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49 Cards in this Set
- Front
- Back
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Which teeth are candidates for endodontic treatment? (4)
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1. teeth with pulpal pathology
2. teeth with periradicular pathology 3. prior to crown fabrication which will lead to pulp involvement 4. extraction contraindicated due to medical reasons |
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When may extractions be contraindicated due to medical reasons?
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IV bisphosphenate therapy (affect ability of bone to heal)
H&N radiation therapy |
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What are some contraindications against endodontic therapy? (4)
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- non restorable teeth
- inadequate peridontal support - non strategic teeth when there is no future indication for retaining these teeth - vertical root fracture |
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Major steps in non-surgical endodontic therapy
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1. access preparation
2. working length determination 3. debridement 4. cleaning and shaping (MAF) 5. master cone 6. obtruation 7. cleaning pulp chamber 8. temp filling 9. final resoration (coronal seal) |
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How many radiographs are indicated for a RCT?
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6 total
1. pretreatment 2 x PA 2. Trial file for PWL 3. MAF 4. MAC 5. Post treatment |
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What should be included in an endo tray set up for access preparation?
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- mirror
- periodontal probe (to check for root fracture) - cotton pliers - DG 16 explorer - spoon excavator - rulers |
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Which items should you make sure are in your endo bur block for access preparation?
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- FG carbide fissure (regular and surgical)
- FG #4 round carbide fissure - FG safe-ended tapered tungsten carbide - latch #4 and #6 round carbide (surgical low speed) |
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which burs are recommened for intial access?
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- FG carbide fissure (regular and surgical)
- FG #4 round carbide fissure |
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Which burs are recommended to prepared canal walls?
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- FG safe-ended tapered tungsten carbide
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Which burs are recommened for refining and shaping of the access prep floors and walls?
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- latch #4 and #6 round carbide (surgical low speed)
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Features of a completed accesss prep
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- expose full extend of pulp chamber incl pulp horns
- allow for locating the canal orifice - provide straight line access into the canal - provide access for cleaning and shaping - provide access for obtruation - never result in unnecessary sacrifice of dentin |
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How to access anterior teeth?
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1. direct bur 90º to the clinical crown in the middle 1/3
2. once bur has entered pulp chamber you should feel a drop 3. redirect bur to the long access of the root 4. using DG16 confirm pulp chamber has been entered, check for catches, help verify straight line access |
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T/F: the DG16 explorer is the same on both ends
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false. the two ends have differing angulations
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What are the rules for outline form?
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1. determined by the pulp chamber anatomy
2. refers to shape of external opening only 3. goverened by the need for straight line access to apical 1/3 4. varies for individual teeth |
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Outline form for max central, lateral and canine?
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central: triangular
lateral: triangular or ovoid canine: ovoid |
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Outline form for mand central, lateral and canine?
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ALL OVOID
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What is the Radiographic Length (RL)?
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distance from referance point to apex
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What is the provisional working length?
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Radiographic length -1mm
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If upon WL determination using trial file radiograph, the WL is 1mm short of apex, how much would this affect your actual WL?
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it wouldn't affect it at all.
PWL = WL in this case |
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If upon WL determination using trial file radiograph, the WL is 1.5 mm short of apex, how much would this affect your actual WL? Would you need another radiograph
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adjust PWL by 0.5mm
PWL +0.5 = WL NO NEED for another radiograph |
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If upon WL determination using trial file radiograph, the WL is 2.1 mm short of apex or 0.1mm past apex, how much would this affect your actual WL?
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Need to adjust trial file accordingly and TAKE ANOTHER RADIOGRAPH.
PWL -1.1 = WL PWL +1.1 = WL |
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Where is:
apical constriction anatomcal apex radiographic apex |
- apical constriction located at opening of root canal to orifice (aka minor foramen)
- anatomical apex is the last point before exiting canal apically (aka major foramen) - radiographic apex = longest point of tooth |
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Why is WL set at 1mm short of RL?
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anatomically, the apical constriction (aka minor foramen) can locate anywhere from 0.5 to 2mm short of the radiographic apex
- based on average distance, the consitrciotn is considered to be 1mm coronal to the radiographic apex |
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What are the consequences of intrumenting the canal short of or beyond the apical contriction?
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beyond: performation of PA area
short: distal void could lead to root canal failure (?) |
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What is the cutting length of all files?
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16mm
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What is the DO and D16 for a size 6 file?
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0.06mm DO
0.38mm D16 (DO + (0.6*16mm)) |
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Which files type can be used in a filing motion
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K files
hedstroem |
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Which files can be used in a balancing form motion
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k-files
reamers |
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Which files can be used in a reaming motion?
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reamers only
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Which files have a square symbol associated? triangle? circle?
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square K files
circle hedstroem triangle reamers |
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What types of files in the ubc endo kit come as 06-10, 60-140?
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Stainless steal K files
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What types of files in the ubc endo kit come as size 15-25?
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Flex stainless steel K files
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What type of files in the ubc endo kit come as size 20-50?
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Flexible niti K files
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What does it mean to recaptiulate?
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return to WL with small file (#10 or #15) and take progressively larger files to full WL
- used to remove canal debris in the apical third that would other wise block instrumentation to full WL |
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Gate gliden at ________ cutting burs.
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side cutting burs
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FIrst file to bind at WL is size 15, what is the MAF?
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30
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Coronal and apical preparation in step back?
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coronal flaring using GG burs and circumferential filing
apical prep using step back instrumentation (increase 5 files up and reduce file length each time by 0.5mm) |
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Benefits to using sodium hypochlorite for irrigation
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- antimicrobial
- dissolves vital and necrotic pulp tissue - dissolves organic component of dentin - lubricant - bleaching effect |
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3 ways to instrument curved canals
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- filing motion with hand SS instruments (08-20)
- balancing force with hand nickel titanium files (25-50) - rotary niti files : crowndown intrumentation |
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How ofter and how much irrigation?
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after every file
0.2-0.5cc of irrigant |
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How to use gate glidden burs
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- for coronal enlargment
- side cutting only - go to resistance point approx mid-root level and withdraw the bur while it is rotating |
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Desired properties of filling material
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- seal the canal apically and laterally
- bactericidal or not allow bacterial growth - not irritate periapical tissues - be sterile or easily disinfected - easy to place in the canal - radiopaque - not staining - does not shrink after placement - easily removable |
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Types of root canal sealers
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1. zn-oxide based : ROTH
2. resin based : AH plus |
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When to obtruate?
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- after instrumentation complete
- patient ASYMPTOMATIC - healing of sinus tract |
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Techniques for obtruation
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- lateral compaction
- vertical compaction - thermoplasticized injection - gutta percha carrier systems (ex gutta core) |
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Steps in obtruation (11)
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1. irrigatio (NaOCl finse, EDTA rinse for 3 min OR Qmix as final irrigant)
2. Dry canal with paper points 3. Fit and form master cone 4. Add sealer to canal ( use file size one smaller than MAF, coat 1/3 of file w sealer) 5. Add sealer to master cone and insert 6. insert spreader to apical root third (D11T spreader to 1-2 mm from WL) 7. Remove spreader and add accessory cone(smaller than spreader, coat with sealer) 8. take trial cone film 9 burn off GP from orifice and condense 10. complete obtruation with spreader and accessory cones 11. restore access cavity with cavit, IRM, permanent restoration or post/core buildup |
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When if MAF film taken?
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after ALL instrumentation is completed
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What is a master cone?
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A gutta percha cone that conforms to the apical preparation
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What is a trial cone film?
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a radiograph of a tooth with a master cone and one accessory cone in the canals
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