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16 Cards in this Set
- Front
- Back
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What is the difference between implant and endo success? |
No significant difference. 98.4% for implants at 36 months, 99.3% for RCT at 22 month follow up.
Hannahan J, Eleazer P. Comparison of success of implants versus endodontically treated teeth. J Endod 2008;34:1302-5
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Short term success with Resilon/Epiphany vs. Gutta percha/Kerr sealer |
No significant difference at 25 months. Short term outcome is similar. Cotton T, Schindler W, Hargreaves K. A retrospective study comparing clinical outcomes after obturation with Resilon/Epiphany or gutta-percha/kerr sealer. J Endod 2008;34:789-97. |
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1 vs 2 visit for necrotic cases that are asymptomatic with apical periodontitis. What do you do? |
Apparently no significant difference as published. But there was a 65% success with 1 visit, and 75% with 2 visit group with uncertain healing in 27% of 1 visit and 13% of 2 visit. The biggest factor in healing seemed to be if cultures were positive or negative prior to obturation, canals with negative cultures healed at 80%, positive cultures healed at 44%. Molander A, Warfying J, Reit C, Kvist T. Clinical and radiographic evaluation of one and two-visit endodontic treatment of asymptomatic necrotic teeth with apical periodontitis: a randomized clinical trial. J Endod 2007;33:1145-8 |
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Do you use ultrasonic activation? How? |
Yes! 40k hertz at 3 min cleans significantly cleans the isthmuses better than mechanically cleaning alone (about 92% vs 37% at WL-3mm) Goodman A and Reader A 1985 Weller et al 1980 said ultrasonic activation is most effective after completion of shaping of the canal. Archer also showed superior cleanliness with ultrasonic activation at 1 and 3mm from WL. |
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What is your irrigation protocol? |
Full strength NaOCl (5.25%) followed by 17% EDTA, then final rinse of NaOCl gives the cleanest canal walls (Yamada 1983) |
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Who said 2 visit endo with CaOH2 Is good? |
Bystrom and Sundqvist 1985. CaOH2 left in the canals for 1 month killed all bugs. More effective than phenol based medicaments. The CaOH2 teeth were irrigated with 5% rather than 0.5% |
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Who talked about cleaning with ultrasonics after prep for cleaner canals? |
Goodman and Reader 1985- significant cleaner canals at 1mm, better at cleaning isthmuses and fins compared to step back alone. Archer and Reader-1992 Nusstein and Reader-2005 All studies show canals cleaner with ultrasonics following final instrumentation. |
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The smear layer.... Who, what, why? |
McComb & Smith 1975 first discussed it. Mader & Baumgartner 1984-1-2 microns thick also observed 40micro thick buildup in tubules. |
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Irrigation protocol? |
Yamada 1983 said cleanest canals with full strength NaOCl followed by EDTA then NaOCl again. |
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PCA? |
Basrani 2007. |
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What are coronal sinus tracts associated with? |
Vertical root fracture. 35% of vertical rt fx have this. Tamse 1999 |
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What benefit do you get from removing the restoration prior to RCT? |
Better at locating caries, cracks and marginal breakdown, almost 2x better. Abbott Australian Dental Journal 2004 |
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Do you do one visit or two visit RCT? |
Typically 1 visit. Peters & Wesslink 2005: necrotic with lesions obturated in 1 vs 2 visits. NSD in healing (actually 1 visit did better) regardless of cultivable bact in canal at time of obturation. 4.5yr follow-up, 2% hypo, apical prep at least 35. |
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Silver cones.... |
Corrosion products: silver sulfates, silver sulfides, silver carbonates, silver amines, silver amine hydrates (all toxic).-Seltzer 1972 |
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Needle irrigation |
Segley-deeper the needle more bact killed. 3x more effective at 1mm than 5mm About Ross- more debris cleared the deeper needle. Kahn- max I probe best needle. |
