Midterm Study Guide Flashcards
Dentists are held to the ____ safe standard as endodontists
Same
Working length is:
1.0 mm short of canal exit
Device used in clinic (not lab) to determine working length:
Apex locator
Gentle right and left rocking motion, which causes the instrument to cut while a light inward pressure, keeps the file engaged and progressing toward the apex.
Watch-winding motion
Technique used during scouting of the canal with a hand file:
Watch-winding
Increased responsiveness and reduced thresholds of nociceptors to stimulation of their receptive field:
Peripheral sensitization
T/F: Myofascial pain emanates from small foci of hyper excitable muscle tissue (trigger points)
True
You can see the canal from access with:
endo explorer
Best prognosis:
Pure endo lesion
Worst prognosis:
True combined lesion
Patient presents to clinic with a lesion described as:
- wide base
- cone shaped
- calculus present
What origin is this lesion?
Periodontal origin
Vertical root fracture is described by:
- J-shaped lesion
- Drop off pocket
- something else
(all of the above)
Vortex blue size for straight-line access and high cervical break:
.25/.12
A 4th root (DL Canal) found in molars especially in Native American and some Asian populations
This 4th root exits the coronal portion of the tooth in a lingual direction and often curves abruptly back to the facial
Bulls eye
Tooth #29 has a total length of 24 mm and a crown length is 9mm, to file the middle 1/3 of root with wave one file, one would set the stop at:
19mm
Take total length - crown length then divide that by 3
24-9 = 15
15/3= 5
First 1/3: (9+5= 14)
Middle 1/3: (14+5 =19)
Apical 1/3: (19+5=24)
What file do we use for scouting?
10
T/F: Master cone should be placed in a wet canal
False
T/F: It is NOT necessary to take master cone x-ray if you did proper fitting
True
T/F: Incident report should be filed within 24hrs
False- must be filled out within 48 hours
Select all that apply for a recall appointment:
- tooth pain
- DST
- something else
Best radiographic option to see resorptive defects:
CBCT
Possibly the worst iatrogenic injury; caused when a large instrument is misdirected or used aggressively
Strip performaton
“too thick in canal”
A- Zip
B- Crown perforation
C- Strip perforation
All posterior teeth need a full restoration after RCT because:
A- esthetic concern for patient
B- prevent root fracture
C- proper healing and function
D- all of the above
(All of the above)
A straight file would cause a ledge on what wall of the curve?
Outer wall of canal
Iatrogenic error means:
caused by clinician
The mesial root of the mandibular molar occurs:
distal
Select the 2 teeth most likely to have 2 roots:
A- Max 1st PM
B- Max 2nd PM
C- Mand 1st PM
D- Mand 2nd PM
A & B
What is the shape of access for maxillary central incisor?
Triangle with base at incisal
Master cone should only bind at:
working length
Why do we use a #15 file to radiograph?
because a #10 is too thin and you can see #15 better
All are incorrect except:
Hand files do not need to be lubricated
(Canal needs to be irrigated following any active instrument)
What is a common mistake for boards?
Access
All requires an incident report except:
too much NaOCl
Where do we bend irrigation syringe?
2 mm from tip
what canal is commonly missed in the maxillary first molar?
MB2 canal
Pt presents with this dilacerated tooth, what treatment should be done?
re-treat with endo (refer this tho for someone else)
Patient presents with a maxillary first molar that has been previously treated with endo, however after a few years the P/A lesion has not healed. What is your diagnosis?
Missed MB2 canal; non-surgical pretreatment
A student doctor perforated the coronal part of the root. The pt only had pulpal symptoms before, but after that RCT, they had periapical symptoms. What do you do now?
- carefully disinfect area (NaOCl)
- protect found canals with easily removable material
- complete easily removable temp seal over perf using “cavit” or IRM
- Seal the tooth with a secure temp filling over cotton pellet
- refer to endo
Pt presents with fever and slight swelling. What is your PA diagnosis?
AAA- Acute apical abscess
There was a molar that had an RCT a few weeks ago. PA symptoms now, and there was a possibility of perforation. What do you do?
Refer due to possible perforation
Persone presents with a bump on their gums that appears to be a “pimple”. What is your diagnosis and what should you do?
DST; Trace with gutta percha points on radiograph to determine tooth affected. RCT?
What do you need for hydraulic technique?
BC sealer and 0.04 GP cone (singular cone)
What do you need for cold lateral compaction (CLC)technique?
0.02 cone, finger spreaders, accessory GP cones
What is temp of alpha phase? What is temp of beta phase?
Alpha: 42-44
beta: below 42
What is the main component of gutta percha?
zinc oxide
What do you use to get rid of dentin triangle?
.25/.12 vortex orfice opener
What size files do you scout canals with?
10
What bend do you have to do to get past curves?
45 degree in last 1.5mm (maybe last 2 mm)
When are you done with the vortex?
When you have white filings on the apical 1/3
Where are you gonna transport the canal?
outer wall of canal
What is it when 2 canals from orifice turn into 1 canal at apex?
type 2
Describe a Type 2 canal:
two at orfice, one at apex
How do you determine between a type 2 or type 3 canal?
Two file technique
The two file technique can help determine between:
Type 2 and Type 3 canals
The single most important factor for RCT success is…
case selection
T/F: WL is 1 mm beyond apex
False- 1mm shy of apex
What does the apex locator tell you?
Where the apex constricts/ when you’ve gone beyond the apex and out of the tooth
T/F: If you perforate: then dry carefully, put CaOH, then put cavit, then cotton, then temp restoration.
True
What’s the main thing we use bw appointments in the canals?
CaOH
Which one is transported easily?
- distal of mesial root in mandibular molars
- MF of upper molars and upper premolars (with 2 roots)
Which one is the least likely to get transported?
MANDIBULAR PM
a. MF canals of max molars
b. 2 canal PMs
c. Mesial canals of mand molars
(these are all likely to get transported)
What is the worst mistake to make?
Perforation
Iatrogenic errors can be prevented with education, care, etc:
true
Ledges can lead to
blockage, transportation, perforation
After correct dx, there is never an excuse to do RCT on the wrong tooth
true
Which is not a consideration when deciding if you can do RCT?
color of the pulp
What do you use to get rid of smear layer?
EDTA
Something about how long the apical constriction is or something
1mm
What’s the purpose of recall appointment?
- to determine status of tooth (healed/ diseased)
- for documentation purposes
- to see if further treatment is needed
What step is done following determination of WL?
Create glide path using #15
What do you do for a blow out?
shorten the working length and create more of a taper (SSB)
What is the preferred thing to fix perforations?
MTA
what file do you use for the Buccal of maxillary premolar?
.30/.06
Primary consideration for RCT tx except
Esthetics
why use wave one every 1/3 of root?
because they push debris ahead of file
shape of maxillary central incisors access?
triangle with base toward incisal
obturate canal?
goes to WL
