
Periodontal abscess forms due to infection that has moved deeper into the gum areas.
Periapical abscess is abscess of the tooth due to infection of the pulp.
What is Pulp Fibrosis?
A decrease in living cells within the pulp that causes fibrous tissue to take over the pulpal canal
- older patients or traumatic injury to tooth
What is a Periradicular Cyst?
develops at or near the root of a necrotic tooth
- inflammatory response to pulpal infection and necrosis of the pulp
How is pain relieved with “Open and Drain”?
- The pulp chamber of the tooth may be ‘opened’ to allow infection to drain and provide relief immediately
Traumatic ___ occurs when the injured tooth has been forced inward.
intrusion
Which of the following are designed to hold open space when a primary tooth has been lost prematurely?
Space maintainers
Where is a stainless steel crown contoured?
Cervical margin
What are indicators of child abuse?
bruises in various stages of healing
Trauma to oral tissues
bite marks
if a child is 10 years old and acts like an 8 year old, you are describing his or her ___ age.
emotional age
Which teeth are injured most frequently in a child’s mouth?
maxillary anterior
When performing a pulpotomy of a primary tooth, what instrument will the dentist use to remove pulp tissue?
Spoon excavator
Which item is NOT used in a pulpotomy procedure?
High speed handpiece
What is used..
ZOE base
Dental dam
slow-speed handpiece
A fracture to the crown of the tooth which also includes pulpal involvement is classifed as:
Class III
What is true of hand-operated files?
-are used for cleaning and shaping the pulpal canals
-designed for a specific function once placed in the tooth
-are available in stainless steel or nickle titanium
NOT colour coded according to the flexibility of file (its according to length)
Which process is used to remove bacteria, necrotic tissue, and organic debris from the root canal?
Debridement
What is the most common symptom of pulpal damage?
Sharp pain when occluding
Which sign or symptom is uncommon for pulpits?
FEVER
It is common for..
facial swelling
pain during chewing
sensitivity to hot/cold
Two types of tests that determine whether the inflammatory process has gone into the periapical tissues are ___ and ___.
palpation; percussion
If a tooth has necrotic pulp, it with NOT respond to:
hot and cold stimulus
When the tooth pulp has symptoms of lingering pain, a diagnosis of ___ can be made.
Irreversible pulpitis
What is pulp fibrosis?
The decerase of living cells within the pulp
What would NOT cause endodontic failure
recurrent caries
What would cause..
-severely curved roots
-accessory canal not being treated
-perforation of the canal
List the order of use for the instruments..
- Endodontic explorer
- Files
- Paper points
- Gutta Percha
- Glick
What is NOT a purpose of irrigation solutions in root canal therapy?
indication of root canal length
the purpose is for..
-bleeding control
-deodorizing the canal
-tissue dissolution
Thumb sucking beyond the age of ________, will affect the upper facial structure & anterior teeth.
5 years
What is debridement?
The process by which the pulpal tissue is completely removed from the tooth, and the canal or canals cleaned and shaped to receive the filling material.
What is Obturation?
the process by which the pulp canals and chamber are filled so that the tooth cannot be re-infected through the apical foramen and the tooth does not remain hollow
What type of local anesthetic is given for a severe pulpal infection?
Anesthetic is deposited directly into the pulp
Is local anesthetic required for a necrotic tooth?
NO!
What type of dental damp clamp is used for anterior root canal?
Anterior butterfly clamp
How does the dentist access pulp for anterior teeth?
Lingually - near the cingulum
(Posterior = occlusal)
What is Chemical Debridement?
Once the pulp has been removed from the canals, the dentist will destroy the bacteria present in the canals using irrigation syring with sodium hypochlorite or hydrogen peroxide
How is the length of a canal measured?
The traditional way to measure is to place small files into each canal to the depth of the estimated apex of the root, then take a radiograph to see if it is
correct
or by using an apex locator machine (uses sonar type waves)
Where in the root is debridement performed to?
TO the apex - not short or perforated through the foramen
What happens if an apex is perforated?
If an apex is perforated, it allows the root canal sealer to exit the tooth and may cause irritation in the alveolar bone
What would cause the apical bone to not properly heal after a RCT?
If the canals are not cleaned of all pulpal material or if the apex is perforated
What if the root canal is not completely debrided?
all bacterial/pulpal tissue must be eliminated from dentinal tubules… failure to do so will allow bacteria to re-infect the area, and may result in the dentist having to redo the entire endo procedure in the future
Why is Endo Surgery done?
to check the end of a tooth’s root for cracks
to remove parts of a root that could not be adequately sealed during conventional root canal treatment
to clear up infection that has not healed after conventional treatment
What is Apical curettage?
procedure where infectious and granular tissue is removed from the apical area of the a tooth
What is an apicoectomy?
Done when the apex was perforated, is the removal of the apex of the tooth
What is the most common endo surgery procedure?
Apicoectomy
When is a retrograde restoration done?
Done when the gutta percha filling in the canal did not reach the apex, and the remaining tissue is causing an ongoing infection
How is a Retrograde restoration completed?
- The apex of the tooth is opened with a surgical bur, to the area where gutta percha is visible
- On a diagonal across the apex
- A small restoration preparation is made in the apex, using a very tiny specialized handpiece and bur
What is a root amputation procedure?
one root, of a multirooted tooth, is removed, leaving the crown intact
What is a hemisection procedure?
is performed on mandibular molars, and involves bisecting the tooth at the furcation, and removing half the crown and one root
What is Emotional Age?
Childs level of emotional maturity
What are the management style options for a challenging child patient?
-speak calmly but firmly
-sedation
-nitrous oxide-oxygen
-physical restraint
What is a common oral condition for an Autistic patient?
Xerostomia - caused by psychotropic medications
What is often required for a patient with Cerebral Palsy?
Premedication is frequently required to help control and relax the patient. For some, general anesthesia may be necessary
What is interceptive treatment?
Prevents or eliminates irregularities in the developing dentition.
ex) Space maintainer, thumb sucking appliance, fixed appliance to correct cross-bite, palatal expansion appliance
When is indirect Pulp capping indicated?
Procedure used when decay is near the pulp chamber (but not exposed.)
What is the goal of indirect pulp capping?
To allow the pulp to form secondary dentin under the carious dentin so that a pulp exposure is avoided.
When is direct pulp capping indicated?
Indicated when the coronal portion of the pulp has been exposed. When performed the tooth is still vital.
What is the goal of a Pulpotomy?
the goal is to remove the inflamed portion of thepulp in the coronoal portion while maintaining the healthy vital pulp tissue within the canals.
What 2 materials can be used for a Pulpotomy?
Mineral Trioxide Aggregate (MTA) - stimulating healing and
osteogenesis
Calcium Hydroxide -Used on permanent teeth with open apices
What are the benefits of stainless-steel crowns for children?
- Can be placed in a single appointment
- Sufficiently durable
- Tolerated well by the gingiva
- Less expensive than cast restorations
What is a Pre-Trimmed Stainless Steel Crown?
They have straight sides and must be trimmed and ontoured to fit the tooth
What is a Pre-Contoured Stainless Steel Crown?
come precontoured and only require minimal adjustment
What is Traumatic Intrusion?
An injury where the tooth is forcibly driven into the alveolus
What is Extrusion and Lateral Luxation?
Injuries that occur when the teeth are displaced from their position
Extrusion - further out
Luxation - to the side
Severe damage to the periodontal ligaments usually
What should you do in an Avulsed tooth emergency?
- Recover tooth as fast as possible
- Wrap the tooth in a moistened paper towel or cloth
- Go ASAP to the dentist
best if its replanted within 30 minutes
What is a Pulpectomy?
“baby root canal”
The entire pulp is removed when the disease process has affected both the coronal and radicular areas. The procedure is the same as in an adult RCT, but instead of using an inert material to fill the pulp canals – the material chosen must be resorbable so no material is left in the site as the primary roots resorb and the permanent tooth erupts.
