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Flashcards

Endodontics VI (100 Flashcards)

ACAPUN INSTITUTE Flashcards: Endodontics Praxis Spanish 100 cards

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Cards in this deck (100)

  1. 1List the Pre-treatment Diagnostic categories Requiring treatment-Reversible pulpitis
    -Symptomatic irreversible pulpitis w/ symptomatic apical periodontitis or normal apical
    -Pulpal necrosis w/ symptomatic apical periodontitis or acute apical abscess +/- swelling    List the Pre-treatment Diagnostic categories Requiring treatment
  2. 2What Etiologies can lead to Reversible pulpitis?Defective restorations: marginal leakage
    Hyperocclusion
    Caries
    Incomplete crown fracture
    Post-operative sensitivity
    Hypersensitive dentin    What Etiologies can lead to Reversible pulpitis?
  3. 3What treatment is given for a diagnosis of Reversible Pulpitis?Conservative management
    -Remove decay or replace defective restoration
    -Manage pain +/- NSAIDs
    Reevaluate to ensure resolution of pulpitis    What treatment is given for a diagnosis of Reversible Pulpitis?
  4. 4T/F Emergency treatment requires completion of NSRCT to provide Pain Relief.False: Pain relief Requires Initiation of treatment, not necessarily completion of treatmentT/F Emergency treatment requires completion of NSRCT to provide Pain Relief.
  5. 5What are the main Treatment Options for Emergency treatment of Symptomatic irreversible pulpitis?*Pulpotomy*: removal of the Coronal portion of a Vital pulp
    -normal pulpal diagnosis
    *Pulpectomy*: complete removal of vital pulp from the root canal system
    -symptomatic apical periodontitis (tenderness to percussion)
    *Partial pulpectomy*: Removal of pulp from the Widest canal only (Palatal root of Mx molars. Distal root of Mn molars)    What are the main Treatment Options for Emergency treatment of Symptomatic irreversible pulpitis?
  6. 6What are the Emergency Treatment Options for Symptomatic apical Periodontitis?Administer long acting LA
    Reduce occlusion
    Prescribe a Mild to Moderate Analgesic
    Reassure patient
    (antibiotics indicated only in cases of Systemic involvement)    What are the Emergency Treatment Options for Symptomatic apical Periodontitis?
  7. 7What are the Emergency Treatment options for Acute apical abscess?Debridement: Removal of necrotic, infected pulp tissue (debridement is the same as pulpectomy except the pulp tissue is not vital)
    Extraction
    Analgesics: NSAIDs, others as needed
    Drainage if Swelling is present    What are the Emergency Treatment options for Acute apical abscess?
  8. 8How is Drainage of an Acute apical abscess achieved?Apical Trephination: drainage through the tooth. #15 file past the apical foramen
    Incision and Drainage through the swelling itself    How is Drainage of an Acute apical abscess achieved?
  9. 9T/F In extreme cases of acute apical abscess it is acceptable to leave the tooth open to allow continued drainage of the abscess through the tooth.False: Leaving the tooth open Worsens the condition due to additional bacterial contaminationT/F In extreme cases of acute apical abscess it is acceptable to leave the tooth open to allow continued drainage of the abscess through ...
  10. 10What are the Indications for use of Antibiotics for dental infections?Patient has Systemic involvement
    -Febrile
    -Lymphadenopathy
    -Cellulitis    What are the Indications for use of Antibiotics for dental infections?
  11. 11T/F Most patients are More fearful of the Injection than of the actual treatment.TrueT/F Most patients are More fearful of the Injection than of the actual treatment.
  12. 12What steps can be taken before and during the LA injection to reduce pain?Topical anestheic used
    Needle gauge selection
    Heat anesthetic solution
    Inject slowly
    Wiggle mucosa around injection site
    Inject as the needle is being inserted
    Don't inject into acutely inflamed or infected areas    What steps can be taken before and during the LA injection to reduce pain?
  13. 13You are planning on doing a root canal on tooth #3. You give a PSA block. The patient reports pain when you start the access opening. What is the likely reason the patient still has pulpal sensitivity?MB root of #3 innervated by MSA nerve 28% of the time.
    Must do a MSA block to anesthetize tooth #3    You are planning on doing a root canal on tooth #3. You give a PSA block. The patient reports pain when you start the access opening. Wha...
  14. 14According to the 1998 article from the journal of endodontics, _____% of Maxillary and _____% of Mandibular teeth required Supplemental injections to achieve adequate anesthesia to perform endo treatment.12%
    81%    According to the 1998 article from the journal of endodontics, _____% of Maxillary and _____% of Mandibular teeth required Supplemental i...
  15. 15In patients with Irreversible pulpitis in Posterior teeth _____% of patients required supplemental anesthesia.42%In patients with Irreversible pulpitis in Posterior teeth _____% of patients required supplemental anesthesia.
  16. 16Why are Anesthetic failures more common in Endodontics?-Infection and inflammation of involved teeth causes ↓pH making anesthetic less effective
    -Increased metabolism in the area due to
    infection causing ↑ Local Dilution
    -Morphologic changes in the nerve fiber
    -TTX resistant (tetrodotoxin resistant) Na⁺ channels    Why are Anesthetic failures more common in Endodontics?
  17. 17According to Malamed, SF, when should you change your technique after giving an injection?According to Malamed, SF, when should you change your technique after giving an injection?According to Malamed, SF, when should you change your technique after giving an injection?
  18. 18What different techniques may be used for giving a LA injection?Intraosseous
    Intraligament
    Intrapulpal    What different techniques may be used for giving a LA injection?
  19. 19When giving a 2nd or 3rd injection it is recommended to _____Use a new needleWhen giving a 2nd or 3rd injection it is recommended to _____
  20. 20What is the Target location of a Gow-gates block?Anteromedial border of the Mn Condylar neckWhat is the Target location of a Gow-gates block?
  21. 21How is the Akinosi block given?Closed mouth injection
    Needle positioned along the Maxillary buccal fold
    Needle passes Lingual aspect of the Ramus to a depth of ≈25 mm (no bone contact)
    LA deposited in the Superior portion of the Pterygomandibular space    How is the Akinosi block given?
  22. 22____% of patients that reported Lip and Tongue numbness did not have adequate Pulpal anesthesia. A Negative response to Endo ice is _____% accurate in determining pulpal anesthesia.63%
    92%    ____% of patients that reported Lip and Tongue numbness did not have adequate Pulpal anesthesia. A Negative response to Endo ice is _____...
  23. 23What are the Advantages and Disadvantages of giving a PDL injectionAdvantages
    -Profound pulpal anesthesia w/ minimal anesthetic
    Disadvantages
    -Less effective in Long roots
    -Post-operative comfort    What are the Advantages and Disadvantages of giving a PDL injection
  24. 24How is an Intraosseous anesthetic injection given?Small opening in the Cortical bone made
    LA deposited through the opening into the trabecular bone    How is an Intraosseous anesthetic injection given?
  25. 25How is Intrapulpal anesthetic given?Warn the patient that it is a painful injection.
    -Make a Small Pulpal Exposure with a #1 round bur w/ high speed and irrigation
    -Anesthesia produced by both Pressure and anesthetic solution    How is Intrapulpal anesthetic given?
  26. 26pulp contains...-loose fibrous connective tissue with nerves, blood vessels, and lymphatics
    -fibroblasts
    -odontoblasts
    i. primary dentin
    ii. secondary dentin
    -undifferentiated mesenchymal cells
    i. tertiary dentin    pulp contains...
  27. 27pulp is surrounded by...-hard dentin ; limits ability for pulp to expand
    -more driven to infection    pulp is surrounded by...
  28. 28pulp lacks...-collateral circulation ; limits its ability to cope with infection
    -more driven to infection    pulp lacks...
  29. 29sclerotic dentin-calcification of tubules in response to slowly advancing caries or agingsclerotic dentin
  30. 30reactionary dentinSecondary dentin
    -reaction to MINOR damage    reactionary dentin
  31. 31reparative dentinTertiary dentin
    -repair for MAJOR damage    reparative dentin
  32. 32pulpal necrosis-response to rapidly advancing caries or other severe damagepulpal necrosis
  33. 33what is main cause of damage to the pulp?damage is because of BACTERIAwhat is main cause of damage to the pulp?
  34. 34Histologic zones of pulp (from outer to inner)Predentin --> Odontoblastic layer --> Cell-free zone of Weil --> Cell-rich zone --> Pulp coreHistologic zones of pulp (from outer to inner)
  35. 35**dental pain-A delta fibers
    -large myelinated afferent nerve
    -course CORONALLY through pulp
    -sharp transient , "first pain"
    -COLD    **dental pain
  36. 36**pulpitis pain-C fibers
    -small unmyelinated afferent nerve
    -course CENTRALLY in the pulp stroma
    -dull throbbing, "second pain"
    -HEAT    **pulpitis pain
  37. 37hyperalgesiaheightened sensitivity/response to painhyperalgesia
  38. 38allodynia-reduced pain threshold
    -pain due to stimulus that does not normally provoke pain
    ex; sore throat, sunburnt skin (grab aloe)    allodynia
  39. 39referred pain-preauricular pain ofter refers from mandibular molars since both share V3 innervationreferred pain
  40. 40*normal pulpPULPAL DIAGNOSIS
    -asymptomatic
    -mild to moderate transient response to thermal and electrical stimuli    *normal pulp
  41. 41what is the least reliable pulp vitality test?EPT, electrical stimuliwhat is the least reliable pulp vitality test?
  42. 42*reversible pulpitisPULPAL DIAGNOSIS
    -hyperalgesia
    -symptomatic
    -thermal (usually cold) stimulus causes quick, sharp, HYPERSENSITIVE, transient response
    -NO spontaneous pain
    -caused by irritant that affects the pulp --> if you remove irritant, pulp will return to normal    *reversible pulpitis
  43. 43*symptomatic irreversible pulpitisPULPAL DIAGNOSIS
    -symptomatic
    -pulp has been irreversibly damaged beyond repair
    -SPONTANEOUS pain
    -thermal (often cold) stimulus causes LINGERING pain
    -postural changes exacerbate dental pain    *symptomatic irreversible pulpitis
  44. 44*asymptomatic irreversible pulpitisPULPAL DIAGNOSIS
    -asymptomatic
    -no clinical symptoms    *asymptomatic irreversible pulpitis
  45. 45*pulp necrosisPULPAL DIAGNOSIS
    -usually asymptomatic
    -can be partial or total
    -crown discoloration    *pulp necrosis
  46. 46*normal apical tissuesPERIAPICAL DIAGNOSIS
    -asymptomatic
    -no pain on percussion or palpation    *normal apical tissues
  47. 47*symptomatic apical periodontitisPERIAPICAL DIAGNOSIS
    -painful inflammation around apex
    -painful percussion
    -intense throbbing pain
    -localized inflammatory infiltrate within PDL    *symptomatic apical periodontitis
  48. 48*asymptomatic apical periodontitisPERIAPICAL DIAGNOSIS
    -asymptomatic
    -apical radiolucency
    -confirmation of pulpal necrosis    *asymptomatic apical periodontitis
  49. 49*acute apical abscessPERIAPICAL DIAGNOSIS
    -rapid swelling
    -severe pain
    -exudate    *acute apical abscess
  50. 50*chronic apical abscessPERIAPICAL DIAGNOSIS
    -draining sinus tract, usually without discomfort
    -NO swelling    *chronic apical abscess
  51. 51root canal treatment : Access-most important technical aspect of RCT
    -conservation of tooth structure
    -deroof chamber to expose pulp horns and orofices
    -straight-line access to orifice and apex    root canal treatment : Access
  52. 52incisior access cavitytriangularincisior access cavity
  53. 53canine access cavityovoidcanine access cavity
  54. 54premolars access cavitynarrow ovalpremolars access cavity
  55. 55maxillary molars access cavityrhomboidal / blunted trianglemaxillary molars access cavity
  56. 56mandibular molars access cavitytrapezoidalmandibular molars access cavity
  57. 57SS hand files-.02 taper
    •K file = twisted square, watch winding
    •H-file = spiral cone, only cuts in retraction    SS hand files
  58. 58NiTi rotary.04 or .06 taperNiTi rotary
  59. 59colors and sizes of hand fileswhite (15) , yellow (20) , red (25) , blue (30) , green (35) , black (40) , white (45)...colors and sizes of hand files
  60. 60D1-diameter at tip
    ex; size 15 file => .15mm    D1
  61. 61D2 or D16-diameter 16mm from tip where cutting flutes endD2 or D16
  62. 62cleaning and shaping : Crown-down-big to small
    -rotary    cleaning and shaping : Crown-down
  63. 63cleaning and shaping : Step-back-small to big
    -hand instruments    cleaning and shaping : Step-back
  64. 64sodium hypochlorite (NaOCl)-irrigant
    -dissolves ORGANIC material    sodium hypochlorite (NaOCl)
  65. 65EDTA-chelating agent
    -lubricant
    -dissolves INORGANIC (smear layer of dentin) material    EDTA
  66. 66primary endo infection bacteria is...Bacteroides
    -gram -
    -anaerobic    primary endo infection bacteria is...
  67. 67failed endo treatment bacteria is...Enterococcus faecalis
    -gram +
    -facultative anaerobe    failed endo treatment bacteria is...
  68. 68ZOE is in...gutta percha and sealersZOE is in...
  69. 69surgical treatment-retrograde
    -if RCT fails and problem is at or by the APEX    surgical treatment
  70. 70retreat-if RCT fails and problem is in the CANALretreat
  71. 71*incision and drainage-surgical opening in soft tissue to release exudate and pressure
    -best for localized and fluctuant swelling    *incision and drainage
  72. 72*Trephination-surgical opening in hard tissue to release exudate and pressure
    -drilling into bone    *Trephination
  73. 73periapical microsurgery-trying to achieve better closure of apex
    -resect 3mm of apex (apicoectomy), shallow bevel of root tip removal
    -instrument 3mm of root canal from new apex
    -fill with MTA    periapical microsurgery
  74. 74ledge formationPROCEDURAL COMPLICATIONS
    -artificial irregularity created on surface of root canal wall
    -occurs because of lack of straight line access and/or inadequate irrigation and lubrication    ledge formation
  75. 75ledge formation pro-flexible NiTi files are less likely to ledge
    -use smaller instrument to bypass ledge    ledge formation pro
  76. 76instrument separationPROCEDURAL COMPLICATIONS
    -breakage of an instrument within the confines of a canal
    -occurs because of excessive force, skipping file sizes, inadequate irrigation and lubrication, and/or not replacing files enough    instrument separation
  77. 77instrument separation con-flexible NiTi files are more likely to fractureinstrument separation con
  78. 78when is the best time for an instrument to break?the LATER the better the prognosis ; more bacteria was cleanedwhen is the best time for an instrument to break?
  79. 79perforationPROCEDURAL COMPLICATIONS
    •coronal
    •furcal
    •strip ; due to excessive coronal flaring, relevant for mandibular molars
    •root    perforation
  80. 80danger zonemandibular molars; distasl of mesial root
    -concavity    danger zone
  81. 81trauma protocolTetanus booster (avulsions only)
    Radiographs
    Antibiotics (avulsions only)
    Vitality testing [false negative after trauma]
    More
    Appointments    trauma protocol
  82. 82Ellis Classification : Class Ienamel only (1 layer)Ellis Classification : Class I
  83. 83Ellis Classification : Class IIenamel and dentin (2 layers)Ellis Classification : Class II
  84. 84Ellis Classification : Class IIIenamel, dentin, and pulp (3 layers)Ellis Classification : Class III
  85. 85Ellis Classification : Class IVtraumatized tooth that has become non-vitalEllis Classification : Class IV
  86. 86Ellis Classification : Class VluxationEllis Classification : Class V
  87. 87Ellis Classification : Class VIavulsionEllis Classification : Class VI
  88. 88**uncomplicated fracture-without pulp involvement
    -enamel only --> smooth edges
    -enamel and dentin --> restore    **uncomplicated fracture
  89. 89**complicated fracture-with pulp involvement
    - <24 hrs --> direct pulp cap
    - >24 hrs --> Cvek Pulpotomy (remove part of coronal pulp tissue)
    ->72 hrs --> pulpotomy    **complicated fracture
  90. 90**horizontal fracture-coronal segment displaced, apical segment not
    -take 3 PAs, 1 occlusal
    -ideal is calcific healing
    -Vital --> splint ASAP
    -Necrotic --> RCT    **horizontal fracture
  91. 91horizontal fracture : coronal fracturerigid splint for 6-12weekshorizontal fracture : coronal fracture
  92. 92horizontal fracture : midroot fractureflexible splint for 3 weekshorizontal fracture : midroot fracture
  93. 93horizontal fracture : apical fractureflexible splint 2 weeks max to avoid ankylosishorizontal fracture : apical fracture
  94. 94which is better, an apical fracture or coronal fracture?apical is betterwhich is better, an apical fracture or coronal fracture?
  95. 95which is better, an oblique fracture or a transverse fracture?oblique is betterwhich is better, an oblique fracture or a transverse fracture?
  96. 96**Concussion-no displacement, no mobility
    -PDL sore
    -let tooth rest    **Concussion
  97. 97**Subluxation-no displacement
    -increased mobility
    -PDL rips and bleeds
    -flexible splint for 1-2weeks
    -more favorable with open apices    **Subluxation
  98. 98**Extrusion-partially extruded from socket
    •open apex --> reposition, flexible splint, monitor
    •closed apex --> reposition, flexible splint, RCT if needed
    -high chance of necrosis with CLOSED apices    **Extrusion
  99. 99**Lateral Luxation-displacement of tooth in any direction except axially
    -usually crown is displaced palatally (in), root apex is displaced labially (out)
    -same treatment as extrusion:
    •open apex --> reposition, flexible splint, monitor
    •closed apex --> reposition, flexible splint, RCT if needed
    -higher chance of necrosis with CLOSED apices    **Lateral Luxation
  100. 100********Intrusion-apical displacement of tooth
    •open apex --> allow to re-erupt
    •closed apex --> reposition, flexible splint, RCT
    -highest chance of necrosis with CLOSED apices    ********Intrusion

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Praxis Flashcards: Endodontics Flashcards on Endodontics VI (100 Flashcards) , created by ACAPUN INSTITUTE on 02/08/2021.
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