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Questions and Answers
How many root canals are found in the maxillary first molar?
How many root canals are found in the maxillary first molar?
What is the shape of the access opening in the mandibular first molar?
What is the shape of the access opening in the mandibular first molar?
What is the average length of the maxillary first molar?
What is the average length of the maxillary first molar?
How many canals are found in the mandibular second molar?
How many canals are found in the mandibular second molar?
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Where is the access opening located in the maxillary first molar?
Where is the access opening located in the maxillary first molar?
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What is the shape of the canal orifice at the cervical level?
What is the shape of the canal orifice at the cervical level?
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What is the possibility of having two canals located distally in the mandibular first molar?
What is the possibility of having two canals located distally in the mandibular first molar?
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What is the average length of the mandibular first molar?
What is the average length of the mandibular first molar?
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What is the average length of the root canal of a maxillary first premolar?
What is the average length of the root canal of a maxillary first premolar?
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What is the shape of the canal orifice of a maxillary second premolar?
What is the shape of the canal orifice of a maxillary second premolar?
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What percentage of maxillary first premolars have a single canal in a single root?
What percentage of maxillary first premolars have a single canal in a single root?
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What is the shape of the canal at the cervical level of a mandibular first premolar?
What is the shape of the canal at the cervical level of a mandibular first premolar?
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What is the average length of the root canal of a mandibular first premolar?
What is the average length of the root canal of a mandibular first premolar?
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What percentage of mandibular first premolars have Type I canal configuration?
What percentage of mandibular first premolars have Type I canal configuration?
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What is the shape of the access opening of a maxillary first premolar?
What is the shape of the access opening of a maxillary first premolar?
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What is the percentage of maxillary second premolars that have two canals?
What is the percentage of maxillary second premolars that have two canals?
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What is the access opening shape for a Maxillary Central Incisor?
What is the access opening shape for a Maxillary Central Incisor?
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Which tooth is described as having similar shape to the Maxillary Central Incisor but smaller in size?
Which tooth is described as having similar shape to the Maxillary Central Incisor but smaller in size?
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Where is the curvature found in the Maxillary Lateral Incisor?
Where is the curvature found in the Maxillary Lateral Incisor?
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What is the average length of the Maxillary Canine?
What is the average length of the Maxillary Canine?
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When taking an X-ray of Mandibular Incisors from the buccal direction, what is observed?
When taking an X-ray of Mandibular Incisors from the buccal direction, what is observed?
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What is the typical shape of the access opening for each anterior tooth?
What is the typical shape of the access opening for each anterior tooth?
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What shape is the canal in the Mandibular Canine?
What shape is the canal in the Mandibular Canine?
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Which of the following teeth has the possibility of two canals, one labially and one lingually?
Which of the following teeth has the possibility of two canals, one labially and one lingually?
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What is the usual condition of a tooth affected by an acute phase apical abscess?
What is the usual condition of a tooth affected by an acute phase apical abscess?
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Which is the most common cause of an acute apical abscess?
Which is the most common cause of an acute apical abscess?
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What are the symptoms of an acute apical abscess?
What are the symptoms of an acute apical abscess?
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What is a necessary part of treating an acute apical abscess?
What is a necessary part of treating an acute apical abscess?
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Which diagnostic tool's findings are variable for acute apical abscess?
Which diagnostic tool's findings are variable for acute apical abscess?
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What differentiates chronic apical abscess from acute apical abscess?
What differentiates chronic apical abscess from acute apical abscess?
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Which of the following treatments might be performed after the acute symptoms of an apical abscess have subsided?
Which of the following treatments might be performed after the acute symptoms of an apical abscess have subsided?
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What is a potential consequence if an acute apical abscess is not treated?
What is a potential consequence if an acute apical abscess is not treated?
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What is condensing osteitis a variant of?
What is condensing osteitis a variant of?
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What is the common radiographic feature of condensing osteitis?
What is the common radiographic feature of condensing osteitis?
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What is another term for acute exacerbation of asymptomatic apical periodontitis?
What is another term for acute exacerbation of asymptomatic apical periodontitis?
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What triggers an acute inflammatory response in Phoenix abscess?
What triggers an acute inflammatory response in Phoenix abscess?
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What is the primary difference between Phoenix abscess and acute apical abscess?
What is the primary difference between Phoenix abscess and acute apical abscess?
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Which type of communication resembles a periodontal pocket?
Which type of communication resembles a periodontal pocket?
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What is the primary treatment method for solitary tracts caused by root canal issues?
What is the primary treatment method for solitary tracts caused by root canal issues?
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What is prepared to obtain direct access to the apical foramen in a tooth?
What is prepared to obtain direct access to the apical foramen in a tooth?
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Study Notes
Root Canal Anatomy
- Maxillary First Molar: 3 roots, 3-4 root canals (mesiobuccal, distobuccal, and palatal), average length 21mm
- Access opening is in the mesial part of the tooth, rhomboid in shape, and may leave the oblique ridge as it is if caries free
Maxillary Second Molar
- Similar to Maxillary First Molar, but distobuccal canal is located between the mesiobuccal canal and palatal canal, and slightly distally
- Average length 20mm
- Variations: 2 canals, one buccally and one palatally, instead of 3 canals, with large canals opposite each other
Mandibular First Molar
- 3 canals, 2 mesial (mesiobuccal and mesiolingual) and 1 distal, average length 21mm
- Access opening is triangular-trapezoid in shape, starts in the mesial part of the tooth
- Possibility of 2 canals located distally (33%), with separate or joined orifices
Mandibular Second Molar
- Similar to Mandibular First Molar, with 3 root canals (2 mesial and 1 distal), average length 22.5mm
- Possibility of additional root canal lingually to the major root canal (rare)
Access Openings of Posterior Teeth
- Maxillary First Premolar: access opening is ovoid and elongated buccopalatally, average length 21mm
- Maxillary Second Premolar: mostly single root, canal shape is ovoid and wide in buccopalatal direction, average length 21.5mm
- Mandibular First Premolar: 60% single canal, 40% 2 canals, average length 21.5mm
- Mandibular Second Premolar: has a well-developed buccal cusp and a small lingual cusp, root is more rounded and shorter than Mandibular First Premolar
Access Openings of Anterior Teeth
- Maxillary Central Incisor: triangular access opening, single root, average length 22.5mm
- Maxillary Lateral Incisor: similar to Maxillary Central Incisor, but smaller in size, with disto-palatal curvature at the apex of the root
- Maxillary Canine: big canal, wider bucco-lingually than mesio-distally, average length 26.5mm
- Mandibular Incisors: small, tiny root canal, possibility of 2 canals (labially and lingually), average length 21mm
- Mandibular Canine: one canal, big and oval in shape, average length 21mm
Acute Apical Abscess
- Localized collection of pus in the alveolar bone at the root apex, following death of pulp with extension of infection through apical foramen
- Symptoms vary from moderate discomfort to systemic involvement, tooth is non-vital, pain is rapid onset, readable localized, and tooth is tender to percussion
- Radiographic changes are variable, but usually, there is a well-defined radiolucent area
- Initial treatment involves removal of the cause, drainage, and antibiotics if necessary, then root canal therapy or extraction
Chronic Apical Abscess
- Also known as suppurative apical periodontitis, associated with gradual egress of irritants from root canal system into periradicular area
- Abscess has formed a communication through which it discharges, such as intraoral sinus or extraoral sinus
- Treatment involves root canal therapy or extraction, and communications or tracts heal spontaneously following treatment
Condensing Osteitis
- Variant of chronic apical periodontitis, represents a diffuse increase in trabecular bone in response to irritation
- Radiographically, a concentric radioopaque area is seen around the offending root
- Treatment is only required if symptoms/pulpal diagnosis indicate a need
Acute Exacerbation of Asymptomatic Apical Periodontitis (Phoenix Abscess)
- Defined as an acute inflammatory reaction superimposed on an existing asymptomatic apical periodontitis
- Etiology includes influx of necrotic products from diseased pulp or bacteria and their toxins into chronic periapical lesion
- Symptoms similar to acute apical abscess, treatment includes drainage and root canal treatment once symptoms subside
Access Opening
- Cavity prepared in the crown of a tooth to obtain adequate and direct access to the apical foramen
- Critical step in a series of procedures that potentially leads to the three-dimensional obturation of the root canal system
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Description
This quiz covers the symptoms and treatment of nonvital teeth and acute apical abscess, including endodontic therapy and tooth extraction.
