robbypowell's version from 2016-05-05 15:49


Question Answer
What kind of rubber dam frame should be used for endo procedure and why?Plastic, radiolucent and won’t interfere with tooth image
Pulp Vitality test helps reveal what?Blood supply
4. According to Salehrabi, Lazarski, and Aquilino, what is one of the BIGGEST factors in outcome assessment of root canal treated teeth?Coronal restoration
5. When should a rubber dam be used?RCT, Deep caries & Something else ANSWER: All of the above
7. Which is a component of biofilm?Something polysaccharide matrix
8. Which of the following is true when a deep horizontal fracture of a previously normal tooth?Apical portion remains vital?
9. If you take a straight radiograph on a maxillary 1st PM and see just one root canal, but a mesial shift shot shows 2 canals, which is true?Palatal root is mesial
10. Apical foramen most often exits the root0.5 mm from the apex
11. Which of the following contribute to RCT failure?coronal restoration & no rubber dam
12. Thou shalt not treat a case without proper?Diagnosis
13. ____% mandibular molars with 4 canals?50% (35% has 2nd distal canal, while another 15% has a 3rd mesial canal)
14. Which of the following is not an option for aiding in rubber dam placement where you have loss of tooth structure?Orthodontic intrusion
15. Treatment of swelling of endodontic origin?I & D with canal instrumentation
16. Deep horizontal fracture?Apical portion stays vital OR immediate splint (not sure)
17. What percentage of 1st premolars have multiple roots?90%
18. What to give patient with MI in the past 6 monthsIbuprofen?
19. Quality of success in endodontic treatments when works togetherBetter results from an endodontist and restorative dentist working together
20. Upon viewing an FMX, you find radiolucencies in mandibular anteriors that’s not part of the normal anatomy. What do you do?Find out if there was a CC, take dental and medical history and do tests
21. T/F: Lip numbness is sign of profound pulpal anesthesiaFALSE
22. Principles of proper endo access includes which of the following?After accessing all orifices, taper walls in order to increase visibility.
23. Which of the following is NOT part of the root canal system?Transverse concavities
24. What is the most common cause of failure in mandibular incisors?Two canals
25. A 12 y.o patient with a vital first molar with 2 mm carious lesion, what is treatment?NSRCT
26. Which of the following can modulate nociception?Interneurons, projection neurons, descending neurons ANSWER: All of the above
27. Where is the first place that nociception afferents synapse?Trigeminal nucleus
28. Admin LA to #30. Pts lip is tingling, so you know you have pulpal anesthesia?FALSE
29. Admin LA to #19. Lip tingling, but patient is not yet anesthetized. What should you do?Do mucosal infiltration and X tip
30. Phase when nerve potential goes from -70 mV to -50 mV.Slow depolarization
31. How many nodes of ranvier does local anesthesia work onWorks on 2-3 consecutive Nodes of Ranvier
32. According to central core theory, can you diffuse to anteriors?Diffuse to anteriors, because innervated by core
33. A febrile patient with #30 irreversible pulpitis and acute periapical abscess localized to vestibule. Which are important to Tx.I & D and Pulpectomy and drainage through apex (B and C)
34. Pt. with slight fever, necrotic pulp, acute periapical abscess localized to buccal space. Which are important to treatment?Antibiotics, I & D, Pulpectomy and drainage through apex ANSWER: (All of the above)
35. Acute perioapical abscess. Which is impt to Tx?Antimicrobial medicator into the pulp canal
36. What is elective root canal therapy?If don’t have enough tooth structure to hold crown (and so need to post and core)
37. Mandibular, posterior tooth, NSRCT, which is NOT appropriate perm restoration?MODB amalgam
38. Which of the following access preps are triangular?Max incisors
39. Most consistent root canal anatomyMaxillary canines
40. Internal resorption visible on radiograph. patient likely has a history of what?history of trauma
41. Why do you palpate?To assess if involvement through cortical bone
42. If shift radiograph mesially for maxillary premolar, which way does palatal root shift?Palatal root shifts mesially
43. Which of following can be seen on straight radiograph?Periodontal ligament
44. What is least desirable attribute of sodium hypochlorite?Toxicity to vital tissues
45. What is a pulpectomy?Extripate the chamber and root canal
46. What is order from superficial to deep?Dentinal tubules, predentin, odontoblasts, cell poor zone, cell rich zone, pulp proper
47. Sudden onset of pain, radiolucency, not responding to pulp testing. Necrotic pulp, chronic periapical abscess
48. Arachidonic breakdown prodcuts= all EXCEPTPhospholipids
49. Which of the following is an accommodation for curved canals?Light pressure, away from concavities
50. What is most common access failure perforation for #9?Facial
51. Palatal canal of max molar often curves:Buccally
52. Kakashashi, Stanley, Fitzgerald proved association between _____ and _____ _____bacteria and pulpal inflammation
53. Burch and Hulden did a study…anatomical apex to the most coronal portion of the apical foramen is ___ mm0.6 mm
54. Taper of file:Is the change in file’s diameter per 1 mm of length; how to calculate
55. Treatment cannot be done unless you... FORMULATE A DIAGNOSIS.
56. There are two components to making a diagnosis PULPAL and APICAL/PERIAPICAL/PERIRADICULAR


Question Answer
List all Pulpal DiagnosesNormal, reversible pulpitis, irreversible pulpitis (sym, asym), necrotic, previously treated, previously initiated
List all Periapical DiagnosesNormal sym apical periodontitis, asym apical periodontitis, acute apical abscess, chronic apical abscess, condensing oseostis


iii. Test
1. Percussion – helps to detect inflammation in the PDL
2. Palpation – helps to reveal swelling
3. Endo Ice test – prolonged response to endo ice indicates irreversible pulpitis
4. Test Cavity
5. Heat testing
6. Electric Pulp Testing
7. Selective Anesthesia
8. Laser Doppler Flowmetry – measures pulpal blood flow
9. Pulse Oximetry
10. Mobility & probing – narrow deep probing can indicate
11. Tooth sleuth- fracture
12. Transillimination
Question Answer
when would a prosthodontist refer elective endo therapyonly if prosthodontist needs it bc tooth is extruded and when he cuts down the tooth he knows he’ll get into the pulp.
t/f: Necrotic pulp→ endo tx.True
Treat Previously treated- pulpotomy or pulpectomy, with end?YES (easy diagnosis, root canal even if its badly done)
58. Form a DX
a. Chief Complaint
b. Med Hx
c. Dental Hx
d. Exam – look/see exam
i. Extraoral
ii. Intraoral
e. Testing – sensitive to cold
f. Radiographs – PARL or looked like normal tissue


How many canals would you expect to find?
Question Answer
Max 1st premolar 1 canal 9%
Max 1st premolar 2 canals89%
Max 1st premolar 3 canals2%
Mand 2nd premolar 1canal– 97.5%
Mand 2nd premolar 2 canals– 2.5*
Max 1st Molar 3 canals50%
Max 1st Molar 4 canals50-96%
Mand Central Incisor 1 canal– 60%
Mand Central Incisor 2 canals- 40% - only 4-5% have 2 through and through
Do NOT force Instruments down canal... but what is the only instrument we CAN force down canals?endo explorer is the only one you can use with force, it is used to look for canals.


Color Coded Safe Flex-R Files
a. Purple
b. White
c. Yellow
d. Red
e. Blue
f. Green
g. Black
Question Answer
Book= Cohen’s Pathways of the Pulp


Question Answer
Radiograph files look like it is at the apical foramen which means it is actually where? 1mm BEYOND the foramen.
file seen in radiograph at foramen most likely where in reality?beyond the apical foramen (always longer than what it looks like on xray)
65. Determine working length by what?apex locator and radiographs
66. NiTi has two crystalline phases ______ – at rest, when it deforms & ____ – movementAustenite; Martensite
67. Assume tooth is restorable and peri healthy needs RCT what is the diagnosis for the best outcome?Irreversible pulpitis & Normal periapical
68. Pt CC is tooth hurts when she bites – why might she needs RCT why would she not? RCT – if diagnosis is irreversible pulpitis & symptomatic apical periodontitis (Would not need it if it was reversible pulpitis, normal pulp or symp AP)
69. Evidence based dentistry – making decisions based on science, not based on what works in my hands best- making decisions based on controlled science studies
a. An approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient’s oral and medical condition and history, with the dentist’s clinical experience
70. Kakehashi Study – effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats, kakehashi, Stanley, & fitzgerald wrote article O.S. O.M. & O.P. on study of two groups of rats, method- pulped the teeth, bugs in sterile environment healed, ones exposed to bacteria caused endodontic disease
a. Bonus point – Moller studied in monkeys ?
b. moller also agreed with this study
Question Answer
Apexogenesis immature tooth, immature tooth needs root canal but you do pulpotomy, (root still forming)
Apexificationblunder buss /wide open apex on a mature tooth, you need to get a barrier down below (iatrogenic opening of apex)
ApicoectomyRemove end of root, disinfect canal as best as possible, prep made with ultrasonics, fill material = MTA
73. Which is not component of root canal system?Peninsula
74. Endo vs Implants?Best implant is the patient’s own tooth (endo is better than implants) (Implants should not replace teeth, they should replace missing teeth )
75. 3.5 – 5% Referred Odontogenic Pain
76. Branstrom Theory – movement of tubules inside tooth activates a delta fibers causes pain
77. Cold testing question/false response
a. False negative response- control teeth need to be tested also
78. Transilluminate does not go through crown= cracked tooth, narrow deep probing depth = vertical root fracture
79. Irrigate everytime you instrument canal = TRUE
80. Always clean the flutes every time it goes in canal
81. Classification I, II, III, IV
82. Apical pt of max – distal palatal direction
83. Max 1st premolar has groove on palatal of buccal root that is less than 0.8mm.
84. Apical aspect of palate root max 1st molar = 85% curve buccal by >10 degrees
85. Def. working length = coronal reference pt to where
86. 0.59mm from apical foramen to apex of tooth
87. Diameter of 0.4 size 30 file at 3mm up = 0.42
88. diameter of .02 taper size 30 (3mm up-.36) & 0.4 taper (3mm up- .42)
89. Optimal rotation speed = 500 rpm
90. Why less shape memory? – less ledging and etc.
91. Not desirable properter of NiTi – low yield point
3. What are the success criteria for healing in endodontics? (D)
a. No clinical symptoms
b. No periapical pathology
c. Normal, intact PDL
d. All of the above