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xD3 Endo Final > Retreatment (Archer) > Flashcards

Retreatment (Archer) Flashcards

1
Q

What is the problem with a tooth that is previously endodontically treated that requires retreatment?

A

Bacteria

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2
Q

What can cause problems with an existing root canal?

A

Pre-existing or introduction of new bacteria into the canal

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3
Q

What is the only way to know if a previously endo treated tooth requires retreatment?

A

Accurate diagnostic testing

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4
Q

Is the radiograph enough to determine if a previously endo treated tooth requires retreatment?

A

No

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5
Q

Can a patient be sensitive to percussion without the presence of a periapical radiolucency (PARL)?

A

Yes

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6
Q

What is indicated for a tooth that has no periapical radiolucency, but is sensitive to percussion and it has not had recent restorative work done on it?

A

Evaluate for NSRCT

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7
Q

What 4 factors can lead to retreatment?

A
  1. Leaking coronal restoration
  2. Leaking apical seal
  3. Remaining bacterial irritants from initial therapy
  4. Missed or untreated canals
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8
Q

If a PARL stays the same size or gets smaller on a previously NSRCT tooth, is retreatment (RETX) indicated?

A

No

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9
Q

If the PARL gets larger after NSRCT, should RETX be done, even if the patient does not have symptoms?

A

Yes

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10
Q

What are 3 times RETX is indicated in the absence of symptom?

A
  1. Caries extending into pulp chamber
  2. Lack of permanent restorations for months after initial NSRCT
  3. Existing NSRCT is short, thread, or canal is missed
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11
Q

What are 4 obstacles that complicate RETX?

A
  1. Siilver points
  2. Thermafill
  3. Posts
  4. Separated instruments
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12
Q

What corrode rapidly from the apical and coronal aspects of the tooth to form toxic silver amine sulfate amide hydrate?

A

Silver points

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13
Q

Why are Thermafills poor for NSRCT and why do they make RETX difficult?

A

Stiff plastic carrier allows the obturators to be seated to length in poorly instrumented canals

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14
Q

These can trap bacteria in canal if separate early in cleaning and shaping, and also obscure entry into apical portion of root?

A

Separated instruments

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15
Q

What must be done to a post in an endo treated tooth before it is loosened and removed?

A

All core material around post above and below orifice must be removed

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16
Q

What is used to loosen and remove a post and how long will the post normally take to come loose during this process?

A
  1. Ultrasonic in circumferential rotation w/ continuous irrigation
  2. 10 minutes
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17
Q

What can be used to remove a separated instrument in a canal?

A
  1. Long thin ultrasonic tip

2. Instrument retrieval system to engage and remove

18
Q

What is done during RETX if unable to remove a separated instrument?

A

Attempt to bypass segment with a smaller file

19
Q

What are 3 instances when the RETX of a tooth is not indicated?

A
  1. Clinically unrestorable
  2. Extensive resorption
  3. Vertical root fracture
20
Q

Working around existing materials in the canals requires what 2 things?

A
  1. Light

2. Magnification

21
Q

Why is magnification and light needed to remove NSRCT materials in a RETX?

A

Must be able to see fine detail

22
Q

Ultrasonics used for RETX can do what?

A
  1. Discreet dentin removal
  2. Remove core material
  3. Remove cements
  4. Vibrate out posts
  5. Vibrate out instruments
  6. Vibrate out silver points
23
Q

What is a small beaked forceps that can be used to remove materials during RETX?

A

Stieglitz

24
Q

What is a threaded tube system used to engage the visible part of a separated instrument?

A

Instrument removal system

25
Q

What consists of trephine burs and taps used to extract tight posts?

A

Post removal system

26
Q

What is a Trephine?

A

Cylindrical or crown saw for the removal of a disk of bone or other firm tissues

27
Q

A small amount of this chemical can be used to initiate the softening of hard gutta percha during a RETX?

A

Chloroform (solvent)

28
Q

Why are the past concerns about chloroform not relevant?

A

Amount of chloroform found past apex is several orders of magnitude less than permissible dose

29
Q

How does Dr. Perry Jones retreat previous endodontically treated teeth?

A

Invisalign

30
Q

What can be used to irrigate?

A
  1. NaOCl
  2. EDTA(ethylenediamine tetraacetic acid)
  3. CHX
31
Q

What is a medicament for RETX?

A

Ca(OH)2

32
Q

What are 2 good things about 2.5% and 5.25% NaOCl?

A
  1. Dissolves vital and necrotic tissue

2. Antimicrobial

33
Q

What does using EDTA do for irrigation?

A

17% EDTA for 1 minute removes inorganic smear layer and leaves organic tissue components

34
Q

What must be used after irrigating for 1 minute with EDTA and why?

A

Irrigate w/ NaOCl to get rid of organic debris

35
Q

What is a use of Chlorhexidine as an irrigant?

A
  1. Broad spectrum antimicrobial
  2. Substantive
  3. 2% CHX has approximately the same properties as 5.25% NaOCl, but 2% CHX is more effective against Enterococcus faecalis
36
Q

Can Chlorhexidine dissolve necrotic tissue or remove the smear layer?

A

No

37
Q

Why is Calcium Hydroxide a medicament?

A
  1. Antimicrobial due to alkaline pH

2. May aide in dissolving necrotic tissue remnants, bacteria, and their byproducts

38
Q

What % of root canals done by general dentists and endodontists that fail?

A

10%

39
Q

RETX is an option that should always be evaluated by whom?

A

Endodontist (don’t EXT until consult)

40
Q

What is the healed rate of endodontic retreatment cases when the cause of failure is identified and corrected?

A

81%

xD3 Endo Final (8 decks)

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