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36 Cards in this Set
- Front
- Back
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gutta percha:
alpha vs beta |
-beta is commercial form
-alpha is heated, pliable form |
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if tug back is not short (quick)
if cone is scrunched (2) |
-cone is binding higher up
-ledge, or lost patency |
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Thermafil Technique:
def adv (3) disadv (3) |
-plastic center ("carrier") w/ alpha phase gutta percha surrounding. Hydraulic pressure
-gp gets pushed forward, excellent length control, no cone fit required -expensive, apex might seal w/ plastic not gp, retx VERY difficult |
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microseal technique:
def (2) |
-injected alpha phase gp delivered on beta gp
-acts like centrifuge, flinging alpha gp onto sides of canals |
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MTA:
def adv uses (3) disadv (2) |
-portland cement (concrete)
-promotes cementum regrowth -exposures, apexification, trauma -cannot be removed, must pack densely |
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Failures:
heat sensitive j-shaped lesion |
-missed canal, vertical root fracture
-vertical root fracture |
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limitations of lateral condensation
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-gp entraps pools of sealer
-gp concentrates more in middle and coronal 1/3s |
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temperature range:
beta alpha amorphous |
- 20-45 C
- 45-65 C - 65-80 C |
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alpha gp:
traits (6) |
-natural state
- brittle - high temperature - flows - sticky - 45-65 C |
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beta gp:
traits (5) |
- commercial points
- flexible - low temp - pliable - non-adhesive - 20-45 C |
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hydraulic pressure compensates for ________
and increases |
-thermal expansion and shrinkage
-overall mass |
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trauma incidence:
2-5 yo trend after |
- 30%
- decrease 5-8, then increase 8-12 |
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dental trauma by age 20:
men women |
- 1 in 3
- 1 in 4 |
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kids w/ ______ are ____ x's more likely to get trauma
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- >3mm overjet
- 2x's |
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types of blows:
under chin to ant lips padded blows sharp blows |
-fracture any tooth
-anterior damage (bone, crown, or root) -root fractures/displacements -coronal fractures |
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Trauma:
external exam |
-opening and symmetry (condylar/mand fracture
-soft tissue: lacerations. palpate -hard tissue: # of teeth, malpositioning, occlusal plane, mobility, fractures, transillumination |
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trauma:
pulp tests (4) |
-use as baseline only
-beware of false neg's -retest at 30, 90, 180 days -laser dopler flowmetry |
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trauma:
radiographs (3) for soft tissue rgs |
-diff angles
-apical closure -re-eval in 6 weeks, months, annually -decrease kvp |
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Trauma:
instructions to pt (4) |
-2 weeks soft diet
-soft toothbruch after EACH meal -CHX 0.12% BID -diligent recall |
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infraction
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-no tx or possible bonding agent; in enamel only
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uncomplicated fracture (4)
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-in enamel and dentin
-seal tubules w/ comp and base -3mo, 6mo, yearly recall -good prog |
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complicated fracture (2)
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-in enamel, dentin, and pulp
-maintain pulp vitality by capping or pulpotomy |
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pulp capping (3)
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-clean w/ saline & 0.12% CHX
-MTA placed over exposure -temp or GI filling |
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apexification:
used when irrigate w/ fill w/ -dry and place _____ w/ _____ wait, why place wait moniter w/ |
-immature tooth w/ open apices and thin walls
-low strenght NaOCl -light filling (b/c thin walls) -creamy Ca(OH)2 w/ lentulospiral -1 week, make sure is not inflammed -pure Ca(OH)2 w/ plugger and backfill canal -6-18mo -radiographs |
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Apexification w/ MTA
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-calcium sulfate is pushed through apex
- 3-4mm of MTA packed against it |
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Apexification:
prognosis f/u |
-good (80-95%)
-3wk, 3mo, 6mo, yearly |
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partial pulpotomy (Cvek):
used when steps f/u prog |
-tooth w/ larger exposure and immature roots
-remove 1-2mm pulp w/ round bur -place Ca(OH)2 or MTA and restore -3wk, 3mo, 6mo, yearly -good |
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possible pulpal responses to trauma (4)
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-repair
-mineralization -internal resoption -necrosis |
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Luxation:
Concussion Subluxation |
-adjust, moniter 3mo, SA
-reposition/splint if needed, moniter, SA |
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lateral luxation
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-over 5 mm
-reposition, splint -if closed apex -> RCT w/ Ca(OH)2 in 1-2 week -fair prog -A/SA |
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extrusive luxation
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-over 5mm
-reposition, splint up to 3 wwks -A |
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intrusive luxation
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-if minimal might erupt spontaneously
-lightly luxate w/ forceps -if severe, retrieve w/ forceps -begin RCT in 1-3 weeks -fair/poor prog -SA |
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root fractures (3)
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-take RGs at diff angles
-non-rigid splint 2 weeks -if severe, RCT (but coronal section only) |
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Avulsion:
success rate danger if replanted in 6-48hrs |
-90% if replanted in <30min
-ankylosis |
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Avulsion:
Tx |
-keep wet
-clean w/ saline -do not remove PDL unless extraoral time is > 1hr, then remove necrotic PDL and soak in NaF for 5 min -replant (no anesthesia) -RCT 1-2 wks later, non-rigid splint |
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Avulsion:
diff in tx btw open and closed apex |
-for open apex: place in 100mg Doxycycline/20ml saline for 5 min before replantation
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