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61 Cards in this Set
- Front
- Back
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barbed broach
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-takes out nerve
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ISO file specs (3)
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-ALL 16mm (cutting edge)
-tip size varies -increases .02mm for every 1mm (eg. a #20 is .20mm at tip and .22mm 1mm up from tip) |
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GT file specs (2)
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-ALL .20mm at tip
-taper varies -cutting edge length varies |
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what type of pain (sharp/dull) is associated with pulpul tissues?
what type of nerve fibers are they |
- dull
- C-fibers |
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pain upon percussion indicates what
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-PDL involvement
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pain worse if bending/lying down
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-?
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pain upon palpation of soft tissue indicates
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-PDL involvement
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what can cause mobility (4)
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-inflammation!
-ortho -root fracture -chronic bruxism |
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cold testing:
apply where |
-midfacial of crown
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electronic pulp test (EPT):
tests for how apply (2) false positives (3) |
-tests a-delta fibers (innervation), not pulp (vascularity)!
--:. tests vital/non-vital. Tooth can be non-vital and still have vasculature -dry tooth, use toothpaste -saliva, restorations, touching gingiva |
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what measures pulp capillary flow
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-laser doppler flowmetry
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best way to tell root fracture (2)
other ways (2) |
-probing depth
-light -uniform halo in xray -pain on biting, esp if upon release |
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how do dentists sometimes create root fractures
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-too much pressure w/ spreader when packing cutta percha. GP is not compressible! So be careful
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is reversible pulpitis a disease?
what is it indicative of (4) |
-no, it is a symptom
-caries -periodontal scaling -microleakage -unbased restorations |
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What has:
lingering pain (sharp or dull) no pain on palpation/percussion nondistinct radiographs hot/cold can effect lying down can increase pain |
-irreversible pulpitis
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hyperplastic pulpitis:
color appearance aka |
-reddish
-cauliflower-like pulp tissue thru and around carious exposure -aka pulp polyp |
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internal resorption (3)
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-painless
-resorption -will continue until perforated root is fixed |
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necrosis
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-thickened PDL (may be?) visible over root apex in radiograph
-if complete -> tests non-vital. No response to hot/cold -if partial -> can test vital, respond to hot/cold |
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what has:
sensitivity upon percussion/palpation positive or negative thermal test radiographically normal, maybe widened (but not thickened??) PDL |
-acute apical periodontitis
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what has:
sensitivity to palpation apically on gingiva positive or negative thermal test maybe normal radiograph, maybe pathology visible maybe mobile |
-acute Periradicular Abscess
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How distinguish Acute Periradicular Abscess from Lateral Periodontal abscess?
From Pheonix Abscess? |
-LPA will test vital
-LPA will have deep vertical pocket -only radiographically. Pheonix will have radiolucency |
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Phoenix Abcess
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-rebirth of chronic apical period. (CAP)
-will have radiolucency (unlike APA) |
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what has:
excessive bone mineralization around apex asymptomatic tests vital What is treatment |
-periapical osteosclerosis (obvious radiopacity)
-no endo needed |
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pain pathways
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-afferent through trigeminal
-symp from sup cervical ganglion and blood vessels |
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A delta fibers:
location in tooth called how change morphologically pain threshold |
-anastomose just under odontoblastic layer
-plexus of Raschokow -lose myelin sheath -high |
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hyperalgesia
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-painful stimulus even more painful
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allodynia
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-nonpainful stimulus now painful
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APA drainage
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-all max except centrals drain into palatal. Centrals drain facially
-all others drain into buccal mucosa |
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paresthesia
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-prickling, itching
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what can lead to paresthesia of the IA or mental nerves
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-ACA drainage from mand molar/premolar
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what has:
sensitivity to palpation apically on gingiva positive thermal test maybe normal radiograph, maybe pathology visible maybe mobile deep pocket cause |
-Periodontal abscess
(sympt same as APA but vital pulp, and deep pocket) -usually caused by foreign body entrapment |
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what has:
pain tests vital worse when bending/lying down big, thick cloudy region in area above apex of maxillary teeth in radiograph |
-toothache of max sinus origin.
-usually canines, molars -may have post-nasal drip, or recent upper resp tract infection |
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what has:
pain history of recently extracted/endo'd tooth at pain location |
-trigeminal neuralgia (neuropathic)
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What has:
tooth pain head pain |
-toothache caused my migraine
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myofacial pain
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-muscle pain
-from long dental appts |
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random causes of toothaches (4)
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-cardiac (referred from angina pectoris). Anesthesia will not stop pain
-max sinus -neuropathic: trigem. neuralgia (after extract/endo) -neurovascular: migraines |
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EPT tests
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-neural response, not vasculature
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Biting tests
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-fractures
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percussion tests
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-PDL
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palpation tests
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-PDL, but more advanced at this point
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test cavity tests
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-drill on tooth
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selective anesthesia:
type of injection |
-intraligamentary injection
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upper ant are tilted _____
post teeth are tilted ____ why important |
-anteriorly
-lingually -easy to perforate |
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irrigation:
why (3) with what |
-gross debridement
-elimination of bicrobes -dissolves remaining pulp -NaOCl sodium hypochlorite |
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3 types of files, traits
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Reamer: fewer turns, less stress
File: more turns, more aggressive cutting Hedstrom file: very aggressive, breaks easily |
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4 modes of file manipulation
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1) Filing: push/pull
2) watch winding: 1/4 semicircular clockwise/counterclockwise (??) 3) balanced force: slight apical pressure throughout. 90deg clockwise rotation. Then 180-270 counterclockwise to crush dentin -rotation: clockwise |
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complete balanced force technique (8)
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1)preenlarge coronal 1/3 (gates-glidden burs or crown down w/ rotary files)
2)determine working length 3)clockwise 90 w/ slight apical pressure 4)still w/ apical pressure turn 180-270 counterclock 5)restart clockw. until resistance is felt 6)after 1-2 clock/countercl. rotate out of canal (CLOCKWISE) and clean w/ NaOCl gauze 7)when working length is reached, confirm w/ nonworking counterclock. rotations 8)finally, clean w/ clockwise rotation |
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Gates glidden (4)
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-handpiece drills
-to quickly open coronal portion of RC -only for coral, straight parts -#1-6 (#2=#70 file!) |
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nickel titanium rotary files (4)
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-aka GT (Greater Taper)
-strong, flexible -expensive -for middle 1/3 |
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hand files (3)
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-for apical 1/3
-0.02 taper -stainless steel |
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Step Back method:
method (2) disadvantage |
-apical first
-smaller->larger files -leaves highest amount of apical debris. can block canals and impair healing (b/c bact is spread down there and still present |
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Crown Down Method (3)
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-coronal first, apical last
-larger->smaller files -"modern method." |
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define obturation
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-complete filling and closing off of a cleaned shaped root canal using sealer and core filling material
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Why obturate
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-seal out fluid
-seal in irritants |
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types of master gutta percha cones (2)
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-Standardized ISO. Same as ISO final file
-Non-standard. F(fine) or FM(fine-medium). Selected and trimmed |
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why use sealer/cement (2)
how applied |
-tight fluid seal impossible w/out it
-fills wall irregularities -coat cones before insertion |
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Sealer:
most common physical properties (3) |
-ZOE (zinc Oxide Eugenol)
-all cytotoxic when fresh -antimicrobial properties -no/minimal adhesive properties |
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radiograph of chronic Periapical Periodontitis will show
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-lesion, but not thickening like necrosis??
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components of Grossman's root canal sealer
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-(not isoprene!)
-Ba sulfate -Zn oxide -Staybalite resin -euginol |
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NaOCl should be used sparingly/copiously
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-copiously
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% of mand central incisors w/ 2 RCs
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-40%
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