Mixed Endodontic questions Flashcards

1
Q

Define apical delta category 1 to 4

A

Type I – no visible canal ramification
Type II delta – ramification confined to apical 1 mm of root
Type III delta – ramification confined to apical ramification within 1 to 3 mm range from the apex
Type IV delta – ramification extending beyond 3 mm from the root apex

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2
Q

Explain the different types

A
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3
Q

What type is this?

A

Type II delta

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4
Q

What type is this ?

A

Type II delta

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5
Q

What delta type?

A

Type III delta

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6
Q

What delta type ?

A

Type III delta

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7
Q

What delta type?

A

Type IV delta

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8
Q

What delta type is this ?

A

Type IV delta

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9
Q

According to Gamm et al, Prevalence and morphological features of apical deltas in the canine teeth of dogs - How many max, mand canines had an apical delta?

A

**69.7% **of mandibular and maxillary canines had an apical delta

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10
Q

According to Gamm et al, Prevalence and morphological features of apical deltas in the canine teeth of dogs - Did mandibular or maxillary canines have more apical delta ? If yes, what was the %

A

Mandibular canines showed more apical delta compared to maxillary canine

**78% mandibular canines **
56% maxillary canines

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11
Q

According to Gamm et al, Prevalence and morphological features of apical deltas in the canine teeth of dogs - Was there are difference between left and right arcade concerning apical delta in canines ?

A

NO - similar results

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12
Q

Hernandez 2014 - Scanning Electron Microscopic Evaluation of Tooth Root Apices in the Dog - what was the most common size of apical foramina diameter in this study?

A

85.44% had a diameter < 55 micrometer

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13
Q

Hernandez 2014 - Scanning Electron Microscopic Evaluation of Tooth Root Apices in the Dog - what was the most common apical shape ?

A

round to elliptical, round elliptical with mostly regular surfaces

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14
Q

Hernandez 2014 - Scanning Electron Microscopic Evaluation of Tooth Root Apices in the Dog - what was the result concerning diameter of apical foramina and the number of apical foramina between the 3 types of teeth?

A

diameter of apical foramina between the 3 different teeth type showed no significant difference but the number of apical foramina were different

mandibular 1st molar had the greatest amount of apical foramina compared to max 4th PM, canine teeth

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15
Q

Hernandez 2014 - Scanning Electron Microscopic Evaluation of Tooth Root Apices in the Dog - what is the apical delta length to entire root?

A

12 - 18 % of total length of the root

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16
Q

Hernandez 2014 - Scanning Electron Microscopic Evaluation of Tooth Root Apices in the Dog - what was the average apical height?

A

apical height around 2 mm

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17
Q

The entire delta apical is included into cementum - True or False?

A

true

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18
Q

what is RC, D, C

A

Root canal
Dentin
Cementum

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19
Q

What is that image?

A

small foramina that are concentrated near the terminal apex of the root

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20
Q

Hernandez et al, Scanning Electron Microscopy of Pulp Cavity Dentin in Dogs
JVD 2010
What factors of dentin tubules are influenced by age ?

A

diameter and area are influenced by age
NOT density

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21
Q

Hernandez et al, Scanning Electron Microscopy of Pulp Cavity Dentin in Dogs
JVD 2010
What factors are influenced in a coronal apical direction?

A

the diameter and dentin tubule area decrease from crown towards the root

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22
Q

Hernandez et al, Scanning Electron Microscopy of Pulp Cavity Dentin in Dogs
JVD 2010
dentin morphology differs at which section of the tooth- RAT, CR, RCT

A

dentin morphology is different at RAT compared to CR, RCT

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23
Q

what type of dentin is located in apical area ?

A

type III dentin is mainly in apical area
it is similar to tertiary dentin but not the same
human apical area has dentin type IIII

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24
Q

what is the significance of type 3 dentin ?

A

type III dentin does not favor adhesive technique based on penetration of resin into dentinal tubules

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25
Q

What should be the property of sealers?

A

Viscosity to flow and fill irregularities of RC
Provide a bond from obturation material to dentinal wall
Fill the spaces between the core obturation material and the dentinal walls

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26
Q

Give an example of an epoxy amine resin based sealer

A

AH +

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27
Q

Give an example of silicone based sealer

A

Gutta flow 2

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28
Q

List the properties of AH + sealer

A

Epoxy amide resin
long working time of 4 hours and minimum setting time of 8 hours
slight shrinkage during polymerization
volume decreases by 1.76%
excellent solubility
tensile bond strength 4-7 mPa
releases 3.9ppm formaldehyde - nontoxic range
cytotoxic for 4 hours - cause fibrous granulation if placed on tissue
flow characteristic: easy to mix and place and thixotropic

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29
Q

what is thixotropic ?

A

resin material becomes thinner and flows easier when stirred but thickens when left still

ability to decreases viscosity under slight pressure which increases flow ability

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30
Q

List the properties of Gutta flow 2

A

silicone based sealer
cold filling system
working time 10 - 15 min
curing time 25-30 min
Gutta flow 2 - fast - working time 4-5 min and curing time 8-10 min
Expands 0.2% after polymerization
0 % solubility
thixotrophic

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31
Q

Apexification

A

a procedure to promote apical closure of non vital tooth

32
Q

Apexogenesis

A

Physiological formation of the apex of a vital tooth

33
Q

Crown reduction

A

Partial removal of tooth substance to reduce the height or an abnormal extension of the clinical crown

34
Q

Crown amputation

A

Total removal of clinical crown substance

35
Q

Direct pulp capping

A

A procedure performed as part pf vital pulp therapy and involving the placement of a medicated material over an area of pulp exposure

36
Q

Endodontics

A

Specialty in dentistry and oral surgery concerned with the prevention, diagnosis, and treatment of diseases of the pulp dentine complex and their impact on associated tissue

37
Q

Hemisection

A

Splitting of a tooth into 2 separate portions

38
Q

Indirect pulp capping

A

A procedure involving the placement of a medicated material over an area of near pulp exposure

39
Q

Partial pulpectomy

A

Partial removal of pulp tissue to remove inflamed and diseased tissue and create space for medicated and restorative material

40
Q

Partial tooth resection

A

Partial removal of a tooth ( usually crown root segment) with endodontic treatment of the remainder tooth

41
Q

Retrograde filling

A

Restoration placed in the apical portion of the root canal after apicoectomy

42
Q

Root resection ( root amputation)

A

Removal of a root with maintenance of the entire crown and endodontic treatment of the reminder of the tooth

43
Q

Standard (orthograde) root canal therapy

A

A procedure that involves accessing, debriding ( including total pulpectomy), shaping, disinfecting and obturating the root canal and restoring the access and /or fracture sites

44
Q

Surgical ( retrograde) root canal therapy

A

A procedure that involves accessing the bone surface ( through mucosa or skin), fenestration of the bone over the root apex, apicoectomy, retrograde filling

45
Q

Vital pulp therapy

A

A procedure performed on a vital tooth with pulp exposure involving partial pulpectomy, direct pulp capping and access/fracture site restoration

46
Q

What is pulp capping ?

A

Placement of a dental material over an
exposed, or nearly exposed, pulp to initiate the formation of
irritation dentin at the site of injury

47
Q

What is Pulpotomy ?

A

Surgical removal of a small portion of the vital, coronal pulp
as a means of preserving the vitality of the remaining radicular
pulp tissue.

48
Q

What properties does CH has that makes it ideal for pulp capping or pulpotomy ?

A

it seems to stimulate a rapid differentiation
of odontoblasts or odontoblast-like cells that form a hard tissue
barrier in the pulp (2); and (b) it is antibacterial

49
Q

What is the composition of MTA ?
What does it form after mixing with water?

A

Composed of calcium silicate (CaSiO4), bismuth oxide (Bi2O3),
calcium carbonate (CaCO3), calcium sulfate (CaSO4), and calcium
aluminate (CaAl2O4). When mixed with water, MTA forms crystals
of calcium oxide in an amorphous structure consisting of 33%
calcium, 49% phosphate, 2% carbon, 3% chloride, and 6% silica

50
Q

What are the other terms for VPT?

A

Partial coronal pulpectomy
Pulpotomy

51
Q

What are the indications for VPT in dogs ?

A

CCF of immature or mature teeth
pulp exposure during restorative preparation
enamel hypoplasia
debridement of deep caries lesion
Crown height reduction due to MAL O

52
Q

What does the white arrow and black arrow heads indicate ?

A

White: tertiary dental bridge formation
Black: apex formation

53
Q

What is the extension of an infection/inflammation to the periapical tissue as well known?

A

Apical periodontitis
Periapical lesion
and seen on radiograph as PAL

54
Q

Da Bin Lee; Boaz Arzi; Philip H. Kass; Frank J. M. Verstraete. Radiographic outcome of root canal treatment in dogs: 281 teeth in 204 dogs (2001–2018) - Which tooth had the highest failure in RCT in this study?

A

The mandibular 1st molar tooth

55
Q

Da Bin Lee; Boaz Arzi; Philip H. Kass; Frank J. M. Verstraete. Radiographic outcome of root canal treatment in dogs: 281 teeth in 204 dogs (2001–2018) What were the results ?

A

Neither preoperative EIRR nor a preoperative PAL were significantly associated with RCT outcome

Overall, pulp vitality was not significantly associated with RCT outcome.

Overall, treatment staging was not significantly associated with RCT outcome.

Type of sealer and obturation material and method were not significantly associated with RCT outcome.

Overfill was not significantly associated with outcome.

56
Q

2 types of resin sealers

A

epoxy resin sealer
methacrylate resin based sealer

57
Q

Classification of endodontic sealers (4)

A

Zinc oxide eugenol based sealer
Calcium hydroxide based sealer ( Sealapex)
Glass ionomer based sealer
Resin based sealer ( AH plus, Diaket)

58
Q

Function of a sealer

A

o Sealing off voids and multiple foramen
o Patent assessor canal,
o Create a bond between the core filling material and the root canal wall
o Provide a lubricating effect during the placement of the filling core + trapping any remaining bacteria

59
Q

The ideal endodontic sealer should have the following properties

A

high radiopacity, flowable, sealing, biocompatible, low solubility, reliable working time, adhesion to dentinal wall

60
Q

Important characteristic’s of an obturation material (4)

A
  • adhesion to the root canal wall
  • minimal volume change during setting
  • ability to establish a seal
  • biocompatibility
61
Q

What is obturation

A

Sealing and filling a prepared RC

Eliminate routes of leakage

Most critical area is apex

62
Q

Describe Zinc Oxide eugenol

A
  • Zinc oxide eugenol – classic sealer cement
  • Long setting time, easy to remove if needed
  • Zinc oxide powder + eugenol liquid
  • Zinc oxide - Antimicrobial – dissolves quickly with tissue liquids
  • Eugenol – released over time, irritant, cytotoxic
  • Dissolves over time – 11% loss over 180 days –? Create microleakage
63
Q

What are the properties of Zinc oxide eugenol

A

water based cement
eugenol slowly released over 12 months
long setting time - 12- 48 hours
easy to manipulate, flows well
radiopaque
adheres poorly to dentin
pH neutral
biocompatible
eugenol is cytotoxic
low tensile strength
antimicrobial

64
Q

Rodrigues et al, Endodontic Microbiome of Fractured Non-vital Teeth in Dogs Determined by 16S rRNA Gene Sequencing , Frontier 2019

Which bacteria is found the most abundant in endodontic infected tooth of the dog

A

● Bacteroides most abundant genus in dogs with infected endodontic samples

● Snowella significantly more abundant in endodontic samples

65
Q

Rodrigues et al, Endodontic Microbiome of Fractured Non-vital Teeth in Dogs Determined by 16S rRNA Gene Sequencing , Frontier 2019

Which bacteria was found in the sulcus of the same infected tooth?

A

● Porphyromonas and Fusobacterium significantly more abundant in sulcal samples

66
Q

Rodrigues et al, Endodontic Microbiome of Fractured Non-vital Teeth in Dogs Determined by 16S rRNA Gene Sequencing , Frontier 2019

which were the most abundant phyla in all samples ?

A

● Most abundant phyla in ALL samples ( pulp and sulcus) were Bacteroidetes, Proteobacteria, and Firmicutes

67
Q

What are the main causes of tooth discoloration in humans and animals ?

A
  • amelogenesis imperfecta, dentinogenesis imperfecta, tetracycline ingestion , dental fluorosis,
    tooth resorption, hyperbilirubinemia,
    pulp necrosis,
    injury,
    aging
68
Q

Rodrigues et al, Endodontic Microbiome of Fractured Non-vital Teeth in Dogs Determined by 16S rRNA Gene Sequencing , Frontier 2019

Which bacteria was found in significant numbers in sulcus of healthy gingiva ?

A

Proteobacteria

69
Q

What are the radiographic signs of pulpitis?

A

accelerated apparent tooth maturation (narrower root canal),
pulp canal obliteration, cemental hyperplasia.

70
Q

What are the radiographic signs for pulp death ?

A

arrested tooth maturation (wider root canal),
external root resorption, internal root or
root apex resorption, increased width of the periodontal ligament space,
diffuse or distinct periapical lucency, and changes in the trabecular bone pattern around the root apex.

71
Q

Feigin et al, Analysis and Assessment of Pulp Vitality of 102 Intrinsically Stained Teeth in Dogs, JVD 2022

What was the most affected tooth

A

Left maxillary second incisor 202

72
Q

Feigin et al, Analysis and Assessment of Pulp Vitality of 102 Intrinsically Stained Teeth in Dogs, JVD 2022

Which teeth showed the largest intrinsic color difference

A

Molar teeth
Canines
Incisors
Premolars

73
Q

Feigin et al, Analysis and Assessment of Pulp Vitality of 102 Intrinsically Stained Teeth in Dogs, JVD 2022

A

Teeth that showed intrinsic discoloration - total 93 % were intact - abrasion 39.2% + 53.9% intact
6.9 % were fractured

74
Q

Feigin et al, Analysis and Assessment of Pulp Vitality of 102 Intrinsically Stained Teeth in Dogs, JVD 2022
Was transillumination useful in detecting intrinsic stained teeth if vital or not?

A

Yes, 92% showed an abnormal transillumination

75
Q

Recapitulate

A

between increasing file sizes using previous smaller file to ensure WL is maintained