Resvision of endodontic principles Flashcards
What is Endodontology?
Endodontology is the study and treatment of the dental pulp and periradicular tissues, focusing on their health, injuries, diseases, prevention, and treatment, with apical periodontitis being the primary disease caused by infection.
What causes endodontic disease?
Endodontic disease is primarily caused by microorganisms (bacteria), and host factors play a role in the progression of the disease.
What are some common Gram-positive bacteria involved in endodontic infections?
Streptococcus species (strict anaerobe)
Oslenella uli (strict anaerobe)
Peptostreptococcus micros (strict anaerobe)
Lactobacillus species (facultative anaerobe)
Enterococcus faecalis (facultative anaerobe)
What are some common Gram-negative bacteria involved in endodontic infections?
Gram-negative bacteria:
Treponema denticola (strict anaerobe)
Fusobacterium nucleatum (strict anaerobe)
Tannerella forsythia (strict anaerobe)
Dialister species (strict anaerobe)
What is the difference between the apical region and coronal region in terms of bacterial infection?
Apical region: Low oxygen tension, fewer bacteria, and more difficult to treat due to less access to treatment methods.
Coronal region: Higher oxygen tension, more bacteria, and more accessible to treatment.
What is biofilm in the context of endodontic disease?
Biofilm is an aggregation of microorganisms growing on a solid surface, embedded in a protective extracellular matrix. It makes bacteria more resistant to treatment and harder to remove mechanically.
Why are biofilms resistant to eradication?
Biofilms create a physical barrier to antimicrobial agents, making penetration difficult. Additionally, biofilms have varying metabolic states, including slow growth and starvation survival, and can form persister cells that resist treatment.
What does SOCRATES stand for in diagnosing endodontic disease?
SOCRATES is a mnemonic for systematic diagnosis:
S: Site
O: Onset
C: Character
R: Radiation
A: Associations
T: Time
E: Exacerbating/Relieving factors
S: Severity
What is the difference between vitality and sensitivity tests in endodontics?
Vitality test checks whether the pulp is alive and functional.
Sensitivity test checks how the tooth reacts to stimuli such as cold or heat.
What is the importance of using a rubber dam in endodontic treatment?
A rubber dam isolates the tooth, preventing contamination from saliva and improving visibility, patient comfort, and overall treatment success.
What is the goal of chemo-mechanical preparation of the root canal?
The goal is to clean and shape the root canal system, removing bacteria, debris, and necrotic tissue while optimizing irrigation and simplifying obturation (filling).
What are Schilder’s design objectives for root canal preparation?
Continuously tapering funnel from apex to access cavity.
Maintain a narrower diameter at every point apically.
Keep the apical foramen in its original position and as small as possible.
What are Schilder’s biological objectives for root canal preparation?
Confine instruments to the root itself.
Avoid forcing necrotic debris beyond the foramen.
Remove all tissue from the root canal space.
Create space for intracanal medicaments.
Preserve the root canal’s original anatomy.
What are Morgan’s principles in root canal preparation?
The goal is to prepare a canal that can be properly irrigated and obturated (filled), leaving enough tooth structure to prevent fracture, while removing biofilm and debris.
What are the challenges of automated instrumentation in endodontics?
Challenges include file fracture due to torsional failure or cyclic fatigue, and the use of rotary or reciprocating systems to properly shape the canal while avoiding procedural errors.
What are common issues encountered during file manipulation in endodontic treatment?
File fracture due to torsional failure or cyclic fatigue.
Perforations, ledges, and transportation of the canal if incorrect techniques are used.
What is the role of irrigants in chemo-mechanical preparation?
Irrigants are used to clean the root canal, flush out debris, and help remove biofilm. The right flow and choice of irrigant are crucial for effective cleaning.
What is the importance of contemporary CBCT imaging in diagnosing endodontic disease?
CBCT (Cone Beam CT) provides detailed 3D images, allowing for better visualization of lesions that may not be visible with conventional radiographs. It is helpful for diagnosing and planning treatment, though the radiation dose must be considered.
Why must multi-rooted teeth be considered carefully in endodontic diagnosis?
Multi-rooted teeth may give false positive or negative results in tests, so it is important to compare results with the contralateral (opposite) tooth for accuracy.
What are the steps in diagnosing endodontic disease?
The diagnosis should be systematic and thorough, involving history, clinical examination, special tests, radiographs, and considering symptoms, clinical signs, and the results of vitality and sensitivity tests.
: What is the role of isolation during endodontic treatment?
Isolation using a rubber dam is essential for preventing contamination, ensuring better visibility, increasing patient comfort, and improving the overall success rate of the treatment.
What are step-back and modified double flare techniques in root canal preparation?
These are manual techniques for preparing the root canal. Step-back involves gradually increasing the size of instruments as you move from the apex to the access cavity. Modified double flare combines step-back and flaring techniques to create the proper shape.
What are some problems with instrumentation during root canal treatment?
Problems include file fracture, ledges, perforations, and transportation. Proper technique and careful manipulation can minimize these issues.
What is recapitulation in endodontics?
Recapitulation involves re-checking the master apical file to ensure it still reaches the working length after cleaning and shaping the root canal system.
What are the biological objectives of root canal preparation according to Schilder?
These objectives include confining instruments to the root, removing all debris and necrotic tissue, creating space for medicaments, and preserving the root canal’s original anatomy.
Name some file fracture issues
Torsional Failure: When the file twists too much and breaks.
Cyclic Fatigue: Occurs when the file is subjected to repeated bending, causing it to break over time.
Name automated instrumentation
Ni-Ti (Nickel-Titanium) Files: These files are less likely to cause errors like file fractures compared to stainless steel, due to their flexibility and strength.
Rotary vs Reciprocating Systems: Both systems help in shaping the canal, but each has its own benefits depending on the clinical situation.
Describe the Root canal mciorflroa
Planktonic Microorganisms: Free-floating bacteria in the canal.
Biofilm: A community of microorganisms growing on a surface, embedded in a protective extracellular matrix.
Complex Community: These microorganisms interact in complex ways and form biofilms, making them harder to eliminate.
