Procedural Errors Flashcards
Removal of excessive tooth structure beyond the pulp chamber space.
Gouging
An iatrogenic communication with the oral cavity or periradicular tissues.
Lateral perforation
Definition: Pulp chamber is in the center of the tooth at the level of the CEJ.
Law of Centrality
Definition: An iatrogenic communication with periradicular tissues in multirooted teeth.
Furcal perforation
Definition: EDA (est. depth of access).
Measurement from the occlusal table to the roof of the pulp chamber.
How to repair a supraosseous perforation.
Restore
How to repair a subosseous perforation.
MTA/bioceramic
How to repair a crestal perforation
Created a periodontal defect.
Factors affecting repair:
- Time
- Communication with the oral cavity
- Presence of a pre-op lesion at the perforation site.
Definition:
Debris in canal that prevents instruments from reaching working length.
Blocked canal
Blocked canals can be from:
- Restorative material
- Soft tissue
- Dentinal debris
How to remove canals that are blocked with restorative materials.
Ultrasonic
Surgical length round bur
Used to remove temporary filling materials (Cavit, IRM) from the access.
SLOW SPEED round bur!
So you can see if the cotton pellet is dry or not.
This blocked canal will feel sticky.
Filled with soft tissue.
How to treat a soft tissue blocked canal?
- Irrigation to dissolve
- Reaming 1/4 turn and pull with small files.
How are canals blocked with dentin treated differently than those blocked with soft tissue?
Use bleach AND EDTA so help dissolve the dentin.
Reaming action as well.
Definition:
Act of creating an artificial irregularity on the surface of the canal wall that IMPEDES the placement of instruments to the apex of an otherwise patent canal.
Caused by inadequate straight-line access.
Ledging
How to manage ledging.
Pre-curve files to get by the ledge.
Once by, file any times in small amplitude strokes.
Definition:
Removal of canal wall structure on the outside of the curve in the apical half of the canal due to tendency of files to straighten out.
May lead to ledge formation and possible perforation.
Transportation
Definition:
A tear-drop shape formed in the apical foramen during preparation of a curved canal when a file extends through the apical foramen and transports that outer wall.
Zipping
Types of fatigue that cause instruments to fracture.
Torsional or cyclic
Def:
Fatigue when a part of the file binds while the rest rotates.
Torsional
Fatigue caused by repetitive stress.
Cyclic
Fatigue caused by repetitive stress. Typically revolutions around a curve.
Cyclic
T/F: There’s no significant difference in healing between teeth with an instrument and without.
More important is creating a coronal seal!
True
Most common site for a strip perforation.
Furcation side of the mandibular molars.
DEf:
Penetration of a root canal wall due to excessive lateral tooth structure removal during canal preparation.
Strip perforation
How to repair a strip perforation.
Obturate the canal below the strip perforation as usual.
Fill the perforation and backfill with MTA, or bioceramic.
Definition:
An iatrogenic opening to the external tooth surface in the apical 1/3 of the canal.
Usu. occurs after ledging, or attempting patency in blocked canals.
Apical perforation
How to manage an apical perforation:
Treat it like a second canal:
take a new working length, obturate as normal.
Material used to repair a post perforation.
MTA.
This premolar has a second canal 50% of the time.
Maxillary 2nd premolar
Steps to tx extruded irrigant:
- Anesthetize
- Leave tooth OPEN! so it can drain.
- Place on antibiotics/corticosteroids.
- Analgesics
- Cold compress, then heat.
Why put someone who has bleach extrusion on antibiotics?
Bleach will necrotize the tissues, causing an infection.
This implies that the canal space is NOT completely obturated.
Over-Extension
Used to imply that the canal space is completely obturated.
Over-instrumented the foramen.
Over-fill
