Y2 S5 Follow up and summary of procedures Flashcards
When should patients be reviewed following endodontic treatment?
- Review 6 and 12 months post treatment
- Radiograph taken at 12 months
- Further follow up yearly for up to 4 years
What is the success rate for selective, one and two stage carious removal procedures?
70-90%
What is the success rate for full pulpotomy after 1 year?
75-95% (better rate for immature/younger teeth)
What features are seen as a favourable clinical outcome after vital pulp therapy?
- No symptoms of pulpitis or apical periodontitis
- Positive response to sensibility testing (beware of false negatives in older pts, heavily restored teeth, pulpotomies)
- No tenderness on palpation or percussion
- Continued root development for immature teeth
- Healthy periapical tissues
- Potential dentine bridge formation
What are the 2 hydraulic silicate cements used in endo?
- Biodentine
- Mineral trioxide aggregate
Why is Biodentine preferred over MTA?
- Better handling properties
- Similair biological properties to MTA
- Faster setting time
- Tooth coloured
- Results in less coronal staining than MTA
- Cheaper
Describe the main features of MTA.
- Biocompatible
- Prevents microleakage
- Promotes regeneration of tissues
- Longer setting time
- More expensive than Biodentine
Several uses (as a GDP we’ll only use MTA for pulp capping, not the more specialist procedures)
How is MTA used clinically?
- Mixed into a wet sand consistency
- Placed in MTA gun
- Tricky to manipulate and get into the right place
What are the advantages of vital pulp therapy and avoidance of RCT?
- Less risk of tooth fracture
- Simpler, cheaper treamtent
- Tooth remains vital
What is the aim of pulp capping/pulpotomy?
To establish an environment that induces hard tissue formation by pulp cells and seal the exposure site promoting maintenance of pulp vitality
What are the advanatges of hydraulic calcium silicates?
What are the disadvantages of hydraulic calcium silicates?
Why are hydraulic calcium silicates preferred over caclium hydroxide (Dycal)?
Hydraulic calcium silicates have:
- Better dimensional stability
- Sustained high pH
- At least equal if not superior bioactive properties
- Most, but not all, studies suggest superior pulpal healing
What is the difference between stepwise caries removal and selective caries removal?
- Stepwise: removal of caries over 2 appointments to allow pulp healing and minimise risk of exposure
- Selective: single visit, caries left on floor of cavity to minimise pulp damage or exposure, clean periphery.
What are the differences between a partial pulpotomy, full pulpotomy and pulpectomy?
