SDLE Study notes 2

They have enhanced flexibility and fatigue resistance.

A systematic approach to diagnosing, planning, and executing endodontic therapy.

Through lateral canals, dentinal tubules, or apical foramina.

Cease irrigation immediately to prevent further extrusion of the solution.

Highly flexible, allowing them to negotiate curved canals.

Essential for immediate pain relief.

To control infection using systemic or local antimicrobials.

Adequate coronal restoration is essential to prevent reinfection and enhance prognosis.

Due to their efficacy and lower risk of side effects.

Clinical and radiographic evaluation, including CBCT.

For complex cases involving significant infection, severe pain, or extensive canal systems.

They reduce the risk of instrument separation and allow safer, more efficient canal preparation.

They are suitable for filing due to having more twists per millimeter.

Manage periodontal involvement with scaling and root planing (SRP) and possibly surgical intervention.

Bacterial toxins spread from necrotic pulp.

Cone Beam Computed Tomography (CBCT).

Heat generated during cavity preparation or polishing.

Typically range from 3 to 6 months, depending on severity and complexity.

Patients should be fully informed about the treatment plan, alternatives, risks, benefits, and prognosis.

For the diagnosis, cleaning, shaping, and filling of the root canal system.

Endodontic files, reamers, and irrigating solutions.

Pre-treatment counseling to explain the procedure and address concerns.

To enlarge the canal and remove dentin through a push-pull motion.

K-Reamers have fewer twists and are used for reaming.

The extent of periodontal disease, including attachment loss and bone defects, affects the success of endodontic treatment.

To release pus and reduce swelling.

Root canal therapy.

They are made of stainless steel with barbs along the shaft.

Adjust the working length slightly short of the apex.

Pre-treatment counseling and anxiety-reduction protocols.

Improperly applied materials or those containing toxic substances can cause pulpal irritation.

Provide pain management and corticosteroids to reduce inflammation.

Its role in occlusion, aesthetics, and as an abutment for prosthetic devices.

Bacterial toxins from a necrotic pulp.

Biocompatible materials such as mineral trioxide aggregate (MTA) or Biodentine.

Every 3-4 months.

It helps ensure successful outcomes by guiding patients on pain management, oral hygiene, and signs of complications.

High durability, resistance to corrosion, ease of sterilization.

Cone-beam computed tomography (CBCT).

By using electronic apex locators and radiographs.

Direct impact injuries, inadequate cooling during dental procedures, over-preparation of cavities, or excessive orthodontic forces.

Sharp cutting edges and a unique spiral design.

Nitrous oxide or oral sedatives.

Through clinical examination and patient history, showing heightened sensitivity to cold testing but no lingering pain.

Clinical examination, pulp vitality tests, and radiographic examination.

Intraosseous, intraligamental, or intrapulpal injections.

Parallel cutting sides.

Less flexible, higher risk of procedural errors in curved canals.

The diagnosis and treatment of dental pulp and periapical diseases.

Employ proper instrumentation techniques using gentle, controlled motions.

It can cause secondary pulpal infection through accessory canals or the apical foramen.

Strategic value of the tooth, systemic health of the patient, and patient preferences and expectations.

Based on case requirements to ensure successful outcomes.

Through the apical foramina or accessory canals.

Analgesics and anti-inflammatory medications.

Drainage through the root canal or an incision.

Dental caries, as bacteria penetrate through enamel and dentin to reach the pulp chamber.

NiTi instruments, as they are more flexible.

A thorough evaluation of all relevant factors.

Stop irrigation immediately.

NSAIDs, antibiotics if indicated, and possibly additional drainage or retreatment.

Underlying medical conditions like diabetes and cardiovascular disease can affect healing and prognosis.

Intraosseous, intraligamental, and intrapulpal injections.

Thermal and electric pulp vitality tests.

Visual inspection, palpation, percussion, and mobility tests.

MTA, Biodentine, or other biocompatible sealing materials.

Electric pulp testers and thermal pulp testers.

To eliminate the pulpal infection through root canal treatment (RCT).

Complexity of the case, canal anatomy (straight vs. curved), and primary vs. retreatment cases.

Over-instrumentation, incomplete pulp removal, or chemical irritants.

Accurate diagnosis, appropriate treatment sequencing, and the extent of periodontal destruction.

Seal the perforation with biocompatible materials like mineral trioxide aggregate (MTA).

Profound local anesthesia.

To eliminate the irritant, protect the dentin with suitable restorations, and apply desensitizing agents as necessary.

Pain management, oral hygiene practices, and signs of potential complications.

Persistent, intense pain upon thermal testing, with electric pulp testing showing variable results.

RCT to eliminate infection, pain management, and antibiotics if necessary.

Proceed with periodontal therapy including SRP and possibly surgical intervention.

Toothache, sensitivity to hot or cold, and swelling.

To locate canal orifices, detect caries, check integrity of restorations, and assess tooth surface textures.

Nitrous oxide or oral sedatives.

Use instruments with appropriate taper that matches the canal anatomy.

A definitive restoration that prevents reinfection.

A condition often caused by caries, exposed dentin, or recent dental procedures, characterized by sharp, transient pain triggered by stimuli.

Use of NSAIDs or acetaminophen before the procedure.

Probing depths, attachment loss, tooth mobility, presence of sinus tracts, and gingival condition.

Cytokines, prostaglandins, and neuropeptides.

To fill the canal system effectively.

Periapical radiographs.

To alleviate pain, control infection, and preserve the affected tooth.

To monitor healing and address any issues promptly.

Avoid excessive force to prevent deformation or breakage.

To eliminate the endodontic infection first, followed by periodontal treatment.

Stainless steel or nickel-titanium (NiTi).

Acute dental conditions that necessitate immediate intervention due to severe pain and/or infection.

Excessive force during obturation, inappropriate post systems, and undiagnosed cracks.

ProTaper and WaveOne.

Prescribe corticosteroids to reduce inflammation and prevent tissue necrosis.

In cases with systemic involvement.

Reduced patient anxiety and fewer appointments, with success rates comparable to multiple-visit treatments.

Root Canal Treatment (RCT) to remove the inflamed or necrotic pulp.

Refer to specialists if necessary.

Collaboration with periodontists and restorative dentists ensures comprehensive treatment planning.

Pain on biting or percussion.

Unforeseen events that can occur during endodontic therapy, potentially compromising treatment outcomes.

Using ultrasonic instruments to vibrate and dislodge the separated fragment.

To save a tooth that is infected or has damaged pulp.

They alternate between clockwise and counterclockwise rotation.

Adaptive Motion Technology.

They complete canal preparation with a single instrument.

Mechanical removal of plaque and calculus from root surfaces to reduce bacterial load and promote reattachment of periodontal tissues.

Flap surgery, bone grafting, guided tissue regeneration (GTR), and application of biologics.

It is vital for preventing reinfection and ensuring long-term success.

Cone-Beam Computed Tomography (CBCT).

Extraction is often necessary; surgical repair or intentional replantation in some cases.

Clinically symptom-free and responds normally to vitality tests with no radiographic signs of pathosis.

For severe pain not managed by NSAIDs.

Spontaneous pain, prolonged response to thermal stimuli, and possible referral pain.

Use of membranes to guide the growth of new bone and periodontal tissues in cases of large defects.

Complete removal of the pulp tissue from the root canal system.

To monitor healing and ensure infection resolution.

The release of inflammatory mediators leads to tissue destruction and formation of periapical lesions.

Proper cleaning and shaping of the root canal system, coupled with effective irrigation.

Vitality testing (thermal and electric pulp tests), percussion, and palpation.

Use gentle compaction techniques, proper post selection, and avoid excessive removal of tooth structure.

Coronal enlargement and providing straight-line access.

Removal of the irritant and application of a protective restoration.

To address both endodontic and periodontal components, starting with endodontic treatment followed by periodontal therapy.

Mild inflammation that can revert to normal with the removal of the irritant.

Use of a matrix.

To remove the source of infection in the pulp and prevent its spread to the periodontium.

To soften and inject gutta-percha for thermoplastic obturation techniques.

Regular clinical and radiographic evaluations, typically every 6 months to a year.

A definitive restoration, such as a crown.

Usually 121°C for 15-20 minutes.

Immediate sealing with biocompatible materials like mineral trioxide aggregate (MTA), surgical intervention if necessary.

Use flexible NiTi instruments, pre-curve stainless steel files, gentle watch-winding motion.

Extrusion of NaOCl beyond the apex, incorrect needle use.

A surgical procedure where the affected root of a multi-rooted tooth is resected.

To ensure patients are fully informed about the risks and provide consent.

It is essential for the success of endodontic therapy.

Use flexible NiTi instruments, follow canal curvature, and employ gentle controlled movements.

For effective cleaning and shaping to remove all infected tissue and debris.

Better prognosis with continuous monitoring for signs of infection or failure.

Symptoms include spontaneous pain, lingering pain after stimuli removal, and sensitivity to hot and cold.

Thermal (cold and heat) and electric pulp testers.

Inflammation of the periapical tissues due to bacterial infection from the root canal system.

Immediate intervention, typically involving pulpotomy or complete root canal therapy.

High flexibility, shape memory, superelasticity, and ability to navigate curved canals with minimal risk.

A condition arising when the pulp tissue becomes necrotic, leading to infection and abscess formation.

Severe pain, swelling, and possibly systemic signs of infection.

Participate in hands-on workshops and stay updated through journals and conferences.

Often asymptomatic but may include episodes of spontaneous pain.

Inflammation of periapical tissues, usually following pulpal necrosis.

Extraction, followed by appropriate prosthetic replacement like an implant or bridge.

Sodium hypochlorite, EDTA, and other irrigants.

Radiolucency around the root apex or along the root surface.

They can harbor bacteria, leading to treatment failure.

Lesions caused by endodontic infection leading to periodontal involvement.

Clinical examination and radiographic imaging, including CBCT.

To eliminate the source of infection and restore the tooth.

Vibrate at ultrasonic frequencies to enhance cleaning.

Amoxicillin, clindamycin, or metronidazole.

Dental operating microscopes.

Root Canal Therapy (RCT).

To eliminate bacteria and dissolve organic tissue.

Perform root canal treatment (RCT) following the standard protocol.

Misjudgment of canal anatomy, excessive force, improper angulation during access cavity preparation.

Cyclic fatigue, excessive force, improper use, anatomical complexities.

Pain on percussion, swelling, and tenderness.

Use side-vented needles, avoid excessive pressure, keep needle short of working length.

Microbial invasion from caries or periodontal disease.

Following a sequence for thorough cleaning and shaping, minimizing procedural errors.

Periodontal aspects of periapical diseases and their management.

A thorough understanding of both endodontic and periodontal pathologies.

To avoid excessive removal of tooth structure during access preparation.

Initial signs of periodontal disease followed by symptoms of pulpal involvement, such as necrosis and abscess formation.

Performing root canal treatment (RCT) as described for primary endodontic lesions.

To create space for additional gutta-percha points during lateral compaction.

A thorough understanding of the tooth’s condition and the patient’s overall health.

The prognosis of endodontic treatment, strategic value of the tooth, and the patient’s overall treatment plan.

Removal of the coronal portion of the pulp to alleviate pain and inflammation.

Through spontaneous severe pain, swelling, tenderness to percussion, and radiographic examination showing periapical radiolucency.

Root canal therapy to remove the source of infection.

Wear, dull cutting edges, distortion, or fractures.

RCT or extraction, depending on the tooth's restorability.

Well-defined radiolucency at the apex of the affected tooth.

Epithelial-lined cystic cavity at the apex of a nonvital tooth.

In-depth insights into the diagnosis and management of pulpal and periapical pathosis.

The interaction between diseases of the dental pulp and the periodontal tissues surrounding the tooth.

Chronic periodontitis with deep periodontal pockets, gingival recession, and bone loss.

Mastering the use of endodontic instruments.

Their presence and size significantly influence prognosis, with larger lesions typically indicating poorer outcomes.

Non-vital teeth often require more extensive treatment, but absence of periapical radiolucency can lead to similar prognoses as vital teeth.

Periapical radiolucency indicating inflammation or infection.

Cleaning and shaping the root canal, followed by intracanal medication.

Coronal, Radicular, and Furcation Perforations.

Requires prolonged immersion times and potential toxicity.

Overgrowth of pulp tissue in response to chronic irritation.

Careful study of radiographs, use flexible NiTi instruments, avoid excessive enlargement of the apical foramen.

Long-standing pus formation with a draining sinus tract.

Detailed records of treatment plans, procedures, and complications.

Lesions that originate in the pulp and spread to the periodontium.

Lesions that originate in the periodontal tissues and may secondarily affect the pulp.

Thorough exploration, use of magnification and illumination, and advanced imaging (CBCT).

It is integral to ensuring successful treatment outcomes and preventing recurrence of emergencies.

CBCT imaging.

Follow protocols for instrument use, appropriate speed, torque settings, and regular inspection.

A long-standing infection with intermittent pus drainage and typically a sinus tract.

Apical surgery to remove the separated instrument through an apical access.

Assessment of pain history, visual inspection, percussion and palpation tests, and pulp vitality tests.

Regular inspection, following manufacturer’s recommendations, proper techniques.

Initial stages may not show radiographic changes.

Diffuse radiolucency and possible sinus tract formation.

Pulp tissue responds to microbial invasion with inflammation, which can be reversible or progress to irreversible pulpitis and necrosis if untreated.

Comprehensive coverage of pulpal and periapical diseases, including etiology, diagnosis, and treatment.

To maintain appropriate coverage for potential legal claims.

Extensions of the pulp chamber that project towards the cusps of the tooth.

Simultaneous involvement of endodontic and periodontal tissues, developing independently but eventually converging.

Pulpal necrosis leading to periodontal pocket formation and bone loss.

Removal of the apex of the root and sealing of the perforation from the surgical site.

Root canal therapy (RCT) to remove the inflamed pulp tissue.

More expensive and prone to fracture under cyclic fatigue if not used properly.

Removal of debris and biological material immediately after use.

Masserann kit or the Instrument Removal System (IRS).

Periodic clinical and radiographic evaluations to ensure healing of the periapical tissues.

Proper access cavity design, use of magnification, careful exploration.

Visible polypoid growth in the cavity, usually asymptomatic.

Adjust working length and taper, use flexible instruments to redirect canal path.

Radiolucency with sinus tract visible on radiographs.

It enhances removal of debris and biofilm, complementing mechanical action.

They hinder cleaning and obturation.

Number, shape, and complexity, including possible accessory canals and apical deltas.

The extent of infection, host response, and adequacy of treatment.

To control periodontal infection initially, followed by endodontic treatment if pulp vitality is compromised.

Begin with SRP and control of periodontal infection.

Use side-vented needles and controlled pressure.

Autoclaving (steam under pressure).

Root Canal Treatment (RCT) to remove necrotic tissue and prevent infection.

Inadequate knowledge of canal curvature, excessive filing force, improper rotary instrument use.

Severe pain, swelling, fever, and possible lymphadenopathy.

To provide straight-line access and facilitate apical preparation.

Use proper techniques, avoid excessive force, conduct regular inspections, and use fracture-resistant systems.

Tubular extensions from the pulp chamber to the apical foramen.

Diverse microbial communities including pathogens like Porphyromonas gingivalis and Enterococcus faecalis.

To enhance disinfection as an inter-appointment medicament.

Clinical examination reveals a sinus tract, and radiographs show periapical radiolucency.

Using smaller, flexible files and pre-curving them to navigate past the ledge.

Loupes or microscopes.

Re-negotiation using smaller, flexible files, creating a new glide path.

Accumulation of pus at the apex following infection.

Well-defined radiolucent lesion with a sclerotic border.

Extracting the tooth, repairing the fracture extraorally, and then replanting it.

Instrument separation.

Horizontal or vertical bone loss, furcation involvement, and possible widening of the periodontal ligament space.

To achieve optimal patient care and enhance clinical outcomes.

Ultrasonic cleaners.

Using small, flexible NiTi instruments to maintain the original canal curvature.

Retrieval or bypass using specialized tools, surgical removal if necessary.

Chronic inflammatory lesion at the apex of a nonvital tooth.

Often asymptomatic due to drainage.

Often asymptomatic.

Histopathological features and treatment options for periapical lesions.

They are often exposed during cavity preparations, especially in younger patients.

Features of both endodontic and periodontal lesions, with severe attachment loss, deep pockets, and apical radiolucency.

Early detection using magnification and careful examination of the access cavity.

To detect periapical radiolucencies, root fractures, and other abnormalities.

Improper instrumentation, using stiff or large instruments in curved canals.

Usually asymptomatic.

Refinement.

Symptoms include spontaneous pain, swelling, tenderness to percussion, and drainage through the periodontal ligament space.

The coronal portion of the root canal system located within the crown of the tooth.

Lesions where periodontal disease progresses apically to involve the pulp.