Endodontics High Yield Dental Study Notes For Dental Exams
Preparing for Dental exams like NEET MDS, AIIMS MDS, NBDE, DAT or other dental exams like dental hygienist or dental therapist? You will find these endodontics notes as your saviour as we present to you the best endodontic high yield notes from top dental endodontic books. Enjoy !
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For electric pulp testing , the suspected tooth should be tested at least twice to confirm the results. The tip of the testing probe that will be placed in contact with the tooth structure must be coated with a water- or petroleum-based medium. The most commonly used medium is toothpaste. The coated probe tip is placed in the incisal third of the facial or buccal area of the tooth to be tested. Once the probe is in contact with the tooth, the patient is asked to touch or grasp the tester probe, unless a lip clip is used . This completes the circuit and initiates the delivery of electric current to the tooth
The prevalence of traumatic dental injuries varies according to the population studied, but these injuries occur most commonly in children 7 to 10 years of age
The most common type of traumatic dental injuries in the primary dentition are luxation injuries, whereas crown fractures are the predominant dental injury to the permanent dentition
The most common forms of injectable local anesthetics are in the amide class
As a frame of reference, the most commonly used injection for anesthetization of maxillary teeth is infiltration with a cartridge of 2% lidocaine with 1 : 100,000 epinephrine
NaOCl (Sodium Hypochlorite) is the most commonly used irrigating solution because of its an antibacterial capacity and the ability to dissolve necrotic tissue, vital pulp tissue, and the organic components of dentin and biofilms in a fast manner
Direct exposure of the dental pulp to the oral cavity is the most obvious route of endodontic infection. Caries is the most common cause of pulp exposure, but bacteria may also reach the pulp via direct pulp exposure as a result of iatrogenic restorative procedures or trauma. The exposed pulp tissue comes in direct contact with oral bacteria from carious lesions, saliva, or plaque accumulated onto the exposed surface. Almost invariably, exposed pulps will undergo inflammation and necrosis and become infected. The time elapsed between pulp exposure and infection of the entire canal is unpredictable, but it is usually a slow process
Fungi are only occasionally found in primary infections, but Candida species have been detected in root canal–treated teeth in up to 18% of the cases. Fungi gain access to root canals via contamination during endodontic therapy (secondary infection) or they overgrow after inefficient intra-canal antimicrobial procedures that cause an imbalance in the primary endodontic microbiota. Candida albicans is by far the most commonly detected fungal species in root canal–treated teeth. This species has several properties that can be involved in persistence following treatment, including its ability to colonize and invade dentin and resistance to calcium hydroxide
Apical periodontitis lesions are formed in response to intraradicular infection and by and large constitute an effective barrier against spread of the infection to the alveolar bone and other body sites. In most situations, apical periodontitis inflammatory lesions succeed in preventing microorganisms from invading the periradicular tissues. Nevertheless, in some specific circumstances, microorganisms can overcome this defense barrier and establish an extraradicular infection. The most common form of extraradicular infection is the acute apical abscess, characterized by purulent inflammation in the periradicular tissues in response to a massive egress of virulent bacteria from the root canal
The most common causes for endodontic file separation are improper use, limitations in physical properties, inadequate access, root canal anatomy, and possibly manufacturing defects
If the maxillary sinus is entered during surgery, special care must be taken to prevent infected root fragments and debris from entering the sinus. The most commonly used root resection technique involves grinding the root apex with a high-speed drill for approximately 3 mm in an apical to coronal direction; therefore, an opening could allow infected debris into the sinus. A sinus opening can be temporarily occluded with a material such as Telfa gauze, although the gauze should be secured so as to prevent inadvertent displacement into the sinus. A suture can be placed through the packing material to prevent displacement and aid retrieval.
The properties of an ideal suture material for periradicular surgery include pliability for ease of handling and knot tying, a smooth surface that discourages bacterial growth and wicking of oral fluids, and a reasonable cost. Suture material in size 5-0 is most commonly used, although some clinicians prefer slightly larger (4-0) or smaller (6-0) suture. Sutures smaller than 6-0 tend to cut through the relatively fragile oral tissues when tied with the tension required to approximate the wound margins.
Asymptomatic Apical Periodontitis With Reactive Bone Formation: The lesion is usually observed in young patients, and the mandibular first molar is most commonly involved. The teeth often have gross carious lesions and can be vital or nonvital. They are usually asymptomatic. Radiographically, the lesion may have a well-defined or ill-defined radiopaque mass associated with the apex of an endodontically involved tooth. The lamina dura around the root apex is usually intact
The prevalence of external inflammatory resorption (EIR) after luxation injuries ranges from almost 5% 4 to 18%. It affects 30% of replanted avulsed teeth. EIR is the most common form of external resorption root resorption after luxation and avulsion injuries
Migraine is a common headache experienced by about 18% of females and 6% of males. It is associated with significant amounts of disability, which is the motivating factor that brings the patient to seek care and the reason why this type of headache is the one most often seen in medical clinics. Migraine has been reported to present as toothache and is likely the most common neurovascular disorder to do so
Cluster headaches and other trigeminal autonomic cephalalgias (TACs) are rare neurovascular disorders that are strictly unilateral pains defined by the concurrent presentation of at least one ipsilateral autonomic symptom—such as nasal congestion, rhinorrhea, lacrimation, eyelid edema, periorbital swelling, facial erythema, ptosis, or miosis—that occurs with the pain. The major distinguishing features between these headache disorders are the duration and frequency of the pain episodes, as well as the gender most often afflicted. Cluster headache is the most common of the group, occurring in men three to four times more often than in women, with pain episodes lasting between 15 minutes and 2 hours that occur at a frequency of eight episodes per day to one every other day. These headaches come in clusters, with active periods of 2 weeks to 3 months,thus the name. Elimination of pain after 10 minutes with inhalation of 100% oxygen is diagnostic for cluster headache, whereas sublingual ergotamine and sumatriptan are also effective acute treatments for cluster headache.
Oral acyclovir has become the most common treatment for acute herpetic outbreaks and has been shown to be efficacious in decreasing the duration and severity of pain after herpes zoster infection. Efficacy is based only on administration in the prevesicular, not the vesicular, stage. The addition of prednisolone to acyclovir produces only slight benefits over acyclovir alone. Neither acyclovir alone nor its combination with prednisolone appears to reduce the frequency of postherpetic neuralgia
In the orofacial region, neuropathies are most commonly seen in the maxillary premolar area and molar region.
Cardiac pain has been cited as the cause of nonodontogenic toothache in a number of case reports. Classically, cardiac pain presents as a crushing substernal pain that most commonly radiates to the left arm, shoulder, neck, and face. Although not as common, anginal pain may present solely as dental pain, generally felt in the lower left jaw. 16 Similar to pain of pulpal origin, cardiac pain can be spontaneous and diffuse, with a cyclic pattern that fluctuates in intensity from mild to severe. The pain can also be intermittent and the patient may be completely asymptomatic at times. The quality of cardiac pain when referred to the mandible is chiefly aching and sometimes pulsatile.
Ledge formation can occur during biomechanical preparation of the canal system, especially when the canals are more curved. There are a number of factors associated with ledge formation such as the instrumentation technique, instrument type, root canal curvature, tooth type, working length, master radicular file size, clinician’s level of expertise, and canal location. Failure to precurve the instruments, the inability to achieve a proper glide path to the apex, and forcing large files into curved canals are perhaps the most common reasons for ledge formation. The incidence of ledge formation was reported to increase significantly when the curvature of the canal was greater than 20 degrees; more than 50% of the canals in the study were ledged when the canal curvature was greater than 30 degrees
The highest incidence of reported damage to the inferior alveolar and lingual nerves is associated with third molar extractions. Local anesthesia was the second most common cause of nerve injury, and its exact mechanism can be confusing. It may be physical (needle damage, epineural /perineural hemorrhage) or chemical (local anesthetic contents)
A relatively small percentage of inferior alveolar nerve (IAN) injury cases (8%) are associated with an endodontic procedure. Mandibular second molars are most commonly associated with this population, but cases involving treatment of mandibular first molars and premolars have also been reported
Most early reports of cervicofacial subcutaneous emphysema (CFSE) usually follow tooth extractions and were the result of activities the patient engaged in that raised intraoral pressures. With the introduction of air-driven handpieces, there was an increased risk of CFSE. Although tooth extraction, especially of mandibular third molars, remains the most commonly reported reason for CFSE.
Luxation injuries as a group are the most common of all dental injuries, with a reported incidence ranging from 30% to 44%
The most common dental procedure contributing to vertical root fractures is endodontic treatment. Most vertical root fractures occur in endodontically treated teeth. VRFs usually do not occur during the actual obturation of the root canal, but rather they occur long after the procedure has been completed. The etiology of VRFs is multifactorial. It is likely that in the presence of one or an accumulation of more predisposing factors, the repeated functional or parafunctional occlusal loads may eventually lead, over months or even years, to the development of a VRF. Predisposing factors may include natural ones, such as the anatomy of the root, or iatrogenic ones, such as the excessive forces during root canal instrumentation, excessive tooth structure removal, or excessive obturation pressure
The filling materials most commonly used for primary pulp fillings are ZOE paste, iodoform paste, and Ca(OH) 2
Apexification, or root-end closure, is the process in which a nonvital, immature, permanent tooth that has lost the capacity for further root development is induced to form a calcified barrier at the root terminus.This barrier forms a matrix against which root canal filling or restorative material can be compacted with length control. Until recently, the most widely accepted technique has involved cleaning and filling the canal with a temporary paste, most commonly Ca(OH)2 , which was replaced at intervals over several months to stimulate the formation of an apical calcified barrier
The most common location of lateral periodontal cysts is the mandibular cuspid-bicuspid area, although numerous cases have been reported in the anterior maxilla
Aging per se has no significant clinical impact on salivary secretion. The most common cause of salivary hypofunction in the elderly is medication use, and it is most commonly associated with dental caries and oral fungal infections
Most common home bleaching products contain carbamide peroxide at about 10% strength, but it can reach up to 30% (equivalent to 3.5% to 8.6% hydrogen peroxide)
The mix of sodium perborate with water or, alternatively, anesthetic solution remains the most commonly used technique for internal bleaching of nonvital teeth. The enhancement of the mixture with 30% hydrogen peroxide is being used less due to concerns of cervical root resorption but remains an option for stains resistant to whitening that require stronger chemical compounds to achieve good bleaching results
The most common bleaching agent for at-home bleaching is 10% to 22% carbamide peroxide with an effective yield of 4% to 7.5% hydrogen peroxide
The most commonly observed adverse effect after external bleaching is gingival irritation, which may be associated with an increase in tooth sensitivity. Most of the gingival irritations are mild to moderate and disappear after 2 to 3 days without causing significant discomfort for the patient. For in-office bleaching, these issues are mostly related to soft tissue exposures to excessive bleaching gel or liquid hydrogen peroxide in amounts less than necessary to cause severe discomfort or tissue damage. However, when a patient reports tissue irritation, the soft tissues should be checked immediately. Warning signs other than the patient’s sensation are air bubbles rising from the gingival margins. The area should be copiously rinsed without delay. A vitamin E preparation should be on hand to serve as an emergency dressing that will provide an immediate antioxidative effect