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2 - Dental Specialties > Week 2 PP > Flashcards

Week 2 PP Flashcards

1
Q

Endodontic Treatment & Procedures

A
  1. Root Canal Therapy
  2. Endodontic Surgery
  3. Pulpal Therapy
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2
Q

What is the first step/stage of Root Canal Thereapy?

A

Debridement - the process by which the pulpal tissue is completely
removed from the tooth, and the canal or canals cleaned and
shaped to receive the filling material

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3
Q

What is the second stage of Root Canal Therapy?

A

Obturation
* the process by which the pulp canals and chamber are filled
so that the tooth cannot be re-infected through the apical
foramen and the tooth does not remain hollow

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4
Q

Steps for Root Canal Therapy..

A
  • review medical history
    -review chart and radiographs
    -topical/local anesthetic
    -isolation (dental dam)
    -disinfection
    -Accessing the Pulp
    -Tissue Removal
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5
Q

What type of Local Anesthetic is used for RCT?

A

-Acute infection - high epinephrine/long lasting anesthetic
-Severe Anesthetic - Anesthetic directly into pulp
-Necrotic tooth - no anesthetic

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6
Q

What items are to be disinfected?

A

-Tooth
-Clamp
-Surrounding area

  • Solution
  • Iodine
  • Sodium hypochlorite
  • Peroxide
  • Instruments
  • Cotton forceps
  • Cotton pellet
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7
Q

How to Access the Pulp for RCT?

A

Posterior teeth - by occlusal

Anterior teeth - lingual (near the cingulum)

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8
Q

What instruments/materials are needed for Access Preparation?

A

Instruments
* High-speed handpiece
with long shank fissure
bur
* Slow-speed handpiece
with long shank round
bur
* Endo explorer

Materials
-Suction
-water

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9
Q

Tissue Removal for RCT

A

Coronal pulp is removed - this should enable the dentist to see or locate the radicular canals

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10
Q

Instruments/Materials required for Tissue Removal for RCT

A
  • long shanked round bur
    -spoon excavator
    -endo explorer
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11
Q

How is the radicular pulp removed?

A

The radicular pulp is removed using barbed broaches - * depending on whether
the pulp is necrotic or
newly infected, it will
have different
appearances

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12
Q

What is Chemical Debridement?

A
  • Once the pulp has been removed from the
    canals, the dentist will
    destroy the bacteria
    present in the canals
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13
Q

What solution is used in the Irrigating Syringe?

A

With solution such as Sodium Hypochlorite, peroxide, or iodine

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14
Q

How is the Length of the Canal measured?

A

Using files or apex locator

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15
Q

Instruments used for measuring the length of the canal?

A

-Endo files
-File Stoppers
MM Endo Ruler
-PA X-ray Film
-Or an Apex Locator

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16
Q

Measuring File Length

A
  • the canals must be cleaned completely free of all pulpal tissue, bacteria eliminated and the canals properly shaped to receive the gutta percha filling material
  • the length of each canal must be accurately measured so that debridement is performed to the apex - not short of perforated through the foramen
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17
Q

What is the traditional way to measure?

A

The traditional way to measure is to place small files into each canal to the depth of the estimated apex of the root, then take a radiograph to see if it is
correct

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18
Q

Measuring the Canal Length

A

-The dentist uses the diagnostic x-ray to measure the canals – a small sized file is chosen for each canal and the rubber stopper set at the desired length
* A periapical x-ray is taken, and the position of the files observed – the dentist will either continue to use the initial length for further debridement, or will adjust the length the files are set to

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19
Q

What is the second xray called?

A

Working Length Xray

20
Q

What is an Apex Locator?

A

an apex locator device uses sonar type waves to locate the apex for the dentist
* The apex locator still relies on a file being placed into the canal
* The electrode of the apex locator is attached to the file and sonar type waves created
– as the file nears the apex of the tooth, the gauge notes changes in the ‘rebound’ and
indicates when the file reaches the apex

21
Q

What if the length of the canal is not properly determined?

A

The dentist may either leave pulpal material in the ends of the canals, or perforate the apex

  • A perforated apex allows the root canal sealer to exit the tooth and may cause irritation in the alveolar bone
  • Neither situation allows the apical bone to properly heal
22
Q

K-Type File

A

-comes in various sizes
-looks like an auger
-

*colour coding system is consistent across ALL endodontic files

23
Q

3 Types of Files?

A

-K–Type File
-Hedstrom (H) File
-Reamer File

24
Q

What is a Glates-Glidden Bur?

A

Attaches to a slow speed handpiece
-can put it in top of canal to make it wider/open it up

-size is determined by line indentation at bottom

25
Q

How to know what type of file to use?

A

The type of file used is usually based upon DDS preference

26
Q

Once the dentist knows the exact length of each canal, the DA can..

A

the DA can set rubber stoppers on a series of files and the dentist can clean and shape the canals

27
Q

What are Rotary Endo Files?

A

Files that attach to the slow speed handpiece instead of the traditional hand files - this reduces chair time for the patient and hand fatigue for the dentist

28
Q

How often are canals irrigated?

A

Canals are irrigated at regular intervals to remove debris and disinfect the area

29
Q

Where do endodontic files go after procedure is complete?

A

in the SHARPS container

30
Q

Broken Instruments Within Canals..

A

however careful the dentist may be occasinally an instrument will break within a canal - all attemps are made to remove the instrument tip at this point

31
Q

What if removal attempts of broken instrument within canal are unsuccessful??

A

The dentist may complete the remainder of the endodontic procedure, but the patient must be advised of the situatin, and the posibility of re-infection/failure of the endodontic procedure

  • often a document explaining all information and possible consequences is created, to be signed by the patient and detist
32
Q

Why is it important that the dentist completely remove all traces of pulpal tissue for RCT?

A
  • It is critical that the dentist completely remove all traces of pulpal tissue and ensure that all bacteria have been eliminated from the dentinal tubules
  • Failure to do so will allow bacteria to re-infect the area, and may result in the dentist having to redo the entire endodontic procedure in the future
33
Q

Purpose of Paper absorbent points?

A
  • Once the dentist is satisfied with the debridement, the canals are irrigated one final time and then dried using paper absorbent points - NEVER blow air into the canals
34
Q

How to determine size of paper points?

A

Use the same size as the endodontic file used

35
Q

Obturation Procedure

A

-Mater/trial point (gutta percha) is selected
-X-ray is taken to determine fit
-Master point is sealed into canal
-Smaller points of gutta percha are placed until the canal is completely filled
-the sealer fills any auxilary canals or discrepancies

36
Q

If Obturation of the Canal (for RCT) is done at a second appointment..

A
  • if this is the case, a cotton pellet dampened with formocresol or calcium hydroxide is placed in the pulp chamber and a temporary restoration is used to seal the tooth
  • to prevent contamination of the canals by saliva and bacteria (some type of ZOE is the best choice of materials)
37
Q

How is excess protruding gutta percha removed?

A

The excess gutta percha protruding from the tooth is melted off with a hot instrument or heat & touch

38
Q

What are the Oburation Instruments?

A
  • Endodontic spreader
  • Endodontic condenser
  • Heat and touch instrument
  • Mixing spatula
  • Lentulo spiral
  • Root canal sealer
  • Mixing pad
  • Gutta percha points
  • PA X-ray film
39
Q

Types of Root Canal Sealers?

A
  • Calcium Hydroxide
    -Zinc oxide-eugenol
    -glass ionomers
40
Q

Why is a Post Op Xray taken?

A

It is always taken to ensure the canals are completely filled

41
Q

Instruments/Materials used for temporary restoration?

A
  • Plastic filling instrument
    (PFI)
  • Cotton pellet
  • Temporary restorative
    material
  • Possibly a curing light
  • Articulating paper
  • Slowspeed HP
  • Large round bur
42
Q

What is Zinc Oxide Eugenol (ZOE) used for?

A

-Primary Teeth
-Emergencies
-RCT
-Caries management

43
Q

What is Fermit?

A

A temporary restorative material
- no mixing needed
-no eugenol
-light cured

44
Q

What is Cavit?

A

a Temporary restorative material
-pre-mixed
-self-cure
-reduces micro-leakage
-not moisture sensitive

45
Q

What is Term?

A

-a temporary restorative material
-non-vital teeth only
-emphasis on moisture control
-for completely cured and hard restorations

46
Q

What are the Post-Op instructions for RCT?

A
  • be careful of soft tissue due to anaesthetic
    -the complete pulp has been removed and there is a filling material in its place. Be careful eating on that side, particularly sticky foods
    -Minor to moderate discomfort is normal for the first few days but there should be improvement daily - if there is no improvement or the discomfort worsens, call the office
    -if no complications occur, the temporary restoration should be replaced within a few weeks, a crown is recommended on the tooth as it will become brittle with the pulp missing

2 - Dental Specialties (7 decks)

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