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3 Endodontics > Restoration of the Endodontically Treated Tooth > Flashcards

Restoration of the Endodontically Treated Tooth Flashcards

1
Q

What does clinical assessment of a RCT tooth include?

A

Coronal seal
Amount of remaining tooth structure - ferrule
Swelling
Sinus
TTP
Is buccal sulcus tender to palpation
Mobility
Increased pocketing

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2
Q

What does radiographic assessment of a RCT tooth include?

A

Root filling - length, quality of obturation
Unfilled/missed root canals
Shape of canal
Patency - fracture instruments, posts, sclerosis
Bone support
Crown to root ratio (1:1.5)
Pathology

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3
Q

When should endodontics be carried out in relation to prosthodontics?

A

Before

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4
Q

What are the problems seen after RCT?

A

Lack or no ferrule
Wide post holes (re RCT)
Endodontic complications - fractured instruments, perforations, short/long root fillings

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5
Q

Are teeth brittle after RCT?

A

They do not become more brittle

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6
Q

Are root treated teeth more prone to fracture?

A

A root filled tooth with minimal loss of dentine is no more likely to fracture than a vital tooth

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7
Q

Are RCT teeth as hard as non-root treated teeth?

A

Dentine hardness is not altered after endodontic treatment

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8
Q

Does dehydration affect the hardness of a RCT tooth?

A

It doesn’t weaken dentine structure

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9
Q

What is coronal microleakage and when is it significant?

A

Ingress of oral micro-organisms into the root canal system
Important cause of RCT failure
Significant in multi-rooted teeth

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10
Q

Why is a coronal seal important?

A

The technical quality of the coronal restoration is significantly more important for apical periodontal health than the technical quality of the RCT

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11
Q

What are the different anterior restorative options?

A

Veneers
Crowns
Post crown

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12
Q

What is a post/core?

A

Core provides retention for crown
Post retains the core
Gains intraradicular support for a definitive restoration
Posts do not strengthen or reinforce teeth
Perp of the root canal for a post weakens the tooth

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13
Q

What are the components of a post and core?

A

Post is placed in the root canal
Core is what the prosthesis is cemented to eg - crown or bridge abutment

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14
Q

What teeth are suitable for a post placement?

A

Incisors and canines
Avoid in mandibular incisors
Premolars - only in widest root canal
Avoid in curved canals to avoid perforations

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15
Q

What is the root filling length for a post?

A

4-5mm root filling apically

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16
Q

What post width is needed?

A

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

17
Q

What else is needed for post placement?

A

Sufficient alveolar bone support, at least half of post length into the root
Minimum 1:1 post length/crown length ratio
Ferrule - at least 1.5mm height and width of remaining coronal dentine

18
Q

What is a ferrule?

A

Dentine collar - encirclement of 1-2mm of vertical axial tooth structure within walls of a crown
Prevents tooth fracture
Orthodontic extrusion or crown lengthening may be necessary to achieve this

19
Q

Describe the ideal post

A

Parallel sided
Non-threaded (passive)
Cement retained

20
Q

How can posts be classified?

A

By manufacture - pre-formed/prefabricated or custom made
By material - cast metal, steel, zirconia, carbon/glass fibre
By shape - parallel sided or tapered

21
Q

Describe prefabricated posts

A

Only 1 visit required
No imps or lab visits required
Chairside core build up
Post and core are different materials
Immediate prep of core
Large selection of designs and materials

22
Q

Describe custom pots?

A

Cast from direct pattern fabricated in patients mouth
Indirect pattern can be fabricated in the lab
Unified post and core - one piece with the same material
2 visits needed - imps and fit
Risk of contamination of the root canal between visits

23
Q

What metals can be used in posts?

A

Cast gold
Stainless steel
Brass
Titanium

24
Q

What ceramics can be used in posts?

A

Alumina
Zirconia

25
Q

What fibres can be used in posts?

A

Glass
Quartz
Carbon

26
Q

What are the different post shapes?

A

Tapered
Parallel

27
Q

What is a core build up?

A

Internal part of tooth is built up with restorative material to replace the lost tooth tissue
The core is prepared
It provides retention and resistance for permanent restorations

28
Q

What materials can be used for cores and why?

A

Composite - most commonly used
Amalgam - avoid as retention is required
Glass ionomer - avoid as it absorbs water and core expands

29
Q

What is a Nayyar core?

A

Root treatment is removed from the root canals
Amalgam is packed into the root canals and tooth is built up - this provides retention for amalgam
Cannot be prepared for 24 hours until amalgam sets

30
Q

What are the problems with posts?

A

Perforation
Core fracture
Root fracture or crack
Post fracture

31
Q

How is post perforation managed?

A

Repair - internal or external (periradicular surgery)
Extraction

32
Q

What can be used for post removal?

A

Ultra-sonics
Masseran Kit
Eggler
Mskoti Forceps (screw retained)

33
Q

What are the percentages and reasons for post failures?

A

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

34
Q

What is important in core design?

A

Taper and length important
6º taper
Length to allow 2mm clearance for MCC

35
Q

How is GP removed?

A

Dental dam
Soften with heat and solvent
Gates glidden to minimum size 3 (straight part of canal only)
Use working length and rubber stopper on gates glidden
Essential to leave 3-5mm GP in apical third

36
Q

What should be written on a lab prescription for post and cores?

A

Please construct cast post and core
Para post (colour)
Core 6º taper
Please leave 2mm space in occlusion for crown
Enclosed registration, opposing impression, shade

37
Q

What happens in try in of a post and core?

A

Check post space for temp bond
Irrigate with chlorhexidine 0.2%
Dry paper points
Ensure fits around prep
Check you have enough occlusal clearance

38
Q

What is important when fitting a post and core?

A

Be careful not to fill post with cement
Firm apical pressure
Get rid of excess
No excess around when taking crown impression/fitting MCC

3 Endodontics (1 decks)

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