Single vs multiple appointments Flashcards
What are the 7 steps of RCT?
Diagnosis, informed consent, LA and isolation, access and pulp extirpation, chemo-mechanical preparation, obturation, coronal seal
What is the usual alternative treatment option for RCT?
Extraction
How do you know when the tooth is ready to be obturated?
When paper point comes out dry
Which type of pulp/treatment is more likely to require multiple visits?
Infected pulp / peri-radicular periodontitis / retreatment
Which type of pulp/treatment is more likely to be completed in one visit?
Elective RCT / vital pulp / irreversible pulpitis
What are some patient factors that can influence if you complete RCT in one visit or multiple?
Medical conditions - can pt stay in chair?, anxiety, work/family commitments
What dentist factors can influence if the RCT can be completed in one visit or multiple?
Skills and expertise, preference, diary schedule
Why is a medicament used?
Antimicrobial, degradation of necrotic tissues, resolve pain, swelling and sinus, controls peri-radicular exudate
What are some examples of medicaments used in RCT?
Calcium hydroxide, antibiotic steroid paste, phenols, aldehydes, halogens
What is the medicament of choice for RCTs?
Calcium hydroxide
What is a disadvantage of calcium hydroxide as a medicament?
Does not reduce all antimicrobial load, decreases dentine hardness if left for too long, can cause complications if extruded
What kind of syringe do we use for irrigating and using medicaments in the canals?
Side venting to prevent extrusion
What are the advantages of calcium hydroxide as a medicament?
Reduces microbial load, easy to deliver
How long should medicaments be left in the canals for?
2-4 weeks
Why is a coronal seal required in between appointments?
Prevents contamination, prevents seepage of the medicament, supports remaining tooth structure, minimises discomfort
What can be used as a coronal seal?
Sterile cotton wool or PTFE tape, followed by a temporary restoration eg GIC, ZOE
Why should premixed materials eg cavit be avoided for the temporary restoration?
Has a higher wear rate and so can compromise the coronal seal
