Endo spring Final

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Author:
emm64
ID:
223553
Filename:
Endo spring Final
Updated:
2013-06-12 10:24:55
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Endo Final
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Endo Final
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  1. Pain and don't chew post tx?
    2-3 days
  2. cold sensitivity not lingering, w/ recession, nothing else tx?
    dentinal bonding agent & sensodyne
  3. When do teeth blush?
    broken vessels from drilling w/o water, will eventually become non-vital
  4. C fiber pain?
    dull, achy, wakes you up at night
  5. Adelta fibers?
    cold not hot, fash sharp
  6. anesthetics of choice for long buccal?
    articane or septicaine (not for IA)
  7. intraligamentary and col injections are contraindicated if
    • recent perio surg,
    • acute inflammation,
    • swelling and infection
  8. which supplimentary injection should be used if recent perio surgery?
    inerosseous
  9. col injection
    • area between tooth in embrasure-> depression is col
    • enter 45 degreee give on both mesial and distal
  10. interpulpal injection
    • largest pulp horn
    • small opening same as needle to build up pressure
    • painful initially
    • 27 gauge not 30
  11. stabident injection
    • 45 degrees to hard bone
    • need radiograph
  12. Only inject intraosseus on ____
    distal w Marcaine (1/3 carpule, not LIDO)
  13. waveone
    both reciprocating and rotary but expensive
  14. is preop pain indicative of postop pain?
    usually
  15. max spreader pressure?
    3 lbs
  16. pulp exposures
    • VITAL
    • near: dycal, IRM or FUJI IX
    • little or no time: NaOCl cotton pellet 30-60 secs, dycal, IRM Fuji IX, schedule endo
    • 30 mins: remove pulp to canal orifice, calcep and cotton over stump, IRM, endo
    • >1 hr: remove to canal orifices, instrument to #25 or #30 minimum, IRM, ENdo
    • Non-Vital: prep acess, mesure and instrument all canals to 25 or 30, calcep, IRM, Endo
  17. NaOCl accident protocol
    • attend to pain & swelling
    • regional block w/ long acting
    • monitor for .5 hr
    • HVevac discharge
    • leave tooth open
    • AB 5-7 days
    • non-aspirin narcotic analgesics
    • follow up daily
    • refer
  18. pulp unique characteristics
    • no collateral circulation
    • encased hard tissue
    • can't swell
    • inc pressure from injury
    • compressed venules, reduced flow
    • pain
  19. dentin tubules are largest where?
    closest to pulp (don't use high speed, use slow or hand)
  20. dentin classification
    • primary: b4 eruption
    • secondary: after root formed
    • tertiary: response to stimuli
    • rectionary: mild injury, same structure
    • reparative: moderate stimuli, irregular (pulp exposure)
  21. most important cavity prep factor regarding pulp?
    depth
  22. Eugenol on pulp
    • tissue toxic, blocks nerve impulses
    • inhibit bacteria, good seal
  23. zinc phospate causes sensitivity for ___
    2 weeks
  24. which material is not that strong but doesn't irritate pulp?
    polycarboxylate
  25. too fast orthodontics
    change pulpal flow, injure sensory nerves causing necrotic like apical radiolucencies
  26. vital pulp therapies
    • indirect: sound dentin, preexpose, use CaOH or ZOE for 6-8 weeks
    • direct: small <1.5mm, use dycal, good blood supply, liner base filler
    • partial pulpotomy
    • pulpotomy
    • pulpectomy
  27. direct pulp capping side effect
    calcification
  28. apexification:
    non vital, close apex, pulpectomy and fill with gutta percha, CaOH -> Ca diffuse through apex
  29. apexogenesis
    like direct pulp cap, apex will close on it's own after medicated.
  30. caries organisms found where in active lesions
    outer layers
  31. indirect time between appt
    • 6-8 weeks
    • 2nd appt: xray, remove flaky dried out, leave whit soft predentin, CaOH, base ZOE or GI final restoration
  32. acute trauma
    • within few hrs
    • avulsion
    • fracture
    • extrusion
    • lateral lux
    • root fracture
  33. subacute trauma
    • within 24 hrs
    • intrusion
    • concussion, subluxation
    • crown fractures w/ pulp exposure
    • primary teeth
  34. delayed trauma
    crown w/o pulp
  35. tooth color indications of pulp
    • gray: necrotic
    • yellow: calcified (obliteratied) increased dentin
  36. external root resorption
    • transient: not clinically significant (20% ankylosed), reversible, damage to cementum(blasts), vital healthy
    • progressive: replacement (bone) or inflammatory
    • detect early, infraocclusion, incomple alveolar process
    • remove infection (perio, endo)
    • ankylosis: non-mobile, high pitched percussion, no PDL uneven root contour, infaocclusion, sequale of dry, dead PDL, no tx (prevent by replanting tooth within 60 mins)
  37. concussion
    • mild PDL injury
    • flexible splint optional
    • recall
    • CHX for 1 week
  38. extrusive:
    • reposition, splint with flexible 3 weeks
    • endo if closed apex
    • CHX
    • high obliteration (open apex)
  39. lateral:
    • high metallic percussion
    • locked into new position
    • reposition, splint 3 weeks
    • longer if marginal bone (3-4 more weeks)
    • RCT
    • most often obliterated (open apex)
  40. splint material
    • temporary bridge: semi-rigid
    • composite: rigid
    • occlude during polymerization to ensure reposition
    • ortho wire
    • monofilament (60lb fishing line)
  41. intrusive luxation
    • dull percussion
    • pulp necrosis nearly 100% mature
    • immature may spontaneously erupt
    • endo 1-3 weeks
  42. closed apex necrosis likeliness
    • concussion
    • sublux
    • extrusion
    • lateral
    • intrusion
  43. avulsion
    • replant within 30 mins
    • extirpate pulp 7-10 days to prevent external inflammatory root resorption
    • >1 hour most likely replacement resorption, RCT no effect, extirpate pulp externally or before spint removal
    • spint non-rigid 1 week
    • prophy AB, tetanus booster > 5 yrs since immunization
  44. tooth storage material
    milk, saline, saliva
  45. root extrusion needs to leave crown-to-root ratio of
    1:1
  46. intrapulpal hemorrhage
    • impact injury
    • discolor increases w time
    • internal bleach
  47. calcific metamorphosis
    • excessive irregular dentin
    • vital pulp
    • yellow, yellow-brown
    • internal bleach
  48. developmental stains
    • fluorosis: external bleach
    • tetracycline: binds Ca in dentine, external or intentional endo with internal bleaching
    • enamel hypocalcification: hard but distinct brown, white areas, bleach with pumice and acid etching
    • enamel hypoplasia: bleaching is not permanent, defective porous enamel
  49. blood dyscrasias
    • erythroblastosis featalis:
    • high fever: hypoplasia
    • porphyria: red or brown
  50. bleaching materials
    • H2O2: unstable, caustic, tissue irritant
    • Na perborate: oxidizer, powder, stable when dry
    • carbamide peroxide: urea H2O2, acidic, damage teeth, mucosa
  51. bleaching tech
    • thermocatalytic: heat, external cervical root resorption, not more effective
    • walking: INTERNAL, safe, least chair
  52. walking bleach
    • 1. discuss
    • 2. periapical x-rays: assess obturation

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