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BDS3: Endodontics > Restoration Of RCT Tooth > Flashcards

Restoration Of RCT Tooth Flashcards

1
Q

What should you assess radiographically in an RCT tooth?

A 
Root filling - length, quality, obturation
Unfolded/missed canals
Sclerosis
Bone support
Crown to root ratio (1:1.5)
Radiolucency - healing
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2
Q

What problems can arise after RCT/re-RCT?

A

Amount of tooth structure remaining
Lack of ferrule
Wide post holes
Fractured instruments, perforations, ledges etc.

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3
Q

Are RCT teeth more brittle than vital teeth?

A

No.

They have reduced structural integrity which leads to weakening of the tooth.

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4
Q

How long can you leave a root filled tooth unrestored before you should consider re-RCT?

A

Re-RCT if left any longer than 3 months

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5
Q

What is more important for the apical periodontal health -
Technical quality of the coronal restoration?
Technical quality of the RCT?

A

Technical quality of the coronal restoration?

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6
Q

What are the restoration options for anterior teeth with intact marginal ridges?

A

Composite restoration (veneer)

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7
Q

What are the restoration options for anterior teeth with intact marginal ridges & discoloured crown?

A

Bleaching or
Veneer or
Crown

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8
Q

What are the restoration options for anterior teeth with marginal ridges destroyed?

A

Post crown

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9
Q

What is the purpose of a post/core?

A

To gain intraradicular support for a definitive restoration.
Core provides retention for crown
Post retains the core (doesn’t strengthen or reinforce the teeth, the preparation actually weakens the tooth)

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10
Q

What are the components of a post/core?

A

Post - placed in the root canal

Core - is what the prosthesis is cemented to e.g. Crown

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11
Q

What length of root filling should be left apically when placing a post core?

A

4-5mm root filling apically

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12
Q

What is a ferrule?

A

Dentine collar
Encirclement of 1-2mm of vertical axial tooth structure within walls of a crown.
Prevents root fracture.

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13
Q

What are three features of the ideal post?

A

Parallel sided
- avoids wedging and more retentive than tapered
Non-threaded (passive)
- incorporates less stress to remaining tooth
Cement retained
- acts as a buffer between masticatory forces post and tooth

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14
Q

What materials can be used for posts?

A

Metals e.g. Cast gold
Ceramics e.g. Alumina, zirconia
Fibre e.g. Glass, Quartz

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15
Q

What types of posts are available?

A

Prefabricated or custom
Tapered or parallel
Smooth, serrated or threaded

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16
Q

What is a core build up?

A

Internal part of tooth is built-up with restorative material to replace the lost tooth tissue.

17
Q

What materials can be used for cores?

A

Composite - most common, aesthetics, bonds to tooth
Amalgam - requires retention, poor aesthetics, needs 24hrs to set
GI - not used commonly as it absorbs water

18
Q

What are problems with posts?

A

Perforation
Core fracture
Root fracture or crack
Post fracture

19
Q

How can you manage a post perforation?

A

Repair by periradicular surgery
- if perforation buccal, raise gum flap & trim
Extraction

20
Q

How can you remove a post?

A

Ultra-sonics
Masseran kit (like an apple corer)
Eggler (like a corkscrew)
Moskito forceps

21
Q

Why restore an endodontically treated tooth?

A

General - function, occlusion, aesthetics

Endo - coronal seal, cuspal protection

22
Q

What teeth require cuspal coverage after RCT?

A

Molars - 6x more likely to fracture without cuspal coverage

23
Q

What crowns are available for RCT teeth?

A

Metal
Metal ceramic
Ceramic

24
Q

What clinical factors dictate post design?

A

Remaining coronal tooth
Root width
Root length
Canal shape

25
Q

What is the ideal diameter of a post?

A

1/3rd root width

26
Q

When are post stresses produced?

A

During cement action
During masticatory loading
During post-removal

27
Q

What endodontic failures that can occur?

A

Instrument failures - stripping, zips, perforation, instrument fracture
Vertical root fractures
Resorption
Development of peri-apical pathology

28
Q

What should you assess clinically in a RCT tooth?

A 
Coronal seal - leakage?
Swelling
Sinus
TTP
Buccal sulcus - TTPalpation
Mobility - Grade I, II, III
Increased pocketing
29
Q

When should posts be used in posterior (molars) teeth?

A

Avoid when possible!!
If no coronal tissue posts may be inserted for a short distance into the largest and straightest root canal (distal roots of L, palatal roots of U)

30
Q

What is the ideal RCT restoration for premolars?

A

Cuspal coverage

Post in one canal only if roots are sufficiently long, bulky and straight

31
Q

What are the advantages of over denture abutments?

A 
Retention of supporting alveolar bone
Continued periodontal proprioception 
Improved support
Retention of denture's
Denture better able to resist occlusal forces than tissue-borne denture
Psychological advantages

BDS3: Endodontics (11 decks)

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