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ENDO > Seminar 12: Outcomes > Flashcards

Seminar 12: Outcomes Flashcards

1
Q

What outcome measures can we use?

A 
PROM
Peripapical status
Pain 
Functionality 
Tooth survival
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2
Q

What is health ?

A

Complete state of physical mental and social well being NOT JUST absence of disease

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3
Q

How can we undertake PROMs?

A

Patient questionnaires completed by themselves

Should be undertaken for all NHS FUNDED procedures

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4
Q

How can we measure periapical healing for a tooth?

A

Using radiographs or CBCT
Use tooth as whole
Per root

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5
Q

What is the importance of measuring / assessing for apical healing ?

A

This will allow us to identify if the protocol has worked or not

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6
Q

When measuring periapical healing what must be stipulated?

A

Criteria for assessing

Time frame for the assessment to be carried out after treatment completed

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7
Q

What are the risks of using root as a unit of measure of success?

A

Can overestimate compared to tooth as a unit

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8
Q

What are the benefits of using a single root as an outcome measure ?

A

Help to identify pre operative prognostic factors eg perforation/ledge and how this can impact outcome

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9
Q

What are the clinical signs for assessing healing ?

A 
Tenderness to palpate on
TTP
Sinus/ swelling
Radiographic signs of reduction in size of lesion 
Normal PDL space over time
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10
Q

Between radiographs and CBCT which shows lower healing rates ?

A

CBCT

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11
Q

What are the problems with CBCT with regards to diagnosing apical lesions

A

Kruse et al 2019: CBCT better at detecting lesions in non root filled teeth

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12
Q

Healing rates with CBCT strict and PA strict were?

A

58% CBCT
72% PA

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13
Q

How long should we follow up healing ?

A

Peak incidence of healing was at 1 year

Orstavic 1996 and Azim et al 2015

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14
Q

What is the ESE guidelines for following RCT for four years based upon?

A

Strindberg 1956

Stabilisation of Healing not seen until 3 years after operation

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15
Q

What three factors may affect healing time?

A

Few studies have looked at this but (Azim et al 2015)

  • medically compromised
  • over extended
  • more complex root anatomy
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16
Q

How does poor recall rate effect outcome rates ?

A

Can over or underestimate

If tooth been extracted and patient has been lost to follow up this will caused outcomes to be more positive for example

17
Q

How can you categorise prognostic indicators of success into two groups ?

A

Patient related
Operator related

18
Q

Which systemic disease has an impact on periapical healing ?

A

Diabetes
Impaired innate immune response
Smokers
Gene polymorphism eg IL 6

19
Q

Why is healing rate similar amongst ant and post teeth?

A

As the apical anatomy is complex no matter if ant or post teeth and this cleaning and shaping of this area poses a challenge to the operator no matter which tooth it is

20
Q

What impact does vital or non vital pulp have on outcome ?

A

None- healing is the same EXCEPT if there is an apical lesion then success is reduced

21
Q

What is the effect on apical lesion size?

A

Ng et al 2011

Every 1mm increase in apical lesion a 14/15% reduction in healing

22
Q

Access cavity design is dictated by what?

A

Proximity of pulp chamber to external tooth structure providing straight line access to apical tissues

23
Q

What is apical disturbance?

A

Extension of instruments beyond canal terminus

24
Q

Which type of apical disturbance may have a positive impact on outcome ?

A

Patency filing

25
Q

What is the evidence behind use of CaOH

A

Trope et al 1999
Cheung et al 2002
Better success rate when CaOH used

26
Q

What is the biological impact of a periapical

Lesion?

A

Root canal infection

27
Q

What is the biological impact of the size of the PA lesion?

A

Species diversity

28
Q

What is the biological impact of a negative culture test following root canal preparation?

A

Negative test means adequate cleaning

29
Q

What is the biological impact of the quality of coronal restoration?

A

Risk of new infection

30
Q

What are the mechanical and biological reasons compromising tooth survival ?

A

Pre op deep pocketing

Pre op or intra op perforation

31
Q

What are the biological reasons compromising tooth survival ?

A

Pre op pain and sinus tract
Lack of patency
Extrusion

32
Q

What are the mechanical reasons compromising tooth survival ?

A

Lone standing teeth
Absence of cast restoration
Abutments for prosthesis

ENDO (22 decks)

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