Preparation for Endodontic Treatment

Question 1

What questions should be asked to assess the prognosis?

Answer 1

Is there sufficient tooth structure left for further restoration?

What type of restoration will be required?

Post-retained core required?

Any other alternative restorations?

Periodontal (crown lengthening) surgery required?

How predicatable is the entire procedure

Are there alternative procedures?

Question 2

What could impede the ability to accurately assess the teeth when restored?

Answer 2

Cracks and/or fractures

Marginal breakdown

Caries - coronal or root

Question 3

What are the general principles for treating all diseases?

Answer 3

Identify the disease and its cause (history, examination, diagnosis, and cause)

Remove the cause of the disease (Restoration, caries, cracks, etc)

Treat the effect of the disease (Clean the canal removing bacteria and debris, and medicate the canal modifying periapical response)

Prevent further disease and complications (Root Canal Filling)

Restore to normal function (Coronal restoration)

Monitor healing and stability over time (Review 6 months. 3 years. 5 years, etc)

Question 4

What are the main pathways for bacterial penetration?

Answer 4

Caries

Cracks

Breakdown of restoration margins

Fractures

Cracks are easier to assess than fractures.

Question 5

What examination methods are used for assessing teeth?

Answer 5

Visual inspection

Probing of restoration margins

Probing of pits, fissures, grooves, etc

Transillumination with fiber optic light.

Rubber dam isolation (cuff technique)

Question 6

How effective are periapical radiographs for detecting caries under existing restorations?

Answer 6

They are poor indicators of caries under existing restorations