Restorative

Question 1

what does SOCRATES stand for

Answer 1

site
onset
character
radiation
associating factors
time
exacerbating/relieving factors
scale of 1-10

Question 2

functions of dental dam

Answer 2

airway protection
moisture control
isolation
enhance visualisation of tooth

Question 3

function of opal dam

Answer 3

dam sealer for isolation in endodontics
prevents fluid leakage through the dam

Question 4

what do you look for on a radiograph that has been taken post-obturation

Answer 4

length
taper
density
GP is removed to CEJ
if any errors can be corrected

Question 5

what defines a successful root canal treatment according to the ESE

Answer 5

assess after 1 year:
- absence of pain, swelling and other symptoms
- no sinus tract
- no loss of function
- radiological evidence of a normal PDL

Question 6

if a periapical lesion persists on a radiograph after RCT, how long does it have to remain for it to be considered associated with post-treatment disease?

Answer 6

4 years

Question 7

what factors affect the success of a root canal treatment

Answer 7

filling extending to within 2mm of apex
no extrusion
good coronal seal
presence of sinus
perforations
patency
EDTA rinse
flare ups during treatment
missed canals

Question 8

what are the biological reasons for a root canal treatment failing

Answer 8

persistent intra-radicular infection
extra-radicular bacteria
non-microbial agents
cholesterol crystals
foreign body reactions
scar tissue healing

Question 9

how do you remove GP from a canal

Answer 9

hand files and solvent (hedstrom and eucalyptus)
reciproc

Question 10

what is the reciproc retreatment protocol

Answer 10

remove coronal third GP with heated plugger
remove rest with R25
determine working length and remove GP from apical third
increase the apical enlargement with R40/50

Question 11

why would you try to aim to avoid using a solvent when doing re-RCT to remove GP

Answer 11

leaves a smear of GP on surface which obstructs dentinal tubules

Question 12

what are the complications of instrumentation

Answer 12

blockage
ledges
apical damage
perforation
fractured instrument

Question 13

what does the prognosis of a perforation depend on

Answer 13

location
time elapsed
size
periodontal irritation
material used for repair

Question 14

what are the post op complications of a root canal

Answer 14

pain
swelling
failure
prosthetic replacement

Question 15

what are the common issues during access of RCT

Answer 15

too big/small
roof of pulp chamber not removed properly
perforation

Question 16

what are the common issues during mechanical preparation of RCT

Answer 16

blockage
separated file
ledge

Question 17

what are the common issues during obturation of RCT

Answer 17

too short/long
voids
too much GP in pulp chamber
GP in other canals

Question 18

what special investigations are used before commencement of RCT

Answer 18

TTP
palpation
6PPC
sensibility testing
radiographs

Question 19

what is the success rate of RCT over 10 years if the tooth had irreversible pulpitis

Answer 19

90%

Question 20

what is the success rate of RCT over 10 years if the tooth was necrotic

Answer 20

80%

Question 21

what must you discuss with the patient to gain valid consent before RCT

Answer 21

treatment options and alternatives
prognosis
risks
they can ask questions
agreeing on a plan

Question 22

what are the 3 aims of chemomechanical disinfection according to Herb Schilder

Answer 22

create a continuously tapering funnel shape
maintain apical foramen in original position
keep apical opening as small as possible

Question 23

what are the steps of mechanical instrumentation in RCT

Answer 23

ensure the tooth is able to be isolated (build walls etc)
access cavity
straight line access
initial negotiation (K10)
coronal flaring (go to 2/3 working length)
working length determination
apical preparation

Question 24

what is the cleaning protocol for RCT

Answer 24

3% NaOCl (30ml)
17% EDTA for 1 minute
3% NaOCl final rinse

Question 25

symptoms of a hypochlorite extrusion

Answer 25

pain swelling ecchymosis haemorrhage neurological complications airway obstruction

Question 26

what are the risk factors for hypochlorite extrusion

Answer 26

excessive pressure during irrigation needle locked within canal loss of working length larger apical diameters anatomical factors higher NaOCl concentration

Question 27

what is the management of a hypochlorite extrusion

Answer 27

stop treatment keep calm and advise patient explain material has left root canal administer LA gain haemostasis steroid medicament in canal cold/warm compress on face analgesia advice review after 24hrs

Question 28

what is the process of obturation

Answer 28

GP master cone to working length and get tug back dry with paper points coat cone with sealer place to working length finger spread to make space for accessory cones sever GP with endo alpha plug coronal aspect of GP to condense it

Question 29

function of a post and core

Answer 29

gain intraradicular support for definitive restoration

Question 30

how much GP should be left apically when doing a post

Answer 30

4-5mm

Question 31

how wide should a post be

Answer 31

no more than 1/3 of root width at narrowest point and 1mm of remaining circumferential coronal dentine

Question 32

how much ferrule is needed for a post

Answer 32

1.5mm in height and width

Question 33

what are the features of an ideal post

Answer 33

parallel sided non-threaded cement retained

Question 34

how much taper should a core have

Answer 34

6 degrees

Question 35

what length should a core have

Answer 35

10mm

Question 36

what are the problems with posts

Answer 36

perforation core fracture root fracture post fracture

Question 37

what are the percentages of post failure due to restorative, periodontal and endodontic reasons

Answer 37

60% restorative 32% periodontal 7% endodontic

Question 38

what are the principles of caries removal

Answer 38

identify and remove carious enamel remove enamel to identify the maximal extent of the lesion at the ADJ and smooth enamel margins progressively remove peripheral caries in dentine remove deep caries over pulp outline form modification (finishing etc) internal design modification (line angles)

Question 39

what are the principles of tooth preparation for a crown

Answer 39

preservation of tooth structure retention and resistance structural durability marginal integrity preservation of the periodontium aesthetic considerations

Question 40

what is the margin for an all ceramic crown (zirconia/emax)

Answer 40

chamfer of 1-1.5mm

Question 41

what is the margin for a metal ceramic crown

Answer 41

1.3mm - 0.5mm chamfer on the lingual where only metal required - 1.3mm shoulder on the buccal where metal and porcelain required

Question 42

if asked to critique a crown/crown prep what things are you looking for

Answer 42

is it rocking any voids at the margins under/over prepped high/low in occlusion is the lab card right are the teeth either side damaged on the cast

Question 43

prognosis percentage success rate of a tooth which has been crowned but no RCT over 5 years

Answer 43

50%

Question 44

prognosis percentage success rate of a re-root treatment

Answer 44

60%

Question 45

prognosis percentage success rate of a crown over 5 years

Answer 45

90%

Question 46

what are the 2 types of internal root resorption

Answer 46

inflammatory replacement

Question 47

what is the pathogenesis of internal inflammatory resorption and what does it look like radiographically

Answer 47

coronal pulp necrotic apical pulp vital dark circle in centre of root pulp on radiograph

Question 48

treatment for internal inflammatory resorption

Answer 48

orthograde endodontics

Question 49

what does internal replacement resorption look like radiographically

Answer 49

calcifications in the pulp

Question 50

what does external surface resorption look like radiographically

Answer 50

PDL intact but roots are short (orthodontic resorption)

Question 51

treatment for external surface resorption

Answer 51

remove the cause (orthodontics, supernumerary etc)

Question 52

clinical and radiographic findings of external inflammatory resorption

Answer 52

necrotic pulp knife edge resorption

Question 53

aetiology of external inflammatory resorption

Answer 53

pulp is necrotic and periapical inflammation precipitates the resorption process

Question 54

what is external replacement resorption and what would the clinical and radiographic findings be for this

Answer 54

ankylosis! high pitched percussive note no mobility possibly infraoccluded no PDL on radiograph

Question 55

what is external cervical resorption clinical findings

Answer 55

pink spot on tooth and profuse BOP

Question 56

risks for external cervical resorption

Answer 56

ortho trauma wind instruments viral infection