Surgical Endodontics

Question 1

aim for endodontic tx

Answer 1

access, clean and disinfect the root canal system
reduce the number of microorganisms
remove the necrotic tissue
seal the system to prevent reinfection

Question 2

causes of persistent periapical radiolucencies in endo tx teeth

Answer 2

intraradicular infection
extraradicular infection
foreign body reaction
true cyst
fibrous scar tissue

Question 3

2 categories of periradicular cysts

Answer 3

true cyst - enclosed in an epithelial lining
pocket (bay) cyst - epithelium lined cavities that are open to the root canal

Question 4

indications for surgical endodontics

Answer 4

failure of previous endodontic tx
anatomical deivations (tortuous curved roots)
procedural erros
exploratory surgery (root fractures)

Question 5

contraindications to endodontic surgery

Answer 5

anatomical factors (thick cortical bone, proximity to neurovascular bundles)
inadequate periodontal support
non-restorable tooth
medical history

Question 6

magnification range

Answer 6

x3 to x30

Question 7

preoperative medications

Answer 7

anti-inflammatory agents (ibuprofen)
antibacterial rinse (0.2% chlorohexidine night before)
premedication (5mg diazepam if very nervous)

Question 8

what does anaesthesia do in endo surgery

Answer 8

prevents pain during surgery
obtains presurgical haemostasis

Question 9

what flap design should NOT be used

Answer 9

semilunar flap

Question 10

what flap designs are used

Answer 10

full mucoperiosteal flap (1 or 2 relieving incisions)
papilla based incision

Question 11

what flap design do we tend to use in endo surgery

Answer 11

papilla based incision

Question 12

what does the papilla based incision prevent

Answer 12

gingival recession

Question 13

what size blades are used

Answer 13

size 15 or 15c

Question 14

what is used to elevate the flap

Answer 14

prichard periosteal 4.5/5.5mm

Question 15

what does flap retraction avoid

Answer 15

slippage and repositioning

Question 16

what is osteotomy

Answer 16

removal of cortical plate to expose root end

Question 17

types of haemostatic control

Answer 17

preoperative
intraoperative
postoperative

Question 18

what topical haemostatic agents are used in the intraoperative phase

Answer 18

epinephrine pellets

Question 19

in root end resection how much is resected

Answer 19

3mm

Question 20

root end filling material

Answer 20

mineral trioxide aggregate

Question 21

suture material of choice

Answer 21

prolene 6-0

Question 22

complications of endodontic tx

Answer 22

post operative pain
swelling
ecchymosis
paraesthesia