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Endotontics > Restoration of Endodontically Treated Teeth > Flashcards

Restoration of Endodontically Treated Teeth Flashcards

1
Q

loss of moisture leads to

A

increased tooth fragility

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2
Q

sodium hypochlorite and chelator used in canal irrigation effect

A

interact with root dentin –> leading to dentin erosion and softening

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3
Q

less than 50% of tooth structure? anterior and posteiror?

A

anteiror - restore

psoterior - crown and maybe a post

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4
Q

where do you put post?

A

larger and straighter canals

pre-molar or molar - bigger

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5
Q

upper molar post location

A

palatal canal

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6
Q

lower molar post locaiton

A

distal canal

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7
Q

conservative endo access affects tooth stiffness by?

A

5%

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8
Q

endo access combined with an MOD prep results in?

A

max tooth fragility

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9
Q

3 reasons why we are restoring endodontically treated teeth

A
  1. protect the remianing tooth from fracture
  2. prevent reinfection of the root canal system
  3. replace the missing tooth structure
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10
Q

primary considerations beforeRCT?

A
  1. restorable?
  2. periodontally sound?
  3. strategic and functional?
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11
Q

what to restore it with? dictated by?

A

dictated by the amount of tooth that is left
1. direct composite restoration

  1. indirect restorations (composite or onlays)
  2. full crowns
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12
Q

how to evaluate? need what?

A

2 periapicla radiographs

1 bitewing radiograph

perio probe needed

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13
Q

major differences between endo treated teeth and vital teeth

A
  1. loss of tooth structure
  2. altered physical properties
  3. altered esthetics

loss of moisture and coloration

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14
Q

how much less fluid in RCT treated teeth

A

3-7% less

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15
Q

describe structural integrity in relation to RCT teeth

A

endodontic tx. requires removal of tooth structure (pulpal roof) which destroys the ‘boxed beam’ and weakend the basic structural integrity of the tooth

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16
Q

boxed beamcreates?

A

superior strength and rigidity

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17
Q

access cavity importance?

A

YES – one of the most important aspects

- unique structure and the bigger is not always better

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18
Q

aim in restoring these teeth?

A
  1. protect
  2. prevent
  3. replace
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19
Q

main functions of anterior teeth

A
  1. protect posteiror teeth from lateral forces
  2. esthetic considerations
  3. minimal restorative procedure
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20
Q

implication for crown

A

more than 50% of tooth gone

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21
Q

characteristics of posterior teeth

A
  1. carry occlusal load
  2. ‘always’ considers crowns
  3. posts/ cores depends on remaining tooth structure
22
Q

1 cause of failure following successful RCT

A

CORONAL LEAKAGE

23
Q

when to restore the RCT

A

as soon as possible

4-6 weeks

24
Q

describe / explain situation with coronal leakage

timeline?

A

all restorations are less than perfect
- essentially remporaries (they leak)

  • when saliva leaks into the gutta percha ‘seal’ contamination occurs rapidly

somewhere between 1 day and 4 weeks following exposure to saliva, contamination extends to the peri-apical tissues and retreatment becomes necessary

25
Q

2 cause of RCT therapy

A

crown and or root fracture

26
Q

materials used for temporary restorations? length of time last?

A
  1. cavit - last for 2 weeks
  2. IRM is less leakproof than cavit
  3. TERM
  4. Fugi XI
  5. Composite
27
Q

how to reinforce the tooth - one big answer

A

FERREL EFFECT

28
Q

risk 1 with use of posts

A

can present a formidable obstruction to re-treatment

29
Q

risk 2 with post

A

use of the rotary drill provides
- an excellent opportunity to perforate the root (unless done correctly)

  • PIEZO reamers - dangerous in the canal
30
Q

risk 2 with post

A

use of the rotary drill provides
- an excellent opportunity to perforate the root (unless done correctly)

  • PIEZO reamers - dangerous in the canal
31
Q

perforation if more apical?

A

better prognosis because away from the saliva more

32
Q

what do you do if you cannot get the ferrule effect

A
  1. crown lengthenign
  2. extract and FPD or RPD
  3. Extract and implant
33
Q

discoloration comes from which mainly?

A

inadequate cleaning and shaping (leavingi necrotic tissue in the coronal horns)

root filling material (gutta percha) retained in teh coronal aspect

organic substances in dentin – hemoglobin breadgown

food and drink pigment

34
Q

2 cause of failure following successful RCT?

A

crown and or root fracture

35
Q

ferrule dimensions?

A

must be at least 2mm
- the amount of sound tooth structure located under a crown margin and the build up restorativie material

must not impinge on biological width

minimum thickness = 1mm
ferrule walls almost parallel

36
Q

Indirect posts aka

A

Casted

37
Q

direct posts aka

A
  1. prefabricated metal posts
  2. fiber posts
  3. zirconia posts
38
Q

retention refers to

A

ability of post to resist vertical forces

39
Q

resistance in a post refers to

A

abbility of the tooth / post combinatio to withstand lateral and rotational forces and is influenced by

  • the presence of a ferrule
  • the posts length and rigidity
  • the presence of anti-rotational features
40
Q

indicationfor post

A

ONLY FOR RETENTION OF THE CORONAL RESTORATION - inn a tooth that otherwise meets ALL the requirements for conventional restoration

41
Q

posts increase resistance to vertical fracture?

A

no – may contribute to vertical and shear fracture

42
Q

benefits to post

A

retention for crown

better than pin retained build up

43
Q

perforations are what?

A

one of the worst iatrogenic errors we can create

tooth is compromised on all cases and repair is questionable

44
Q

post requiremetns

A
  1. ferrule effect with 2 mm of crown margin on root without impinging on biological width
  2. 4.1mm minimum of tooth above bone
45
Q

more then 50% tooth structure is gone what is indicated?

A

not necessarily a post – but need core / plug

46
Q

3-4 mm of cervical tooth structure? type of post if using one

A

fiber

47
Q

if do not have 2mm for ferrule?

A

consider crown lengthening or orthodontic extrusion

or extract for RPD FPD

48
Q

minimum length of post

A

long as possible

minimum is 1-1.5 x length of clinical crown (so length of clinical crown)

2/3 length of the root

equal to length of crown

1/2 the bone support (need 4.1 mm of tooth above bone)

49
Q

remaining root canal filling material?

A

4-5 mm

50
Q

too big post? then what

too small post? then what

A

too big –> root can break

too small –> post can break

51
Q

plugs use?

A

composite or amalgam

but only if 50% oro more tooth strucutre

52
Q

purpose of the plug

A

holds the core and the crown – RETENTIVE FEATURE

protect the apical seal from bacterial contamination

usually it does not reinforce tooth structure

Endotontics (21 decks)

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