Questions and Answers
What type of access cavity has divergent walls?
Which files are used in ultraconservative access cavities?
In traditional access cavities, all pulp horns are included.
True
What happens if infection is not removed from the apical part of the tooth?
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After accessing the cavity, loss of tooth structure leads to loss of __________ integrity.
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What causes tooth fractures after endodontic treatment?
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What is a biological necessity for structural integrity?
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What modern instrument is used for ultraconservative access cavities?
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Loss of __________ minerals by irrigation causes loss of structural integrity.
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Study Notes
Minimal Invasive Access Cavity
- Traditional access cavity features divergent walls, facilitating direct entry of stainless steel files without risk of fracture.
- Conservative access cavity has convergent walls, preserving more tooth structure while utilizing nickel-titanium (Ni-Ti) files and ultrasonic tips.
- Ultraconservative access cavity (ninja) involves minimal openings to retain maximum tooth structure, also utilizing Ni-Ti files and ultrasonic technology.
Importance of Magnification
- Use of magnification tools, like loupes and microscopes, essential for visualizing the apical area of the tooth, which is most curved and prone to infection spread.
- Infections not cleared from this area can lead to bone resorption from apex exposure.
Guided Endodontic Access
- Employs 3D imaging via Cone Beam Computed Tomography (CBCT) to shape the access cavity, preserving tooth structure and avoiding critical zones.
Pulp Horn Management
- Traditional access includes all pulp horns, potentially compromising tooth integrity.
- Conservative methods can avoid exposure of all pulp horns.
- Advanced irrigation systems can disinfect pulp horns without the need for access openings.
Types of Access Cavity
- Access can be gained through the removal of caries or older restorations, aimed at tooth preservation.
Stress and Fracture Considerations
- Flexible nickel-titanium files are preferred for conservative preparations to minimize fracture risk.
- Advanced irrigation systems are crucial in maintaining tooth integrity during procedures.
Structural Integrity Loss
- Cavity size directly affects tooth structure:
- Small access (5% strength loss)
- Loss of one marginal ridge (21% strength loss)
- Mesio-occluso-distal (MOD) cavity leading to 63% strength loss due to loss of both marginal ridges.
Fracture Causes Post-Endodontic Treatment
- Tooth becomes brittle from dentin elasticity loss due to dehydration, leading to structural integrity loss.
- Major contributors to structural integrity loss include the access cavity's size, the decrease in dentin minerals from irrigation, and drilling for post and core restorations.
Biological Success and Structural Integrity
- Key structural integrity factors include maintaining a height of 4 mm above and below the bone level and at least 2 mm of parallel walls.
Modern Endodontic Instruments
- CK endodontic access bur is designed for ultraconservative access cavities.
- Ultrasonic tips enhance operational precision and efficacy.
- Self-adjusting files (SAF) aid in the biological and mechanical removal of debris and bacteria while interacting with irrigants.
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Description
Explore various access cavity techniques in endodontics, including traditional, conservative, and ultraconservative approaches. Learn the significance of magnification tools and guided endodontic access using advanced imaging tools. This quiz will enhance your understanding of preserving tooth structure during endodontic procedures.
