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FINALS - Endodontics > Restoration of Endodontically Treated teeth > Flashcards

Restoration of Endodontically Treated teeth Flashcards

1
Q

What do you assess on an endodontically restored tooth?

A

Coronal seal
Amount of remaining tooth structure
Swelling
Sinus
TTP
Tender soft tissues
Mobility
Increased pocketing

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2
Q

What do you look for on a radiograph when assessing a root treatment?

A

Unfilled/missed root canals
Shape of canal
Bone support
Crown to root ratio
Apical pathology

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3
Q

What are the restorative problems faced after RCT?

A

Amount of remaining tooth structure
Lack or no ferrule
Wide post holes
Endo complications (Fractured instruments)

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4
Q

Are teeth brittle after endodontic treatment?

A

No

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5
Q

Are root treated teeth more prone to fracture?

A

No

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6
Q

Is dentine hardness affected after RCT?

A

No

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7
Q

Does dehydration affect the hardness of a RCT tooth?

A

No

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8
Q

What is coronal microleakage?

A

Ingress of microorganisms into root canal system

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9
Q

What can coronal microleakage cause?

A

Infection of the apical tissues
Failure of RCT

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10
Q

How do you create a good coronal seal

A

Trim GP to the ACJ and place RMGI over pulp floor and root canal openings.

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11
Q

What restorations could you give for an anterior tooth with intact marginal ridges?

A

Porcelain/composite veneer

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12
Q

What restoration could you give for anterior teeth with intact marginal ridges and discoloured crown?

A

Bleaching or veneer crown

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13
Q

What restoration could you give for anterior tooth with marginal ridges destroyed?

A

Core build up for crown
Post crown

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14
Q

What prep modificaiton is required for a direct post?

A

A ferrule

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15
Q

What does a post/core do?

A

Gain intraradicular support for definitive restoration, and provides retention for crown retains the core.

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16
Q

When do you avoid placing a post/core?

A

If sufficient coronal dentine present mandibular incisors (thin roots) curved canals (avoid perforations)

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17
Q

Wow long should the root filling length be when placing a post?

A

4-5mm apically

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18
Q

How wide should the post be for a post crown?

A

No more than 1/3 of root width at narrowest point and 1mm of remaining circumferential coronal dentine

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19
Q

What should the minimum post length to crown ratio be?

A

1:1

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20
Q

How much ferrule do you need for a post/core crown?

A

1.5mm height and width

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21
Q

What is a ferrule?

A

Dentine collar - encirclement of 1-2mm of vertical axial tooth structure within walls of a crown

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22
Q

What is the purpose of a ferrule?

A

Lowers risk of root fracture and increases crown retention.

23
Q

When is the risk of root fracture significantly increased

A

If a crown margin is not placed onto solid tooth

24
Q

How can you achieve a ferrule if there there is not enough coronal dentine?

A

Orthodontic extrusion or crown lengthening

25
Q

How deep should a post go for a post crown?

A

At least halfway down the root to ensure good alveolar bone support

26
Q

What is the ideal post in a post crown?

A

Parallel sided
Non-threaded
Cement retained

27
Q

What does a parallel sided post avoid?

A

Wedging

28
Q

What does a non-threaded post allow?

A

Less stress to remaining tooth structure

29
Q

What categories are post crowns classified into?

A

Manufacturer
Material
Shape

30
Q

What are the different types of manufactured post crowns?

A

pre-formed or custom made

31
Q

What are the materials available for post crowns?

A

Cast metal
Steel
Zirconia
Carbon/glass fibre

32
Q

What are the shapes that a post crown can have?

A

Parallel sided or tapered

33
Q

What are the advantages of prefabricated posts?

A

Only 1 visit required
No impressions or lab needed
Chairside core build up
Immediate preparation of core
Large selection of designs and materials

34
Q

How are custom posts made?

A

Impressions/casts from patients mouth

35
Q

Typically how many visits are needed for custom posts?

A

2

36
Q

What material are cast posts made in?

A

Type 4 heat hardened gold

37
Q

What are the properties of metal posts?

A

Poor aesthetics
Lower root fracture risk
Corrosion resistant
Radiopaque

38
Q

What are the properties of ceramic posts?

A

High flexural strength and fracture toughness
Favourable aesthetics
Difficult retrievability
Root fracture more common

39
Q

What are the properties of fibre posts?

A

Flexible
Similar mechanical properties to dentine
Aesthetic
Retrievable
Bond to dentine with DBA
Radiolucent

40
Q

What is a core build up?

A

Internal part of tooth built up with restorative material to replace lost tooth tissue

41
Q

What does the core of a core build up provide?

A

Retention and resistance for definitive restorations

42
Q

What materials are used for core build ups?

A

Composite
Amalgam
Glass ionomer

43
Q

What is a nayyar core?

A

RCT removed from canals amalgam packed into canals, then tooth built up

44
Q

What considerations do you need to think of when deciding what restoration to choose?

A

How long the post is
Is there a ferrule
How wide is the post
Is there 3-5mm remaining GP in canal
How straight is the canal
How much space for the core

45
Q

How much taper is needed for a core?

A

6 degree

46
Q

How much GP is left in apical third of canal?

A

3-5mm

47
Q

How do you remove GP for a post crown?

A

Dental dam
Gates gliddens size 3
Working length and rubber stop

48
Q

How much space should be left in the occlusion when a crown is placed?

A

2mm

49
Q

What is the process for trying in a post?

A

Irrigate with chlorhexidine
Dry with paper points
Ensure fits around prep
Ensure enough occlusal clearance

50
Q

What complications can arrise from posts?

A

Perforation
Core fracture
Root fracture
Crack/fracure in post

51
Q

How would you manage a post perforation?

A

Repair internally or extract the tooth.

52
Q

What can be used to remove a post

A

Ultrasonics
Masseran kit
Moskito forceps

53
Q

What are the reasons for post failure?

A

Restorative reasons
Periodontal problems
Endodontic reasons
Heavy occlusal load/abnormal occlusion

FINALS - Endodontics (4 decks)

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