Restorative - Endodontics Flashcards
- What % of maxillary first molars have an MB2 canal?
93%
- What are the three-design objective of endodontics?
- Create a continously tapering funnel shape
- Keep apical formaen as small as possible
- Maintain apical foramen in position
What do access cavities look like for maxillary teeth?
What do access cavities look like for mandibular teeth?
- What are the advantages of the crown down technique?
- Limits the spread of infected material at the apical foramen.
- Remove the coronal aspect first leading to less extrusive material out of the apex and therefore less post-op sensitivity.
- Makes straight-line access easier
- Removes bulk of infected tissue allowing for a reservoir of irrigant
- Keep reference point for WL
- Name 3 laws of pulpal floor anatomy?
- Law of colour. The pulp floor is always darker than the walls
- Law of symmetry 1. Orifices lie equidistant from the MD line through chamber floor (Except maxillary molars)
- Law of symmetry 2. Orifices lie perpendicular to the MD line through chamber floor (except maxillary molars)
- Give 3 rules for locating orifices in the pulpal floor?
- 1- orifices always located at the junction of the walls and floor
- 2- orifices always located at right angles in the floor-wall junction
- 3- orifices always located at the terminus of the root development fusion lines
Chemomechanical Disinfection-
1. Give 4 reasons for irrigation during endodontic treatment?
- Mechanical preperation allow cannot clean or remove all bacteria alone, due to the presense of lateral canals, webbing between canals and finlike extensions.
- Irrigant can reach areas files cant
- Disinfects canal
- Helps flush out debirs
- Dissolves organic tissue
- dampens canal to provide lubrication to instruments
- Removes smear layer
Why is sodium hypochlorite a good irrigant?
- Disinfects canal by removing all organic tissue like pulp and collagen as well as vital and necrotic tissue
What strength of sodium hypochlorite is used?
3% but anywhere between 0.5-6%
Name another common irrigant apart from sodium hypochlorite?
Chlorohexidine
How is the smear layer removed?
WIth 17% EDTA for one minute
Chelating agent
- Name 2 intracanal medicaments and state their use?
- Non setting calcium hydroxide, is an antibacterial as high as pH 11 so kills bacteria (works for 11 days)
- Ledermix (anti-microbrial paste). It is a cortocosteroid and tetracycline paste used for the management of hot pulps to reduce inflammation and kill microorganisms (works 5-7days)
- In general they are placed inside root canal between treatment appointment to destroy microorganisms, prevent re-infection, reduce inflammation and exudate and control root resorption
Two periapical radiographs showing lower anterior 42-32. All teeth are treated endodontically with post and core. You can see radiolucency in all the teeth affected. The patient is referred to you for periradicular surgery.
1. Give to treatment options other than peri-radicular surgery? (2)
- Do nothing and monitor
- XLA
- Orthograde Re-RCT (basically re-RCT)
Orthograde is the use of this material through the coronal access point vs. retrograde which is the use of the material from the apex of the tooth as in the example of apicoectomy
- Give two criteria for valid consent
- Informed
- Non-manipulated
- Not coerced
- Patient must have capacity
- Voluntary