What’s Your Endodontic Know-How? by Laurie Stirling | Mar 2, 2022 | 2 comments Name Email Subscribe for further information! Question 1 For Questions 1 & 2, use this information and radiographs for reference: Patient #1: 34-year-old male patient who reported, “I had swelling last week, but now it’s gone.” Referred for tooth #3 No pain or swelling at the time of evaluation Probings: WNL Palpation: WNL Percussion: WNL Bite: WNL Cold: #2: No response#3: WNL#4: WNL What is your diagnosis for this patient? Necrotic pulp and acute apical abscess #3, Normal pulp and asymptomatic apical periodontitis #2 and #4 Necrotic pulp and asymptomatic apical periodontitis #2, #3, #4 Necrotic pulp and asymptomatic apical periodontitis #2 and #3, Normal pulp and asymptomatic apical periodontitis #4 Necrotic pulp and asymptomatic apical periodontitis #2, Normal pulp and asymptomatic apical periodontitis #3 and #4 Question 2 What is your treatment plan for this patient? Extract #3 RCT #3 RCT #2 Extract #2 Question 3 For Questions 3 & 4, use this information and radiographs for reference: Patient #2: 67-year-old male patient who reported, “I have no pain, but my dentist saw something on the x-ray.” Probings: WNL Palpation: WNL Percussion: WNL Bite: WNL Cold: #13-16: WNL What is your diagnosis for this patient? Necrotic Pulp #14 and 15, Asymptomatic Irreversible Pulpitis #16 and Asymptomatic Apical Periodontitis #14, 15 and 16 Normal Pulp and Asymptomatic Apical Periodontitis #14 and #15, Normal Pulp and Normal Apical Periodontium #16 Necrotic Pulp and Asymptomatic Apical Periodontitis #14, #15, and #16 Normal Pulp and Chronic Apical Periodontitis #14 and #15, Normal Pulp and Normal Apical Periodontium #16 Question 4 What is your treatment plan for this patient? Refer to oral surgeon for possible biopsy RCT #14 only RCT #14 and 15 Extraction #14 only Question 5 For Questions 5 & 6, use this information and radiographs for reference: Patient #3: 53-year-old female patient who shared, “I have a bump on my gum.” Probings: 4-5mm, 9mm on mid-buccal Palpation: WNL Percussion: WNL Bite: WNL Cold: #31: No response#30: WNL#32: WNL What is your diagnosis for this patient? Periodontal Abscess #31 Necrotic Pulp and Acute Apical Periodontitis #31 Vertical root fracture #31 Necrotic Pulp and Chronic Apical Abscess #31 Question 6 What is your treatment plan for this patient? Extract #31 Periodontal regenerative therapy Watch the area for some time RCT #31 Question 7 For Questions 7 & 8, use this information and radiographs for reference: Patient #4: 64-year-old male patient who said, “I can’t chew on my tooth.” Probings: WNL Palpation: WNL Percussion: +++ Bite: + Cold: No responseThe diagnosis for tooth #12 is Necrotic Pulp and Symptomatic Apical Periodontitis. While instrumenting, it was hard for my hand file to get to working length and get to the apex. What endo hack can you do to get to the apex faster? Change your rotary file system altogether. Open the canal coronally a bit to remove coronal interferences that could be binding your file. Irrigate with more sodium hypochlorite. Use a hedstrom hand file instead of a K file. Question 8 Unfortunately, once I started my obturation, I noticed my obturation was short. What is NOT a possible reason this happened? The metal filling gave an incorrect reading while getting my working length. The reference point was off. The canal was under instrumented. My gutta percha was too small. Question 9 Questions 9 and 10 do not pertain to specific tooth stories. In a maxillary first molar, what’s the incidence of 4 canals? 50% 75% 96% 33% Question 10 In a mandibular second molar, how many canals should you expect to see? Usually 1 or 2 canals. Always 3 canals. Usually 3 canals, but sometimes 1, 2, or 4 canals. Usually 4 canals Time is Up! Time's up 2 Comments Drew on February 25, 2023 at 8:06 pm Good information Reply soniachopra on March 7, 2023 at 7:59 pm Thank you! -Sonia Reply Submit a Comment Cancel replyYour email address will not be published. Required fields are marked *Comment * Name * Email * Website
Good information
Thank you!
-Sonia