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BDS3 Endodontics > Restoration of the Endodontically Treated Tooth > Flashcards

Restoration of the Endodontically Treated Tooth Flashcards

1
Q

what should you look for in a clinical assessment of an endodontically treated tooth

A

coronal seal
amount of remaining tooth structure
is the tooth restorable
swelling
sinus
TTP
buccal sulcus
mobility

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2
Q

what should you be looking for on the radiograph of an endodontically treated tooth

A

root filling - length, quality
unfilled/ missing root canals
shape of canal
patency
bone support
crown to root ratio

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3
Q

how often should you follow up with PA assessment of a RCT tooth

A

every year

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4
Q

how often should you follow up with PA assessment of a RCT tooth

A

every year

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5
Q

what are the problems after RCT

A

massive loss of dentine and tooth structure - internally and externally
wide post holes
fractured instruments/ perforations/ curved canals

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6
Q

what is ferrule

A

no tooth preparation above the gum - 2mm of dentine above gingivae

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7
Q

are RCT teeth more likely to fracture

A

because there is a massive loss of dentine they are more likely to fracture

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8
Q

are RCT teeth as hard as non-root treated teeth

A

dentine hardness is not altered

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9
Q

does dehydration affect the hardness of a RCT tooth

A

no it doesnt weaken strength or toughness

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10
Q

what is coronal microleakage

A

ingress of oral-microorganisms into root canal system

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11
Q

what should happen generally to root filled teeth that are left unrestored for 3 months

A

they should be re-root canal treated

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12
Q

how do you create a coronal seal

A

trim GP to the access cavity and place RMGI over pulp floor and root canal openings

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13
Q

if its a small access cavity (eg lingual/ palatal of anteriors)

A

composite restorations

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14
Q

what restoration would be required for an anterior tooth missing marginal ridges

A

post crown

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15
Q

what is the main indication for direct post restorations

A

ferrule present

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16
Q

what is an indication for cast post and cores

A

no ferrule - no dentine above the gum level

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17
Q

what is a disadvantage of doing a cast post crown on a tooth with no dentine above the gum level

A

its not stable and can rock when patients bite and can loosen the cement and cause bacteria ingress

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18
Q

what is a post/ core

A

gains intraradicular support for a definitive restoration
the core provides the retention for a crown
post retains the core

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19
Q

do posts strengthen or reinforce the tooth

A

no preparation of the root canal for a post weakens the tooth

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20
Q

what is the post

A

placed in the root canal

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21
Q

what is a core

A

what the prosthesis is cemented to - eg crown or bridge abutment

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22
Q

what is required for post placement

A

incisors and canines
avoid in mandibular incisors due to thin roots
avoid in curved canals to avoid perforations

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23
Q

what is the root filling length for post placement

A

4-5mm apically

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24
Q

what should the width of the post be

A

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

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25
Q

how much alveolar support is needed for a post

A

at least half of the post length into the root

26
Q

what is the requirements for a ferrule

A

at least 1.5mm height and width of remaining coronal dentine

27
Q

how is a ferrule described

A

dentine collar

28
Q

what are the advantages of retaining a ferrule

A

prevents tooth fracture
prevents root fracture

29
Q

why should posts be parallel sided

A

avoids wedging in the tooth
more retentive than tapered

30
Q

why should posts be non-threaded

A

smooth surface incorporated less stress to remaining tooth than threaded

31
Q

why should posts be cement retained

A

less retentive than threaded posts but cement acts as buffer between masticatory forces and post/ tooth

32
Q

what are the three classifications of posts

A

manufacture
material
shape

33
Q

what is the manufacture class of posts

A

pre-formed/ pre-fabricated or custom made

34
Q

what materials are used to make posts

A

cast metal, steel, zirconia, carbon/ glass fibre

35
Q

what shapes can pots be

A

parallel sided or tapered

36
Q

what are the classifications of pre-fabricated posts

A

tapered smooth
tapered serrated
tapered threaded
parallel smooth
parallel serrated
parallel threaded

37
Q

what are advantages of using prefabricated posts

A

only 1 visit required
no impression and lab visit required
chairside core build up

38
Q

what are custom posts

A

cast from direct pattern fabricated in patient’s mouth

39
Q

how is a custom post manufactured

A

unified post and core made in one piece with the same material

40
Q

what are the properties of a metal post material

A

poor aesthetics, root fracture, corrosion, cant use if patient has nickel sensitivity, radiopaque on radiographs

41
Q

what are the properties of ceramic post materials

A

high flexural strength and fracture toughness, favourable aesthetics, difficult retrievability and root fracture common

42
Q

what are the properties of fibre post materials

A

flexible, similar properties to dentine, aesthetic, retrievable, bond to dentine with DBAs, radiolucent

43
Q

what s a core build up

A

the internal part of the tooth is build up with restorative material to replace the lost tooth tissue

44
Q

what does the core build up provide

A

retention and resistance for definitive restorations

45
Q

what are the three common core materials

A

composite
amalgam
glass ionomer

46
Q

what are the properties of using composite as a core material

A

tooth coloured, good aesthetics, bonds to tooth structure, technique sensitive, moisture control required

47
Q

what type of post is a composite core usually used with

A

fibre post

48
Q

why are amalgam cores tended to be avoided

A

retention is required and poor aesthetics and have to leave for 24 hours to set

49
Q

why are glass ionomer cores not favourable

A

absorb water and core expands in size

50
Q

what is a Nayyar core

A

they cut a bit of the coronal GP away and replace it with amalgam to increase retention

51
Q

what is the difference between inlay and onlay

A

inlays - the cusps are not covered or supported whereas with onlays the cusps are supported

52
Q

how to determine if a tooth needs a post

A

could you build up a core
does the tooth need a post now

53
Q

what factors should you consider when designing the restoration post RCT

A

how long will post be
have you got a ferrule
how wide
3-5mm remaining GP
is canal straight
how much space needed for the core

54
Q

what degree of taper should you have in your canal

A

6 degree

55
Q

how do you fit a post

A

do not fill post space with cement
use firm apical pressure
get rid of excess
ask lab for provisional acrylic crown

56
Q

name four problems with posts

A

perforation
core facture
root fracture or crack
post fracture

57
Q

what is the management for post perforation

A

repair - internal or external (periradicular surgery)
extraction

58
Q

how are posts removed

A

ultrasonics
masseran kit
eggler
moskito forceps

59
Q

what are the reasons by percentage why posts fail

A

60% due to restorative reasons
32% due to periodontal problems
8% due to endodontic reasons

60
Q

do all RCT teeth need a post and crown

A

no - can do onlay or composite build up

61
Q

why are unified post and core preferred for non vital teeth

A

it avoids material interfaces

62
Q

do all cores need a post

A

no

BDS3 Endodontics (2 decks)

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