Endodontics Quiz: Tooth Roots and Canals
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Questions and Answers

What is a 2-dimensional representation of a 3-dimensional object in radiography?

  • A representation of the tooth that is not necessary
  • A 3-dimensional representation of the tooth
  • A representation of the tooth with incomplete information (correct)
  • A complete picture of the tooth

    • What is the purpose of transillumination?

  • To detect cracks on the buccal surface
  • To detect cold sensitivity
  • To detect crack lines (correct)
  • To check for pulp vitality

    • What are the factors to consider in case selection?

  • Clinician considerations only
  • Patient considerations only
  • Tooth considerations only
  • All of the above (correct)

    • What relieves intracanal pressure in irreversible pulpitis or necrotic cases?

    <p>Instrumentation and debridement</p> Signup and view all the answers

    Is it important to take the tooth out of occlusion when the patient says the tooth feels elevated/painful when closing the mouth?

    <p>Yes</p> Signup and view all the answers

    Do most medical conditions contraindicate endodontic treatment?

    <p>No</p> Signup and view all the answers

    What should you do if a dental emergency arises during the first trimester of pregnancy?

    <p>Consult with the OB-GYN</p> Signup and view all the answers

    What should you consider when treating a patient with cancer?

    <p>All of the above</p> Signup and view all the answers

    What is the main purpose of the root canal sealer?

    <p>To fill canal irregularities and minor discrepancies between root canal walls and core filling material</p> Signup and view all the answers

    Do you want the sealer to fill accessory canals?

    <p>Yes</p> Signup and view all the answers

    Can the sealer act as a lubricant during insertion of the master cone?

    <p>Yes</p> Signup and view all the answers

    What should you do if the cone fit radiograph shows the cone is outside the apex by about 1 mm?

    <p>Try on a size 35 cone and take a radiograph</p> Signup and view all the answers

    Which of Schilder's Mechanical Objectives during cleaning and shaping root canals is incorrect?

    <p>Cross section should WIDEN at every point going apically</p> Signup and view all the answers

    Is establishing the glide path the same as determining canal patency?

    <p>No</p> Signup and view all the answers

    What is the concept of enlarging the coronal third of the root canal prior to working length determination?

    <p>Coronal pre-enlargement</p> Signup and view all the answers

    What type of filing involves filing away from the inner curve of a root to reduce the risk of strip perforation?

    <p>Anti-curvature filing</p> Signup and view all the answers

    Does exposure time of the dentin to NaOCl affect the efficacy of the NaOCl?

    <p>Yes</p> Signup and view all the answers

    What is the typical concentration of EDTA used in endodontics?

    <p>10%</p> Signup and view all the answers

    What is the main advantage of using EDTA in endodontics?

    <p>Removes the smear layer</p> Signup and view all the answers

    Is sodium hypochlorite the most important irrigant during instrumentation?

    <p>Yes</p> Signup and view all the answers

    Why should repeated cycling of sodium hypochlorite and EDTA be avoided?

    <p>All of the above</p> Signup and view all the answers

    Should the smear layer be removed at the end of instrumentation?

    <p>True</p> Signup and view all the answers

    Is EDTA a chelating agent?

    <p>Yes</p> Signup and view all the answers

    Should you obturate the canal when there is no more pain but the canal is still weeping?

    <p>No</p> Signup and view all the answers

    How many roots does a maxillary first molar usually have?

    <p>Three</p> Signup and view all the answers

    What is the alternative name for an endodontic file?

    <p>Apical file</p> Signup and view all the answers

    What is the percentage of time the MB root of the maxillary first molar has two canals?

    <p>58%</p> Signup and view all the answers

    Is it necessary to pre-curve endodontic files before inserting them into curved canals?

    <p>False</p> Signup and view all the answers

    How many canals does a maxillary first premolar usually have?

    <p>One</p> Signup and view all the answers

    How many roots does a mandibular molar usually have?

    <p>Two</p> Signup and view all the answers

    What is the size of the master apical file (MAF) if the working length (WL) is 19 mm and the initial apical file is size 15?

    <p>Size 18</p> Signup and view all the answers

    What is the characteristic that makes endodontic access on mandibular incisors challenging?

    <p>They are very narrow mesio-distally</p> Signup and view all the answers

    What is a sign or symptom of acute apical periodontitis?

    <p>Tooth is tender to percussion</p> Signup and view all the answers

    What is the color of a size 10 endodontic file?

    <p>Pink</p> Signup and view all the answers

    What is NOT a part of emergency treatment for an acute alveolar abscess?

    <p>Disocclude the tooth if not extruded</p> Signup and view all the answers

    When determining the working length, what should you do if the size 15 file is out of the canal by about 1 mm?

    <p>Get a bigger file, like a size 20, and insert only up to 21 mm</p> Signup and view all the answers

    Can acute maxillary sinusitis mimic tooth pain in the maxillary posterior quadrant?

    <p>True</p> Signup and view all the answers

    When is the best time to treat a pregnant patient?

    <p>Second Trimester</p> Signup and view all the answers

    How important is the size of the file in determining the working length?

    <p>Very important, as important as the length</p> Signup and view all the answers

    What medical condition can mimic odontogenic pain?

    <p>All of the above</p> Signup and view all the answers

    Study Notes

    Endodontics

    Root Anatomy

    • Maxillary first molar usually has three roots
    • Mandibular molar usually has two roots
    • MB root of maxillary first molar has two canals 58% of the time
    • Maxillary first premolar usually has two canals
    • Mandibular molar usually has two or three canals

    Endodontic Treatment

    • Endodontic treatment of mandibular central incisor can be challenging due to two canals
    • Endodontic access on mandibular incisors is most challenging due to narrow mesio-distal dimension, making it easy to perforate

    Endodontic Files and Materials

    • Endodontic files, gutta percha, and sized paper points are color coded
    • Size 10 file is white, size 35 file is green, size 70 file is blue, size 25 file is red

    Working Length Determination

    • Estimated working length (WL) is determined using a radiograph
    • If the file is out of the canal by 1 mm, adjust the file size or length to achieve accurate WL

    File Selection and Usage

    • Initial apical file should be slightly tight in the canal
    • Master Apical File (MAF) is 3 sizes bigger than the initial file
    • In curved canals, pre-curving files is not necessary
    • When using a size 15 file, the MAF would be size 40

    Signs and Symptoms of Endodontic Pathosis

    • Acute apical periodontitis symptoms: tooth tenderness to percussion, tooth feels extruded, PDL space may be normal or widened
    • Acute alveolar abscess is a dental emergency, treatment involves establishing drainage via the root canal, incision for additional drainage, prescribing antibiotics and analgesics, and disoccluding the tooth if extruded

    Medical Considerations

    • Radiation therapy to the head and neck can result in increased sensitivity of teeth and mimic dental pain
    • Certain medical conditions, such as sickle cell anemia, trigeminal neuralgia, referred pain from cardiac angina, and multiple sclerosis, can mimic odontogenic pain
    • Precautions for treating hypertensive patients: consult with physician, slow injection of local anesthesia, and terminate the appointment if patient becomes stressed

    Case Selection and Radiographic Analysis

    • Factors to consider in case selection: clinician considerations, patient considerations, and tooth considerations
    • A radiograph is a 2-dimensional representation of a 3-dimensional object, providing incomplete information about the tooth

    Pain Relief and Pulpectomy

    • Intracanal pressure in irreversible pulpitis or necrotic cases causes pain, relief methods include pulpotomy/pulpectomy, establishing length control, instrumentation, and debridement
    • Is it extremely important to take the tooth out of occlusion when the patient says the tooth feels elevated/painful when closing their mouth?

    Sodium Hypochlorite and EDTA

    • Sodium hypochlorite (NaOCl) plays a crucial role in endodontic treatment
    • EDTA (ethylenediaminetetraacetic acid) removes the smear layer, helps enlarge narrow canals, and lubricates
    • EDTA is a chelating agent, but not effective as the sole irrigant during instrumentation
    • Mixed irrigants should be avoided, especially repeated cycling of sodium hypochlorite and EDTA

    Obturation

    • The main purpose of the root canal sealer is to fill canal irregularities and minor discrepancies between root canal walls and core filling material
    • Gutta percha gets brittle with age, difficult to introduce into a narrow canal, and lacks adhesion to dentin
    • Do not want the sealer to fill accessory canals, but it can act as a lubricant during insertion of the master cone

    Miscellaneous

    • Schilder's Mechanical Objectives during cleaning and shaping root canals include continuous taper from crown to apex, cross section should widen at every point going apically, preparation should follow the canal, apical foramen should be maintained, and the apex should be kept as small as possible
    • Establishing the glide path is not the same as determining canal patency
    • Coronal pre-enlargement involves enlarging the coronal third of the root canal prior to working length determination

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    Description

    Test your knowledge of endodontics with this quiz covering the number of roots and canals in maxillary and mandibular molars and premolars.

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