2 - Dental Specialties > Week 2 PP > Flashcards

Week 2 PP Flashcards

(46 cards)

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1
Q

Endodontic Treatment & Procedures

A
  1. Root Canal Therapy
  2. Endodontic Surgery
  3. Pulpal Therapy
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2
Q

What is the first step/stage of Root Canal Thereapy?

A

Debridement - the process by which the pulpal tissue is completely
removed from the tooth, and the canal or canals cleaned and
shaped to receive the filling material

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3
Q

What is the second stage of Root Canal Therapy?

A

Obturation
* the process by which the pulp canals and chamber are filled
so that the tooth cannot be re-infected through the apical
foramen and the tooth does not remain hollow

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4
Q

Steps for Root Canal Therapy..

A
  • review medical history
    -review chart and radiographs
    -topical/local anesthetic
    -isolation (dental dam)
    -disinfection
    -Accessing the Pulp
    -Tissue Removal
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5
Q

What type of Local Anesthetic is used for RCT?

A

-Acute infection - high epinephrine/long lasting anesthetic
-Severe Anesthetic - Anesthetic directly into pulp
-Necrotic tooth - no anesthetic

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6
Q

What items are to be disinfected?

A

-Tooth
-Clamp
-Surrounding area

  • Solution
  • Iodine
  • Sodium hypochlorite
  • Peroxide
  • Instruments
  • Cotton forceps
  • Cotton pellet
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7
Q

How to Access the Pulp for RCT?

A

Posterior teeth - by occlusal

Anterior teeth - lingual (near the cingulum)

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8
Q

What instruments/materials are needed for Access Preparation?

A

Instruments
* High-speed handpiece
with long shank fissure
bur
* Slow-speed handpiece
with long shank round
bur
* Endo explorer

Materials
-Suction
-water

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9
Q

Tissue Removal for RCT

A

Coronal pulp is removed - this should enable the dentist to see or locate the radicular canals

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10
Q

Instruments/Materials required for Tissue Removal for RCT

A
  • long shanked round bur
    -spoon excavator
    -endo explorer
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11
Q

How is the radicular pulp removed?

A

The radicular pulp is removed using barbed broaches - * depending on whether
the pulp is necrotic or
newly infected, it will
have different
appearances

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12
Q

What is Chemical Debridement?

A
  • Once the pulp has been removed from the
    canals, the dentist will
    destroy the bacteria
    present in the canals
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13
Q

What solution is used in the Irrigating Syringe?

A

With solution such as Sodium Hypochlorite, peroxide, or iodine

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14
Q

How is the Length of the Canal measured?

A

Using files or apex locator

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15
Q

Instruments used for measuring the length of the canal?

A

-Endo files
-File Stoppers
MM Endo Ruler
-PA X-ray Film
-Or an Apex Locator

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16
Q

Measuring File Length

A
  • the canals must be cleaned completely free of all pulpal tissue, bacteria eliminated and the canals properly shaped to receive the gutta percha filling material
  • the length of each canal must be accurately measured so that debridement is performed to the apex - not short of perforated through the foramen
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17
Q

What is the traditional way to measure?

A

The traditional way to measure is to place small files into each canal to the depth of the estimated apex of the root, then take a radiograph to see if it is
correct

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18
Q

Measuring the Canal Length

A

-The dentist uses the diagnostic x-ray to measure the canals – a small sized file is chosen for each canal and the rubber stopper set at the desired length
* A periapical x-ray is taken, and the position of the files observed – the dentist will either continue to use the initial length for further debridement, or will adjust the length the files are set to

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19
Q

What is the second xray called?

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A

Working Length Xray

20
Q

What is an Apex Locator?

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A

an apex locator device uses sonar type waves to locate the apex for the dentist
* The apex locator still relies on a file being placed into the canal
* The electrode of the apex locator is attached to the file and sonar type waves created
– as the file nears the apex of the tooth, the gauge notes changes in the ‘rebound’ and
indicates when the file reaches the apex

21
Q

What if the length of the canal is not properly determined?

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A

The dentist may either leave pulpal material in the ends of the canals, or perforate the apex

  • A perforated apex allows the root canal sealer to exit the tooth and may cause irritation in the alveolar bone
  • Neither situation allows the apical bone to properly heal
22
Q

K-Type File

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A

-comes in various sizes
-looks like an auger
-

*colour coding system is consistent across ALL endodontic files

23
Q

3 Types of Files?

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A

-K–Type File
-Hedstrom (H) File
-Reamer File

24
Q

What is a Glates-Glidden Bur?

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A

Attaches to a slow speed handpiece
-can put it in top of canal to make it wider/open it up

-size is determined by line indentation at bottom

25
How to know what type of file to use?
The type of file used is usually based upon DDS preference
26
Once the dentist knows the exact length of each canal, the DA can..
the DA can set rubber stoppers on a series of files and the dentist can clean and shape the canals
27
What are Rotary Endo Files?
Files that attach to the slow speed handpiece instead of the traditional hand files - this reduces chair time for the patient and hand fatigue for the dentist
28
How often are canals irrigated?
Canals are irrigated at regular intervals to remove debris and disinfect the area
29
Where do endodontic files go after procedure is complete?
in the SHARPS container
30
Broken Instruments Within Canals..
however careful the dentist may be occasinally an instrument will break within a canal - all attemps are made to remove the instrument tip at this point
31
What if removal attempts of broken instrument within canal are unsuccessful??
The dentist may complete the remainder of the endodontic procedure, but the patient must be advised of the situatin, and the posibility of re-infection/failure of the endodontic procedure - often a document explaining all information and possible consequences is created, to be signed by the patient and detist
32
Why is it important that the dentist completely remove all traces of pulpal tissue for RCT?
* It is critical that the dentist completely remove all traces of pulpal tissue and ensure that all bacteria have been eliminated from the dentinal tubules * Failure to do so will allow bacteria to re-infect the area, and may result in the dentist having to redo the entire endodontic procedure in the future
33
Purpose of Paper absorbent points?
- Once the dentist is satisfied with the debridement, the canals are irrigated one final time and then dried using paper absorbent points - NEVER blow air into the canals
34
How to determine size of paper points?
Use the same size as the endodontic file used
35
Obturation Procedure
-Mater/trial point (gutta percha) is selected -X-ray is taken to determine fit -Master point is sealed into canal -Smaller points of gutta percha are placed until the canal is completely filled -the sealer fills any auxilary canals or discrepancies
36
If Obturation of the Canal (for RCT) is done at a second appointment..
* if this is the case, a cotton pellet dampened with formocresol or calcium hydroxide is placed in the pulp chamber and a temporary restoration is used to seal the tooth * to prevent contamination of the canals by saliva and bacteria (some type of ZOE is the best choice of materials)
37
How is excess protruding gutta percha removed?
The excess gutta percha protruding from the tooth is melted off with a hot instrument or heat & touch
38
What are the Oburation Instruments?
* Endodontic spreader * Endodontic condenser * Heat and touch instrument * Mixing spatula * Lentulo spiral * Root canal sealer * Mixing pad * Gutta percha points * PA X-ray film
39
Types of Root Canal Sealers?
- Calcium Hydroxide -Zinc oxide-eugenol -glass ionomers
40
Why is a Post Op Xray taken?
It is always taken to ensure the canals are completely filled
41
Instruments/Materials used for temporary restoration?
* Plastic filling instrument (PFI) * Cotton pellet * Temporary restorative material * Possibly a curing light * Articulating paper * Slowspeed HP * Large round bur
42
What is Zinc Oxide Eugenol (ZOE) used for?
-Primary Teeth -Emergencies -RCT -Caries management
43
What is Fermit?
A temporary restorative material - no mixing needed -no eugenol -light cured
44
What is Cavit?
a Temporary restorative material -pre-mixed -self-cure -reduces micro-leakage -not moisture sensitive
45
What is Term?
-a temporary restorative material -non-vital teeth only -emphasis on moisture control -for completely cured and hard restorations
46
What are the Post-Op instructions for RCT?
- be careful of soft tissue due to anaesthetic -the complete pulp has been removed and there is a filling material in its place. Be careful eating on that side, particularly sticky foods -Minor to moderate discomfort is normal for the first few days but there should be improvement daily - if there is no improvement or the discomfort worsens, call the office -if no complications occur, the temporary restoration should be replaced within a few weeks, a crown is recommended on the tooth as it will become brittle with the pulp missing
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