chapter 54 endodontics

xray taken at subsequent appointment for post-op

recall xray

purpose of irrigation solutations

remove debris, clean tissues from canal, bleaches

purpose of reamer file

remove dentin, smooth and increase size of canal

purpose of broaches

remove vital, inflamed hemorrhagic pulp tissue, remove cotton pellets or paper points

A surgical procedure in which the root canal is filled from the apex is a(n)

retrograde

small restoration placed at the apex

retrograde

form of pulp inflammation where pulp may be salvageable

reversible pulptis

removal of one or more roots without removal of crown

root amputation

finished product of RCT

root canal completion xray

removal of pulp and filling of canal with material

root canal therapy

what are ancillary instruments

rubber stops and paper points

purpose of root canal sealers

seal out unfilled voids while filling (cement)

difference in secondary and reparative dentin

secondary- naturally, reparative- response to injury

sizes of files

06- smalles 140-largest

accurate endo film

4-5 mm beyond apex, no distortion, good contrast and density

A ____________ is football shaped and used in a low-speed handpiece.

Gates-Glidden bur

An instrument used for final enlargement of the pulpal canal in endodontics is the

Hedstrom file

____________ are used in the low-speed handpiece to place sealer and cements into the canals.

Lentulo spirals

The standard of care established by the American Dental Association (ADA) for endodontic treatment requires the use of _____________ during endodontic treatment.

a dental dam

doesn't respond to a sensory stimulus

necrosis (non vital)

not living

non vital

localized area of pus from an infection

abcess

What dental emergency can result if bacteria reach the nerves and blood vessels of a tooth?

abscess

surgical removal of infectious material around apex of tooth

apical curettage

A(n) ____________ is the surgical removal of the apical portion of the root.

apicoectomy

surgical removal of apical portion, opening made above the apex

apicoectomy

During electronic pulp testing, the tip is never placed on

metal restorations and gingiva

During endodontic treatment, local anesthesia may

be used selectively as a diagnostic test, not be required when the tooth is non vital, be difficult to obtain in the presence of infection.

char of pesso files

blades long and parallel with noncutting end

what instrument has tiny projections and is used to remove pulp tissue

broach

____________ have tiny fishhook-like barbs along the shaft and are used to remove the bulk of the pulpal tissue.

broaches

rotary files and burs

gates-glidden burs (drills), pesso files (reamers)

what material is used during pulp capping

calcium hydroxide

root canal sealers

claicum hydroxide, zinc oxide-eugenol, glass ionomer

purpose of spreaders and pluggers

condense and adapt the gutta percha into canal

healhty tooth used as a standard to compare to

control tooth

what files is sued for straight canals

convention k-type "stiff"

To remove or clean out the pulpal canal

debridement

when is pulpotomy done

deep caries, pulp exposure, save integrity of tooth erupting

applying material to exposed or nearly exposed pulp

direct pul cap

when is surgical endo needed

endo failure (curved roots, fractured, perforation), exploratory surgery (healing not occurred), biopsy (tissue sample)

purpose of gates glidden burs

enlarge the walls of pulp chamber

what are the hand instruments in endo

explorer, spoon excavator, spreaders & pluggers, glick #1

reasons for physical irritation

extensive decay, abscess

final size files in all canals being treated

final instrumentation xray

what file is used for narrow and curved canals

flexible k-type

char. of gates glidden burs

football shaped, long shank, cutting sides (not end), clockwise direction

what sealer is used in primary pulpotomy

formocresol

Following endodontic treatment, the patient will be referred to a(n) __________for the placement of the final restoration.

general dentist

A(n) ____________ is double ended and used to remove excess gutta percha from the crown.

glick #1

what instrument can be heated for placement or removal of gutta percha

glick #1

purpose of hedstrom file

greater cutting efficiency, used for final enlargement of canal. (spiral edges)

Plastic type of filling material

gutta percha

The prepared canals are filled with

gutta percha

root canal filling materials

gutta percha

purpose of explorer

helps locating canal opening

The surgical separation of a multirooted tooth through the furcation area

hemisection

applying material to partially exposed pulp

indirect pulp cap

purpose of k-type file

inital debridement of canal, shaping and contouring canal (twisted design)

also know as diagnostic film, prior to treatment

inital xray

different types of endo radiographs

initial, working length, final instrumentation, Root canal completion, recall

After placing the dental dam on a tooth to receive pulp therapy, you would disinfect the dental dam with

iodine solution

infections condition where pulp is incapable of healing (RCT required)

irreversible pulpitis

A general dentist ______ legally able to perform endodontic treatment.

is

what are the hand files

k-type, hedstrom, reamer, broaches

where are hemisections common

mandibular molars

factors affecting pulp tester

many restorations, more than 1 canal, moisture

During pulp testing, if the suspected tooth is the maxillary right first premolar, the control tooth should be the

maxillary left first premolar

where are root amputations common

maxillary teeth

list process for RCT

numb area; dental dam; estimate working length of canal; debridement and shaping canal; irrigating canal; filling canal & seal

process of filling a root canal

obturation

purpose of glick #1

paddle end- placement of temporary restoration rod end- removing excess gutta percha

symptoms of pulp damage

pain when occluding or mastication, sensitivity to hot or cold, facial swelling

touching for abnormalities on tissue

palpation

Following irrigation, the canals are dried with

paper points

Endodontic treatment is not recommended when the

patient has a medical condition that precludes any dental treatment, diagnosis is reversible pulpitis, and tooth has severe periodontal involvement.

tapping on incisal of tooth for vitality

percussion

making a hole

perforation

what type of radiograph would be exposed during the course of root canal therapy

periapical

area of nerves, blood vessels, and tissues that surrounds the root of the tooth

periradicular

two sources of pulp nerve damage

physical irritation or trauma

what does a plugger and spreader look like

plugger- flat tip (condenser) spreader- pointed tip (explorer)

purpose of pesso files

post prepartion for placement of final restoration

purpose of pulpotomy

preserves vitality of remaining portion of pulp; usually on primary

purpose for rubber stops

prevent perforation of apex with filling material

what action does the hedstrom file make

pulling stroke, smooth dentinal walls and easier to fill

decrease of living cells within the pulp, causing tissue to take over canal

pulp fibrosis

complete removal of vital pulp

pulpectomy

diagnosis of inflamed pulp tissues

pulpitis

inflammation of pulp

pulpitis

The removal of the coronal portion of the dental pulp is known as a technique called

pulpotomy

removal of coronal portion of vital pulp

pulpotomy

how does abscess look in xrays

radiolucent, well defined borders

purpose of spoon excavator

reach deep into canal to remove coronal pulp tissue, decay, and temporary cements

characteristics of reamer file

similar to K-type, cutting edge are further apart

During endodontic treatment, the pulpal canals are irrigated with

sodium hypochlorite diluted with water

types of irrigation solutions

sodium hypochlorite, hydrogen peroxide, parachloraphenal

what are files made from

stainless steel or nickel titanium

Is pain a subjective or objective component of a diagnosis?

subjective

difference in subjective and objective diagnosis

subjective- patient complaint (pain, sensitivity) objective- examination (xrays, decay, perio, mobility)

characteristics of broaches

thin, flexible, tapered metal

An inaccurate canal measurement may result in

underfilling the canal, overfilling the canal, perforating the apex.

what is lentulo spiral

used to place root canal sealer in canal

opened pulp with file in tooth showing canal length

working length xray