Flashcards
Endodontics IV (100 Flashcards)
Cards in this deck (100)
- 1If a significant isolated pocket is discovered in the absence of periodontal disease, it increase the probability of _______________ ___________ _____________ .vertical root fracture
- 25 clinical features of cracked tooth syndrome:1) Sustained pain during biting pressures 2) Pain only on release of biting pressures 3) Occassional, momentary, sharp, poorly localized pain during mastication that is very difficult to reproduce 4) Sensitivity to thermal changes 5) Sensitivity to mild stimuli, such as sweet or acidic food
- 3If sufficient tooth structure remains on a cracked tooth, how should it be restored?GI or acid-etched, dentin-bonded core without a post and restore with permanent crown. Place core materials 2-3 mm into canal orifice
- 4Vertical root fracture starts ______________ and extends ______________.apically, coronally
- 52 clinical features of endodontic lesions:1) Inflammation 2) Tooth tests nonvital
- 64 clinical features of primary periodontal lesions:1) Presence of plaque or calculus 2) Manifestation of a periodontal abscess during acute phase of inflammation 3) Broad-based pocket formation 4) teeth are vital
- 74 indications for sodium hypochlorite irrigation:1) Disinfection of root canals (through hypochlorite anion) 2) Dissolving organic matter 3) Does not remove smear layer 4) Concentration vary from 0.5% to 6%.
- 87 methods of treatment for hypochlorite accident;1) Long lasting local anesthetic 2) Encourage drainage 3) Steroids 4) Cold compresses 5) Antibiotics 6) Analgesics 7) Daily follow-up
- 92 indications for the use of EDTA:1) Removes inorganic material 2) Removes smear layer
- 10What is considered the best treatment for an acute apical abscess:1) Establish drainage 2) Clean and shape the canal(s)
- 11When performing an incise and drain, what should be the direction of the incision and why?Vertical, to be parallel with major blood vessels and to minimize scarring
- 123 instances where antibiotics should be prescribed to patients with swelling:1) Cellulitis (diffuse swelling) 2) Systemic symptoms (lymphadenopathy, fever) 3) Patients who are immunocompromised
- 134 contraindications for apicoectomy:1) Anatomic factors such as thick external oblique ridge or proximity of the neurovascular bundle 2) Medical or systemic complications 3) Nonrestorability 4) Poor root/crown ratio
- 14_______________: Surgical division (in approximately two equal halves) of a multirooted tooth. A vertical cut is made through the crown into the furcation and the defective half if removed.Hemisection
- 15_____________________: A surgical division but the crown and root of both halves are retained.Bicuspidization
- 165 reasons why ledging occurs:1) Lack of straight line access 2) Anatomy of canal 3) Inadequate irrigation or lubrication 4) Excessive enlargement of curved canals with files 5) Obstruction or the packing of debris in the apical portion of the canal
- 175 ways to avoid separating instruments;1) Recognize the stress limitations of the instrument 2) Continual lubrication of the instrument 3) Examine instruments before insertion 4) Replace files often 5) Do no proceed to larger files until smaller ones fit loosely in the canal
- 184 different kinds of root perforations:1) Coronal 2) Furcal 3) Strip 4) Root
- 19Strip perforations involve the ________________ side of the coronal root surface.furcation
- 20Perforation into the PDL results in a _________________ prognosisquestionable
- 21Testing teeth immediately following injury frequently yields a ____________ ________________ response.false-negative
- 223 types if uncomplicated fractures:1) Infraction 2) Enamel fracture 3) Crown fracture without pulp involvement
- 23___________________: Incomplete crack of enamel without loss of tooth structure.false-negative
- 243 types if uncomplicated fractures:1) Infraction 2) Enamel fracture 3) Crown fracture without pulp involvement
- 25___________________: Incomplete crack of enamel without loss of tooth structure.Infracture
- 26_________ ___________ (Ellis class I): Involves enamel only (enamel chipping and incomplete fractures or cracks).Enamel fracture
- 27What is the proper tx for a crown fracture without pulp involvement?Restoration with a bonded resin technique
- 285 factors that determine whether vital pulp therapy or RCT should be performed for a complicated crown fracture:1) Stage of development of the tooth 2) Time between the accident and treatment 3) Concomitant periodontal therapy 4) Restorative tx plan
- 29If horizontal root fracture has taken place, what indications may be present?Bleeding from the sulcus
- 30___________: No displacement, normal mobility, sensitive to percussion; generally responds to pulp testing. Pulp blood supply is likely to recover.Concussion
- 31___________: Tooth is loosened but not displaced.Subluxation
- 32_________________: Dislocation of a tooth from its alveolus resulting from acute trauma.Luxation
- 33What is the preferred method of treatment of a immature tooth that has undergone intrusive luxation?Allow to reerupt
- 34________: Complete separation of a tooth from its alveolus by traumatic injury.Avulsion
- 352 storage media that create an optimum environment for avulsed teeth:1) Viaspan 2) Hank's Balanced Salt Solution
- 36Endodontic tx is performed on teeth ___-____ days following reimplantation if the apex of ___________.7,10 closed
- 37What is the primary cause of replacement root resorption?Trauma to the PDL
- 38_____________________: Procedure in which a material is placed on a thin portion of remaing carious dentin that, if removed, might expose the pulp in permanent immature teeth.Indirect pulp cap
- 39The "_________ __________" refers to the DISTAL area in the MESIAL root of mandibular molars.danger zone
- 40What form of dental injury has the WORST prognosis?Intrusion
- 41What is the preferred form of tx for intruded primary teeth?Allow teeth to reerupt before possible repositioning
- 42What is the preferred form of tx for intruded permanent teeth?Allow to reerupt and splint
- 43What is the preferred emergency tx of a localized swelling associated with an endodontic infection?1) Achieve drainage either through the root canal or incise and drain 2) Eliminate the source of the infection
- 44In primary endodontic infection, what bacteria are most common?Gram negative strict anaerobes
- 45What are the bacterial flora of an infected previously treated endodontic tooth best characterized as?Gram positive faculative anaerobes
- 46How is EDTA best characterized?Chelating agent; removing inorganic portion of the smear layer
- 47What is the primary target of EDTA?Calcium ions
- 48In comparing accuracy among the three pulpal diagnostic tests, what two tests exhibit the highest sensitivity and specificity?Hot and cold tests
- 49What constitutes the largest portion of gutta percha obturation material?Zinc oxide
- 50What traumatic event is most likely to result in pulp necrosis?Avulsion
- 51Pulp Biology - contains loose fibrous CT w/ nerves, blood vessels, and lymphatics - contains ___, which secrete fibrous CT - contains ___, which secrete primary and secondary dentin - contains undifferentiated mesenchymal cells, which become ___ odontoblasts and secrete ___ ___ to protect the pulp from injuryfibroblasts, odontoblasts,secondary, tertiary dentin
- 52Primary dentin = formed ___ (before/after) root formation is complete Secondary dentin = formed ___ (before/after) root formation is completebefore, after
- 53Pulp is surrounded by hard dentin (secreted by ___ as the tooth was forming) - this hard dentin creates a pressure system that limits the pulp's ability to expand Pulp lacks ___ circulation, which limits its ability to cope with ___ - less avenues for immune cells to reach the pulp (only one way in/out of the rootodontoblasts, collateral, infection
- 54What can the pulp do to defend itself against an infection? ___ dentin - very hard dentin; pulpal response involving calcification of dentinal tubules in response to slowly advancing caries or aging Reactionary dentin - reaction to ___ (minor/major) damage; aka ___ dentin Reparative dentin - repair for ___ (minor/major) damage; aka ___ dentin Pulpal ___ - response to rapidly advancing caries or other severe damage; tooth is dead, pulp has been compromisedsclerotic, minor, secondary, major, tertiary, necrosis
- 55Minor damage is not enough to destroy odontoblasts, so they can still secrete ___ dentin Major damage will destroy odontoblasts, so the undifferentiated ___ cells will have to become secondary odontoblasts in order to secrete ___ dentinsecondary, mesenchymal, tertiary
- 56In endo and operative, there is a technique called ___ ___ - you place a calcium hydroxide liner, which irritates odontoblasts, resulting in the formation of either reactionary or reparative dentin depending on how close you are to the pulp - tooth is alive in this situationpulp capping
- 57In all of these cases (sclerotic dentin, reactionary dentin, reparative dentin, and pulpal necrosis), the main cause of serious pulpal injury is always ___ Bacteria can come from mostly dental ___ - bacteria are small enough to penetrate beyond the caries through dentinal tubules to reach the pulp - patient can be in pain and the pulp can eventually diebacteria, caries
- 58Histologic zones of pulp (from outside to inside) 1. ___ 2. ___ - innermost part of dentin, lighter in color b/c not mineralized, directly adjacent to the pulp 3. ___ layer - can see the nuclei of the odontoblasts that are laying down the predentin layer 4. cell-___ zone of ___ - will not see any nuclei b/c there are no cells; will rather see nerve bundles 5. cell-___ zone - can see more nuclei 6. pulp ___ - central part of the pulpdentin, predentin, odontoblastic, free, weil, rich, core
- 59Dentinal pain is conducted by ___ fibers***, which are ___ (large/small), ___ (myelinated/unmyelinated), ___ (afferent/efferent) nerves - sharp transient "first pain" - these fibers course ___ (coronally/centrally) through the pulp as opposed to ___ (coronally/centrally) like the C-fibers - dental pain is often associated with ___ (cold/hot) temperatures A-delta fibers are transmitting dental pain b/c they are associated with the pulpal-dentinal complex - where the pulp and dentin meet, the a-delta fibers are more easily provokeda-delta, large, myelinated, afferent, coronally, centrally, cold
- 60Pulpitis pain is conducted by ___ fibers, which are ___ (large/small), ___ (myelinated/unmyelinated), ___ (afferent/efferent) nerves - dull throbbing "second pain" - course ___ (coronally/centrally) in the pulp stroma - more often associated with ___ (cold/heat) So the progression of pulpal inflammation can cause you to switch from first pain (a-delta fibers) to second pain (c-fibers)c, small, unmyelinated, afferent, centrally, heat
- 61Pain sensitization ___ - heightened response to pain; inflammatory mediators in the pulp make something that is already painful even more painful ___ - reduced pain threshold; pain due to a stimulus that does not normally provoke pain (ex: sunburnt skin and aloe-dynia)hyperalgesia, allodynia
- 62Referred pain - preauricular pain often refers from ___ molars since both share ___ innervation (mandibular nerve)***mandibular, V3
- 63Every single tooth (whether dead or alive) has 2 different endo dx - ___ dx - health of the pulp - ___ dx - health of the tissues surrounding the apical region of the toothpulpal, periapical
- 64Types of Pulpal Dx 1. ___ pulp - asymptomatic, mild to moderate transient response to thermal and electrical stimuli - ___ - subsides when stimulus is removed aka momentary response - pulpal ___ are stimulated with thermal and electrical stimuli 2. reversible pulpitis 3. symptomatic irreversible pulpitis 4. asymptomatic irreversible pulpitis 5. pulp necrosis 6. previously tx pulpnormal, transient, fibers
- 65Types of Pulpal Dx 1. normal pulp 2. ___ ___ - symptomatic; thermal (usually cold) stimulus causes quick, sharp, hypersensitive, transient response - example of ___ - need to test control teeth to determine a ___ - no ___ pain - caused by an irritant that affects the pulp (caries, deep cleaning, deep restorations w/o proper liner/base) - if the irritant is removed, the pulp reverts to its normal pulp status - if the irritant remains, it can lead to ___ pulpitis (when the bacteria penetrates into the pulp) - symptom, not a disease 3. symptomatic irreversible pulpitis 4. asymptomatic irreversible pulpitis 5. pulp necrosis 6. previously tx pulpreversible pulpitis, hyperalgesia, baseline, spontaneous, irreversible
- 66___ ___ ___ aka EPT (electrical stimulus) - convenient but ___ (least/most) reliable pulp vitality testing - indicates if there are vital sensory fibers present in the pulp, but no info about vascular supply to the pulp - ___ ___ to the pulp is the true determinant of pulp vitality - cold test also does not give info about vascular supply to pulp, but it provides a spectrum of information, whereas EPT only tells you if tooth is alive/dead and nothing in between - EPT can give false positives/false negatives - contraindicated if pt has a ___ ___electrical pulp test, least, vascular supply, cardiac pacemaker
- 67___ Test (thermal stimulus) - ___ ___ = dichlorodifluoromethane, -30 degrees celsius - apply chilled cotton pellet to middle 1/3 of the facial surface of the crown for 5 seconds - intensity and duration of the response will provide the information regarding the pulpal dxcold, endo ice
- 68Types of Pulpal Dx 1. normal pulp 2. reversible pulpitis 3. ___ ___ ___ - microscopically, the pulp has these microabscesses, pockets of inflammation and infection, and intact nerves - so this will be painful aka symptomatic - pulp has been irreversibly damaged beyond repair; even with removal of the irritant, it will not fully heal - characterized by ___ intermittent or continuous pain (unprovoked, can wake patient up at night) - cold/thermal stimulus causes ___ pain (even after chilled pellet is removed) - ___ changes (bending over/lying down) increases BP to the head and can exacerbate dental pain radiographs are generally insufficient and EPT is not good for dx - relying mostly on patient history, explanation of dental pain, and cold test results 4. asymptomatic irreversible pulpitis 5. pulp necrosis 6. previously tx pulpsymptomatic irreversible pulpitis, spontaneous, lingering, postural
- 69Types of Pulpal Dx 1. normal pulp 2. reversible pulpitis 3. symptomatic irreversible pulpitis 4. ___ ___ ___ - asymptomatic (nerves are responding rather normally), but irreversible damage present microscopically/histologically/physiologically - tx is needed 5. pulp necrosis 6. previously tx pulpasymptomatic irreversible pulpitis
- 70Types of Pulpal Dx 1. normal pulp 2. reversible pulpitis 3. symptomatic irreversible pulpitis 4. asymptomatic irreversible pulpitis 5. ___ ___ - usually asymptomatic but can also be painful; death of the pulp tissue (may occur quickly or may require years) - can have partial or total necrosis - due to long term interruption of ___ ___ to the pulp - crown discoloration may accompany pulp necrosis in ___ teeth - can be treated with root canal therapy or internal bleaching - if left untreated, toxins spread beyond the apical foramen and leads to thickening of the PDL, tenderness to percussion/palpation, apical disease (___ dx) 6. previously tx pulppulp necrosis, blood supply, anterior, periapical
- 71Types of Pulpal Dx 1. ___ pulp - normal response to cold test, no lingering 2. ___ ___ - heightened response to cold test, no lingering 3. ___ ___ ___ - heightened response to cold test, lingering 4. ___ ___ ___ - normal response to cold test, no lingering 5. ___ ___ - no response to cold test 6. previously tx pulpnormal, reversible pulpitis, symptomatic irreversible pulpitis, asymptomatic irreversible pulpitis, pulp necrosis
- 72Types of Periapical Dx - inflammatory responses to irritants from the root canal system aka extension of ___ disease into the ___ tissue - can also be caused by occlusal trauma, canal over-instrumentation, and periodontal lesions 1. ___ periapical tissues - asymptomatic, no pain on percussion or palpation 2. symptomatic apical periodontitis 3. asymptomatic apical periodontitis 4. acute apical abscess 5. chronic apical abscesspulpal, periapical, normal
- 73___ dx - cold test and EPT are the main diagnostic tools ___ dx - percussion, palpation, and radiographs are the main diagnostic tools ___ - involves tapping on teeth (ex: with mirror handle) - tap in vertical direction along the vertical axis of the tooth to see how the pt responds - normal response should not be painful ___ - palpating the gums around the apex of the root - normal response should not be painful, no swelling or fluctuationpulpal, periapical, percussion, palpation
- 74Types of Periapical Dx 1. normal pulp 2. ___ ___ ___ - painful inflammation around the apex - characterized by pain on ___ and intense throbbing pain - due to localized inflammatory infiltrate within the PDL - if the tooth is vital w/ symptomatic apical periodontitis, ___ adjustment can be effective so occlusal contact is not too heavy - if tooth is necrotic, ___ therapy is needed to prevent disease progression - assuming that the apical infection is due to an infection that started in the pulp and spread to the apical tissues 3. asymptomatic apical periodontitis 4. acute apical abscess 5. chronic apical abscesssymptomatic apical periodontitis, percussion, occlusal, endo
- 75Types of Periapical Dx 1. normal pulp 2. symptomatic apical periodontitis 3. ___ ___ ___ - asymptomatic - involves apical ___ (radiographs) - confirmation of pulpal ___ - a totally necrotic pulp provides a safe harbor for the primarily anaerobic bacteria that leak out into this PDL space - a periapical radiolucency can be a periapical cyst or periapical granuloma depending on the histolology 4. acute apical abscess 5. chronic apical abscessasymptomatic apical periodontitis, radiolucency, necrosis
- 76Types of Periapical Dx 1. normal pulp 2. symptomatic apical periodontitis 3. asymptomatic apical periodontitis 4. ___ ___ ___ - involves rapid swelling, severe pain, and ___ exudate (liquefaction necrosis) around apex 5. chronic apical abscessacute apical abscess, purulent
- 77Types of Periapical Dx 1. normal pulp 2. symptomatic apical periodontitis 3. asymptomatic apical periodontitis 4. acute apical abscess 5. ___ ___ ___ - involves a draining ___ ___, resulting in no pain and no swelling usually - can insert a ___ ___ cone into the sinus tract until you feel resistance, take a PA, and trace the source and path of the infection aka the chronic apical abscesschronic apical abscess, sinus tract, gutta percha
- 78Types of Periapical Dx 1. ___ pulp - no key features 2. ___ ___ ___ - pain on percussion 3. ___ ___ ___ - apical radiolucency, no pain on percussion 4. ___ ___ ___ - swelling and lots of pain 5. ___ ___ ___ - no swelling and less pain, sinus tract presentnormal, symptomatic apical periodontitis, asymptomatic apical periodontitis, acute apical abscess, chronic apical abscess
- 79Access Preparation Accessing the pulp space by drilling through the most accessible and logical place (___ surface for anterior teeth and ___ surface for posterior teeth) Most important technical aspect of the RCT Conservation of tooth structure, particularly the ___ ___ and ___ ___, which provide significant strength to the tooth as a whole Want to deroof the pulp chamber to expose pulp horns and orifices Want ___-___ access to the orifice and apex Access is usually made with a round bur and/or tapered bur in a high speed handpiece Standard of care is that the patient has a ___ ___ so that saliva, blood, and bacteria do not leak into the operative fieldlingual, occlusal, cusp tips, marginal ridges, straight-line, rubber dam
- 80Incisor access preps Preps are ___ in shape - ensures complete removal of the inflamed pulp horns with the wider coronal portion, protects the marginal ridges, and provides straight-line access to the orifice and apex ___ (maxillary/mandibular) central and lateral incisors have 1 canal almost 100% of the time - so usually do triangular access ___ (maxillary/mandibular) central and lateral incisors (particularly laterals) can have 2 canals - can use the triangular or a more oval shaped access to achieve straight-line access Want to access from the ___ (lingual/facial) surfacetriangular, maxillary, mandibular, lingual
- 81Canine access preps Maxillary and mandibular canines almost always have ___ canal ___-shaped access is often the shape of choice1, oval
- 82Premolar access preps Maxillary and mandibular premolars can have ___ canals Which premolar is most likely to have 2 roots? Answer: ___ ___ ___*** A narrower ___-shaped access is the shape of choice for most premolars1, oval
- 83Maxillary molars access Many of them have 3 roots - but the ___ root often houses ___ canals - so 4 canals in total (making them very difficult and better to refer to endo) The MB canal that is often missed is the ___ canal, which can cause the failure of the endo treatment This access prep is considered a blunted ___ or a ___ access prep shapeMB, 2, MB2, triangle, rhomboidal
- 84Mandibular molars access Easier than maxillary molars because there is no MB2 canal to worry about and usually less canals in general Most of these teeth have 2 roots - the ___ (distal/mesial) root often houses 2 canals (so ___ total canals) But also possible sometimes to have 2 canals in each root (so ___ total canals) - less common ___ access prep shapedistal, 3, 4, trapezoidal
- 85___ - removing the diseased pulp tissue in the canals, shave infected dentin from the canal space, and shape the canal so that we can fill it properly afterinstrumentation
- 86Instrumentation SS (stainless steel) hand files = ___ taper - so the width of the file gets wider by this taper every 1mm you move up from the tip Universal color scheme - the bigger the number, the wider the ___ of the file 2 subtypes of SS hand files - ___-file (Kerr) = twisted square shape, watch winding method - ___-file (Hedstrom) = spiral cone shape, only cuts in retraction aka when you pull the file outward, teardrop cross-section NiTi (nickel titanium) rotary instruments = ___ or ___ taper - looks similar to the hand files except there is a latch at the handle instead that fits into a rotary handpiece (that rotates at some set RPM).02, diameter, K, H, .04, .06
- 872 important points along the cutting edge of the file ___ - diameter at the very tip of the file - ex: size 15 file - 0.15mm at D1 - ex: size 20 file - 0.20mm at D1 ___ or ___ - diameter 16mm from the tip where the cutting flutes end - ex: size 15 K-file - 0.15mm + .02(16mm) = 0.47mmD1, D2, D16
- 88Instrumentation ___-___ drills - top open orifice for straight-line access ___ ___ - entangle and remove things that are caught in the canals ___ - twisted triangle, used by clockwise motions instead of watch winding methodgates-glidden, barbed broaches, reamer
- 89Cleaning and Shaping 2 primary methodologies to cleaning and shaping the root canals: - ___-___ method = big to small - ___-___ method = small to bigcrown-down, step-back
- 90Cleaning and Shaping Crown-down method = big to small; usually done with ___ instruments; start by shaping the coronal 1/3 of the canal that is too large to fit the entire length of the canal; move sequentially downwards into the canal from big files to small files So start with a larger file (ex: 35 file with .06 taper) - run it apically until you meet ___ - then use successively smaller files to get more apically into the canal Poor fit is ideal because it allows for more efficiency, less points of friction, and therefore less risk of ___ ___ (one of the main endo complications)rotary, resistance, instrument fracture
- 91How to find the apex Combination of preoperative radiograph and apex locator and/or intraoperative radiograph with the file in the canal Want to obturate each canal from ___-___mm from the apex (this point is called the ___ ___) - helps confine instruments, materials, and chemicals to the canal space ___ length = distance from the reference point to the apical stop0-2, apical stop, working
- 92Cleaning and Shaping Step-back method = done with ___ instruments; start with a larger file to shape the coronal 1/3; then switch to smaller file to go down to the apex; then start using bigger files as you work your way up coronally You want to ___ out the canal properlyhand, flare
- 93Irrigation and Medicaments Between each file that you use, you need to ___/flush the canals with these chemical agents Sodium hypochlorite (NaOCl) = irrigant, dissolves ___ (organic/inorganic) material aka ___ Ethylenediamine tetraacetic acid (EDTA) = lubricant, dissolves ___ (organic/inorganic) materal aka ___ ___ of dentin from instrumentation; chelating agent since EDTA binds to calcium and other inorganic elements Chloroform = dissolves ___ ___ in retreatment Aerators = spin air into the canals as you shape and clean them - the theory behind this is that the majority of endo bacteria are ___ and don't like O2irrigate, organic, bacteria, inorganic, smear layer, gutta percha, anaerobic
- 94Endo Microbiology ___ endo infection - bacterioides are the primary bacteria present in the root canal system - these are gram ___, ___ anaerobes - cannot live in the presence of oxygen ___ endo treatment - enterococcus faecalis are the primary bacteria present - gram ___, ___ anaerobesprimary, negative, obligate, failed, positive, facultative
- 95___ = sealing the root canal system to prevent any bacteria from entering and to starve any bacteria that might be left ___ ___ color system matches the color system of the files - match the color of the gutta percha with the color of the last file that you use - allows you to properly seal the canals The main ingredient for the gutta percha and the sealer is ___ ___ ___ (ZOE)*** Pick the proper gutta percha size - seat it fully to the apex - use a heated plugger instrument to compress the gutta percha into the canal space (___ ___ condensation) Or you can use a finger spreader to create room in the root canal - place tiny accessory gutta percha cones into that space (___ ___ condensation) Can use one or both techniques You want to place a temporary restoration and then a final restoration over the obturated tooth to seal the access preparation from the ingress of ___ from the oral cavityobturation, gutta percha, zinc oxide eugenol, warm vertical, cold lateral, bacteria
- 96Endo Tx Planning: 1. Non-surgical RCT - ___ direction (accessing the root canal from the coronal aspect of the tooth aka normal direction) - first choice of treatment 2. ___ - re-accessing the canal, removing all the root canal materials, re-instrumenting it, and then re-filling it - done if the RCT fails and the problem is in the ___ 3. ___ RCT - persistent infection around apex of the tooth - involves enlarging an osseous window with a bur, removing that infected tissue, cutting off the root tip, instrumenting in a root-end ___ direction, and filling in the tip of the canal - done if the RCT fails and the problem is at the ___orthograde, retreatment, canal, surgical, retrograde, apex
- 97Incision & Drainage = surgical opening in ___ ___ to release exudate and pressure Best for localized and fluctuant swellings Can tug out the granulation tissue to achieve a drain from the source of infection - can place a drain of some surgical sterilized material to allow for pressure buildup to leak out over timesoft tissue
- 98Trephination = surgical opening in ___ ___ to release exudate and pressurehard tissue
- 99___ ___ = technical term for the complete surgical endodontic treatment process Conventional RCT - access the pulp space from the ___ aspect of the tooth, creating an access preparation and instrumenting and sealing the canals through that access opening Surgical RCT - achieving access through the ___ by the apex of the tooth - accessing and instrumenting and sealing this canal through the apical access - the coronal access is already sealed because of the original orthograde RCT treatment - with surgical RCt, we are aiming to achieve a better ___ apicallyperiapical microsurgery, coronal, bone, seal
- 100After the patient is sufficiently anesthetized, we start by opening a soft tissue flap and drilling through the bone - clean out any apical infection you see at this point Resect ___mm of diseased root tip (embedded in the infected tissue) - called ___ After root tip resection, instrument the canal with a round bur, which requires a ___ degree bevel - but the steeper the angle, the greater the chance of ___, which is what we are trying to avoid Modern microsurgical technique involves using an ___ ___ to instrument the canal - allows for a shallower bevel (___-___ degrees is ideal) So after resecting the root tip, you instrument the canal in a retrograde fashion using the ultrasonic instrument - prepare and instrument ___mm into the root canal Finally, you retrofill with an excellent biocompatible material called ___ ___ ___ (MTA) Then you suture the soft tissue and allow the bone to heal Now you have an ideal seal from the ___ and ___ direction3, apicoectomy, 45, leakage, ultrasonic tip, 0-10, 3, mineral trioxide aggregate, orthograde, retrograde
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- Praxis Flashcards: Endodontics Flashcards on Endodontics IV (100 Flashcards) , created by ACAPUN INSTITUTE on 01/08/2021.
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