Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

xD3 Endo Final > Periradicular Surgery (Replogle) > Flashcards

Periradicular Surgery (Replogle) Flashcards

1
Q

What are 4 treatment modalities for apical periodontitis, especially persistent apical periodontitis?

A
  1. Non-surgical root canal therapy (NSRCT)
  2. Retreat (RETX)
  3. Microscopic Periapical Surgery (Apicoectomy)
  4. Extraction (EXT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the highest success rate study for NSRCT (retained in the oral cavity for 8 years)?

A

97%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the diagnosis of a previously endo-treated tooth if the periodical radiolucency has not filled in with normal bone trabeculation in 6 months to 2 years, the average being 9 months?

A

Failing NSRCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a major histologic difference in marginal periodontitis and apical periodontitis?

A

They have different bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the diagnosis of a previously endo treated tooth that is symptomatic?

A

Failing NSRCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the options for a failing NSRCT?

A
  1. RETX
  2. Apicoectomy
  3. EXT tooth and replace with FPD, RPD, or Implant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What should be done for a failing NSRCT: apicoectomy alone, or RETX then apicoectomy?

A

RETX apicoectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the success rate if only do an apicoectomy (microscopic periscopical surgery) alone on a failing NSRCT tooth?

A

59%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the success rate if you do a RETX followed by apicoectomy (microscopic periodical surgery)?

A

80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Dr Replogle had a slide showing a NSRCT treated molar that turned out to have a missed 4th canal, she said that after the initial poor NSRCT, how long should it take for the periodical radiolucency (PARL) to reappear?

A

6 months - 2 years, but I have no idea where this comes from

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What ist he treatment of choice if the tooth with failing NSRCT had its NSRCT done recently and properly, and there was immediate placement of a coronal restoration?

A

Can skip RETX and go straight to apicoectomy (note: this is the exception, not the rule)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the criteria for a properly done NSRCT?

A

All canals located, ideally irrigated, obturated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are synonyms for apicoectomy?

A
  1. Microscopic periapical surgery
  2. Root end resection
  3. Microsurgical root end resection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the rule of thumb for planning treatment of a failing NSRCT?

A

Retreat prior to doing surgery ensures best success

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What would be the treatment indication for an abutment tooth that has a long post, gutta percha extending out apical foramen, and the FPD has been recently placed on it and why?

A

Apicoectomy. Long post and core prevents RETC and do not want to mess up new FPD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the purpose of periapical surgery?

A

Gain access to root apex and surrounding periodical tissues in order to remove uncleaned or unfilled tooth structure and place a biocompatible seal in the form of a root end filling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The removing of the uncleaned or unfilled tooth structure during periapical surgery is called what?

A

Root end resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is done with granulation tissue or cyst contents removed from the site during periapical surgery?

A

Submit for biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the desired result for periapical surgery?

A

Formation of new cementum on the surgically exposed root surface and on the root end filling which is essential for regeneration of the periodontium (periodical surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is indicated if there is significant overextended obturating material with symptoms / lesions?

A

Endodontic surgery (periapical surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is indicated if a tooth has a long post or irretrievable separated instruments preventing a standard RETX?

A

Endodontic surgery (periapical surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is indicated if a tooth has non-negotiable ledges and canal blockages or transportation?

A

Endodontic surgery (periapical surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is indicated for a suspected root fracture?

A

Endodontic surgery (periapical surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is indicated for hard setting obturation material / cement that cannot be removed during pretreatment (e.g. obturation carrier)?

A

Endodontic surgery (periapical surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Is endodontic surgery contraindicated in areas with close proximity to anatomic structures (e.g. IAN, mental foramen, maxillary sinus, nasal fossa)?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are contraindications to endo surgery?

A
  1. Uncontrolled diabetes
  2. Blood disorders
  3. Immunocompromised
  4. Severe cardiovascular problems
  5. Long term bisphosphonate therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Should microsurgery be referred?

A

Yes. They have microscopes and special instruments.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Besides the ever-present Endo Microscope, what are some other microsurgery armamentaria?

A
  1. Diamond coated micromirrors
  2. Microblade
  3. Ultrasonic tips
  4. MIcrocondensers
  5. MTA delivery instruments
29
Q

What is the first step in apical surgery?

A

Local anesthesia with 1:50,000 epinephrine

30
Q

What is the purpose of the 1:50,000 eli?

A

Hemostasis

31
Q

What is done after anesthesia is attained for endo surgery?

A

Incision and flap reflection

32
Q

What is done after the flap has been reflected?

A

Access root apex

33
Q

What is done after the root apex has been accessed?

A

Curette the diseased tissue

34
Q

What is done after curetting the diseased tissue?

A

Root end resection and inspection under high magnification

35
Q

What is done after the root end resection?

A

Retroprep of the root end

36
Q

What is done after the retropre?

A

Retrofill the retroprepped root apex

37
Q

What is done after the retrofit?

A

Reapproximate and suture flap, give post op instructions

38
Q

What is one design of the flap for endo surgery?

A

Full mucoperiosteal intrasulcular flap with 1 or 2 releasing incisions

39
Q

What is the second flap design for endo surgery?

A

Ochsenbein-Luebke Submarginal flap

40
Q

What is an advantage of the submarginal Ochsenbein-Luebke flap design?

A

Results in recession free healing

41
Q

What is a requirement for submarginal Ochsenbein-Luebke flap design?

A

Must have 2mm or retained attached gingiva

42
Q

Would a submarginal Ochsenbein-Luebke flap design be indicated if there was a suspected fracture in the tooth and why?

A

No, because you cannot see the entire root. The full mucoperiosteal intrasulcular flap is indicated as it gives full root access

43
Q

Can a semilunar (curve submarginal) flap design be used?

A

No

44
Q

Vertical incisions of flap should be parallel to what?

A

Superperiosteal vessels

45
Q

Is it permissible to cut across frenums or muscle attachments when designing a flap?

A

No

46
Q

Can the incision for a flap be made over diseased or compromised bone?

A

No. Must be directly over healthy bone.

47
Q

Can a flap incision be made over a bony prominence?

A

No

48
Q

What is done with the papilla during flap design?

A

Either include or exclude, but do not dissect

49
Q

What is the minimum amount of teeth either side of the tooth to be worked on to allow good surgical access?

A

At least one tooth either side of surgery tooth

50
Q

What is always a concern when working around a flap?

A

Careful reflection and retraction to avoid crushing or tearing of tissue

51
Q

How much root end is resected during endo surgery and why?

A

3mm. Will include most lateral canals and apical ramifications to eliminate most residual microorganisms

52
Q

What is the minimal bevel desired for a root end resection?

A

0 to 10 degrees. Torabinejad says as close to 0 degrees as possible, but consider visualization and access.

53
Q

What are reasons to bevel 0 to 10 degrees for apical resection?

A
  1. More likely to include all apical ramifications and lateral canals
  2. Less dentinal tubules exposed
  3. Less leakage
  4. Better force distribution to reduce fracture risk
54
Q

What are the percent reduction for apical ramifications if you take away 3mm in apical resection?

A

98%

55
Q

What are the percent reduction for lateral canals if you take away 3mm in apical resection?

A

93%

56
Q

Why worry about getting the apical ramifications?

A

Becteria in apical ramifications may be the cause of persistent apical periodontitis

57
Q

What are 6 retrofit (root end filling) materials?

A
  1. MTA
  2. Super-EBA
  3. IRM
  4. Amalgam
  5. Resin
  6. Gi / RMGI
58
Q

Of the 6 retrofit materials listed above, which is the best?

A

MTA

59
Q

What is a disadvantage of amalgam for retrofit?

A
  1. Poor sealing ability

2. Irritating to tissues

60
Q

What are the 5 main constituents of Mineral Trioxide Aggregate (MTA)?

A
  1. Calcium Silicate
  2. Bismuth oxide
  3. Calcium carbonate
  4. Calcium sulfate
  5. Calcium aluminate
61
Q

The hydration of MTA forms what?

A

Calcium oxide crystals

62
Q

What is a diagnostic advantage of MTA over IRM or S-EBA?

A

More radiopaque

63
Q

Do MTA, S-EBA, and IRM have equal sealing abilities?

A

Yes

64
Q

What is the biocompatible phenomenon see with MTA for root resection?

A
  1. PDL fibers attach to it

2. Cellular cementum forms adjacent to it

65
Q

This is a modified Zinc-Eugenol paste that has 37.5% eugenol and 62.5% ortho-ethoxy benzoic acid mixed into the 60% zinc oxide powder (it is not very radiopaque but it is not resorb able, seals well, and is easy to place)?

A

Super EBA

66
Q

What is the success rate for microsurgery with ultrasonics?

A

91.5%

67
Q

What is the success rate for endodontic microsurgery?

A

94%

68
Q

Does endo microsurgery have to be confined to the root apex?

A

No. Dr Replogle’s case with cervical resorption filled with geristore and restored using microinstruments

xD3 Endo Final (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions