Principle Of Endodontic Surgery

Front 1

It is a management and prevention of peri-radicular pathoses by surgical approach

Back 1

Endodontic surgery

Front 2

First recorded endodontic surgery procedure.

Back 2

By aetius, greek physichian 1500 years ago

Front 3

Who recomended puncture of "Gum tumor" in 1839

Back 3

Harris

Front 4

What are the primary objective or root canal treatment?

Back 4

1. Removal of pathologic pulp tissue

2. Cleaning and shaping of root canal system

3. Three dumensional obturation to prevent reinfectiin

Front 5

What are the categories of endodontic surgery

Back 5

1. Abcess drainage

2. Periapical surgery

3. Hemisectional/root amputation

4. Intentional replantation

5. Corrective surgery

Front 6

Usually small superficial collection of pus coveree by an overlying skin mucosa

Back 6

Gum boil

Front 7

Collection of pus in deeper tissue that may reach the surface via fistula or sinus tract

Back 7

Abcess

Front 8

A connection between a cavity lined by granulation tissue and an epithelial surface

Back 8

Simus

Front 9

A connection between two epithelial lined surfaces.

Connect an anatomical cavity to the surface or another body cavity.

Always lined by stratified squamous epithelium

Back 9

Fistula

Front 10

Drainage of periapical abscess is usually done through the canal via?

Back 10

Root canal access

Front 11

Treatment done to alleviate pressure due to pressure im periapical region?

Back 11

Extraction or root canal treatment

Front 12

It is a surgical technique use to alleviate acute pain caused by an accumulation of purulent material when drainage through the root canal is imposible.

Back 12

Trephination

Front 13

Criteria for application: (triphenation)

Back 13

- Acute pain

- absence of soft tissue swelling

- presence of purulent material

- perfomed as an emergency procedure

Front 14

Measurement of approximate area of apical portion of root

- measure the length of the root on the radiograph

- transfer the measurement intraorally to approprimate area od access

Back 14

Endometrics

Front 15

Create a small vertical incision over the area approximating the apex.

Use fo curret or small end of periosteal elevator to strip mucosa and periosteum to expose the underlying bone.

Attempt to probe for possible presence of thin area of bome to facilitate location of apex

Back 15

Apical access

Front 16

The use of a small round bur to create an opening on the bone to release the apical abcess

Back 16

Bone trephination

Front 17

An extension of endodontic treatmemt that involves the surgical extraction of the lesion that is at the end of the tooth root, section of the end and hermetic retrograde filling

Back 17

Periapical surgery

Front 18

Indications for periapical surgery

Back 18

- root fracture

- severe root curveture

- apical aberration (apical delta)

- large apical cyst that do not respond to conventional technique

- broken instruments within the canal that cannot be retrived

- untreated canals or recurrent infection on a tooth with post and core restoration

Front 19

Contraindications of periapical surgery

Back 19

- advanced age

- medical contraindications

- severely compromised teeth

- teeth that are involved in malignancy

Front 20

What are the medical contraindications

Back 20

- diabetes melitus

- heart disease

- hypertension

- immuno-compromised condition

- immunosuppresant drugs

Front 21

Contraindication of advance age

Back 21

- patient >50 have increase risk of complication

- possible presence of systemic disease

Front 22

Contraindication for severely comprimised teeth

Back 22

- non-resorable teeth

- non-functional teeth

- periodontally compromised teeth

- poor crown root ration after surgery

Front 23

Contraindication for teeth involved in malignancy

Back 23

- surgery in malignancy will result in tapid growth

- surgery may encourage metastasis

- bleeding control may be difficult in the sit of malignancy

Front 24

General vonsiderations

Back 24

1. Pre-medication

2. Anesthesia

3. Flap design

4. Apical seal

Front 25

Pre-medication are prescribed considering?

Back 25

- general health status

- age

- extent of surgery

- expected duration og surgery

- pre and post operative infection

Front 26

What are the standard pre medication?

Back 26

- analgesic/NSAIDs

- antibiotics???

- steroids for welling

Front 27

Technique of anesthesia

Back 27

- local anesthesia

- local anesthesia w/ sedation

- general anesthesia

Front 28

Surgical procedure directed at removing the apical third of the root of a tooth

Back 28

Apicoectomy

Front 29

Apocoectomy will?

Back 29

- eliminate apical arboration

- eliminate impassable canals

- eliminate unfilled gross curveture

Front 30

Anatomic considerstion: maxillary anterior surgery

Back 30

- nasal fossa

- anterior nasal spine

- infra-orbital spine

- infra-orbital nerve

- root inclination

Front 31

Anatomic consideration: nasal fossa

Back 31

- large access may invade nasal fossa

- low nasal fossa may be invaded

Front 32

Anatomic consideration: anterior nasal spine

Back 32

May take periapical access to central incisors difficulty due to thickness

Front 33

Anatomic consideration: infraorbital nerve

Back 33

Retractos may cause injury especially during surgery in canine

Front 34

Anatomic consideration: root inclination

Back 34

Roots that are inclined distally may be more difficult to locate

Front 35

How many mm the root must be resected?

Back 35

3mm

Front 36

To reduce the number of tubule and to ensure access to all apical anatomy bur should be angle by?

Back 36

90 degree

Front 37

To achieve resection what bur should be used?

Back 37

Fissure bur

Front 38

It allow better and cleaner preparation?

Back 38

Ultrasonic tips

Front 39

Three instrument used for root-end preparation?

Back 39

- standard head

- micro head

- ultrasonic tips

Front 40

Mandibular anterior surgery. Anatomic considerations

Back 40

- mentalis muscles

- dense cortical and compact bone

- lingual inclination of roots

- possible involvement of mental nerve

- mental nerve and foramen

- mandibular canal and IAN

- buccal bone thickness

Front 41

Nerve trauma that may occur: mental nerve and foramen

Back 41

- during incision

- during flap reflection

- during flap retraction

- during bome windowing

- during root resection

- during curretage

Front 42

Nerve trauma may also occur: mandibular canal and IAN

Back 42

- during root resection

- during curettage

Front 43

Thickness of buccal bone to the missial root of first molar

Back 43

4.09mm

Front 44

Thickness of the buccal bone on the distal root of first molar

Back 44

5.15mm

Front 45

Thickness of the buccal bone to mesial root of second molar

Back 45

7.54mm

Front 46

Maxillary posterior surgery: anatomic considerstion

Back 46

- zygimatic bone

- maxillary sinus

Front 47

Deroof the cystic lesion

Back 47

Marsupiallization

Front 48

Use of guttapurcha to tract the affected tooth

Back 48

Sinus tracing

Front 49

What filling technique use for broken file

Back 49

Retrograde filling

Front 50

How many mm in arborization of canal

Back 50

First 5 mm of apical portion

Front 51

Atleast how many mm is resected to the root?

Back 51

3mm

Front 52

How many mm in retrograde filling

Back 52

2mm

Front 53

Maxillary posterior surgery

Back 53

- vertical incision place mesial to firdt pre molar

- horizontal incision up to the distal of second molar

- distal relief offers additional access and visibility

- apical of pre-molar may terminate in diatal of first molar

Front 54

A minimally invasive that is usually indicated for larger condition that may endanger vital structures of enucleated?

- incertion of tube into the cavity to maintain patency

Back 54

Cystic decompression

Front 55

Advantages of cystic decompression

Back 55

- minimally invasive

- minimal skills are required to perform

- less post-operative morbidity

- generally more acceptable to patient

Front 56

Disadvantage of cystic decompression

Back 56

- incomplete resolution

- requires periodic follow-up

- loss to follow up

- no tissue acquired for histopathologiv examination. Possibility of misdiagbosis

Front 57

Suture must be remove for about how many days?

Back 57

7 days

Front 58

Cystic decompression should be recall every?

Back 58

2 weeks

Front 59

Radiographic recall should be after?

Back 59

3 month

Front 60

Procedure where one of the roots of a bi- rooted mandibular molar is sectioned with the intention of retaining the other for restoration.

- section mesial from distak root

- removal of compromised root

- restoration

Back 60

Bicuspidization or hemisection

Front 61

Careful section and root removal should be perforemed.

Back 61

- makesure tooth is cut up to furcation

- eliminate ledges created by the cut

- take care in accidentally avulsing root to be retained

- removw all pathologiv material

- inspect the removed root

Front 62

What are the three socket preservation method?

Back 62

- bone graft

- guided bone regeneration

- implants

Front 63

Management of socket for optimal healing

Back 63

- Socket prevention method

- suture soft tissue without tension

- wire splint across second premolar, first molar and second molar helps stabilize teeth and maintain space

- remove suture after one week

Front 64

Follow up done after 3 months

Back 64

- assess stability

- absence of pathology

- absence of symptoms

- assess need for further bone graft

- radiographic evaluation

Front 65

An endodontic surgical procedure that involves atraumatic tooth extraction of the offending tooth, root end, resection/preparation/filling and reinsertion of the extracted tooth.

Back 65

Intentional replantation

Front 66

Key factor for consideration of intentional replantation

Back 66

- patient and physical limitation

- endodontic and anatomic tooth factor

- operator factor

Front 67

Solution used to maintain viability for about 30min (intentional replantation)

Back 67

- hank's balanced salt solution

- pedialyte as alternative to HBSS

Front 68

Other term for periapical surgery?

Back 68

Apicoectomy