Showing posts with label Endodontics. Show all posts

To locate the canal orifice use.. endo file with curved tip

To locate the canal orifice use:

A- barite probe
B- endo spreader
C- endo file with curved tip
D- round bur.

The correct answer is C- endo file with curved tip.

An endo file with a curved tip is used to locate the canal orifice because it can be easily guided into the canal and follow its curvature. The other options are not as effective at locating the canal orifice:

A- barite probe:

A barite probe is a blunt instrument that is used to explore the pulp chamber and locate the canal orifices. However, it is not as effective as an endo file with a curved tip because it cannot be easily guided into the canal and follow its curvature.

B- endo spreader:

An endo spreader is used to widen the canal orifice once it has been located. However, it is not effective at locating the canal orifice.

D- round bur:

A round bur is used to remove tooth structure and create access to the canal orifices. However, it is not as effective at locating the canal orifice as an endo file with a curved tip because it can damage the canal if it is not used carefully.

What is the disadvantages of McSpadden technique in obturation:

The McSpadden technique is a method of root canal obturation that uses thermoplasticized gutta-percha to fill the root canal. It is a popular technique because it is relatively simple and fast to perform. However, there are some disadvantages to the McSpadden technique, including:

It can be difficult to achieve a complete seal of the root canal with the McSpadden technique. This is because the thermoplasticized gutta-percha can flow into the dentinal tubules, which can leave voids in the root canal.
The McSpadden technique can be less effective in canals that are curved or have multiple apical foramina. This is because it can be difficult to get the thermoplasticized gutta-percha to flow into all of the areas of the canal.
The McSpadden technique can be more time-consuming than other obturation techniques, such as cold lateral compaction. This is because it requires more steps to complete.
The McSpadden technique can be more difficult to learn and master than other obturation techniques. This is because it requires more dexterity and skill to achieve a good seal of the root canal.

Overall, the McSpadden technique is a relatively simple and effective method of root canal obturation. However, it is important to be aware of its disadvantages before using this technique.

Here are some tips for minimizing the disadvantages of the McSpadden technique:

Use a rotary nickel-titanium file system to prepare the root canal. This will help to create a more uniform canal shape, which will make it easier to achieve a complete seal with the thermoplasticized gutta-percha.
Use a low-viscosity thermoplasticized gutta-percha. This will help the gutta-percha to flow more easily into the dentinal tubules and create a better seal.
Use a backfill technique to obturate the root canal. This will help to ensure that all areas of the canal are filled with gutta-percha.
Use an apical plug to seal the apical foramen. This will help to prevent leakage from the root canal.

By following these tips, you can minimize the disadvantages of the McSpadden technique and achieve a good seal of the root canal.

Tracing of GP used for:

A. source of periapical pathosis
B. acute periapical periodontitis
C. periodental abscess
D. none

The correct answer is A. source of periapical pathosis.

Here's a breakdown of why:

Periapical pathosis refers to pathological conditions around the apex of a tooth, such as cysts, granulomas, and abscesses.
GP (gutta percha) is a dental material used for root canal fillings. It is inserted into the root canal to seal it off and prevent bacteria from re-entering.
Tracing of GP involves using a radiograph (X-ray) to visualize the path of the GP within the root canal. This can help determine the extent of the root canal filling and identify any potential problems, such as incomplete filling or the presence of a periapical lesion.

While GP can be used in cases of acute periapical periodontitis and periodontal abscess, its primary use in these situations is to treat the infection and prevent further damage, not to determine the source of the problem. The source of periapical pathosis is usually determined through a combination of clinical examination and radiographic evaluation.

Tracing GP: A Diagnostic Tool for Periapical Pathosis

Gutta percha (GP) is a thermoplastic material commonly used in endodontic procedures to seal root canals. Tracing GP involves using radiographs (X-rays) to visualize the path of the GP within the root canal. This technique is invaluable in diagnosing and treating periapical pathosis, a term encompassing pathological conditions around the apex of a tooth.

Periapical Pathosis: A Breakdown

Periapical pathosis can manifest in various forms, including:

Periapical abscess: A localized collection of pus at the root tip, often caused by infection.
Periapical cyst: A fluid-filled sac that develops around the root tip, typically due to chronic infection.
Periapical granuloma: A non-inflammatory mass of tissue surrounding the root tip.

The Role of GP Tracing:

Tracing GP serves several critical functions in the diagnosis and treatment of periapical pathosis:

Assessing Root Canal Filling Adequacy: By visualizing the GP's path, clinicians can determine if the root canal has been completely sealed. Incomplete fillings can leave gaps that allow bacteria to re-enter and cause infection.
Detecting Overfilling: GP that extends beyond the root apex can lead to irritation or inflammation of the surrounding tissues. Tracing GP helps identify such overfillings.
Identifying Perforations: If the root canal has been perforated during treatment, GP may escape into the surrounding tissues. Tracing GP can reveal such perforations.
Localizing Periapical Lesions: By comparing the GP's path to the location of a periapical lesion, clinicians can determine if the lesion is associated with the root canal or another source, such as a fracture or periodontal disease.
Guiding Retreatment: If a root canal treatment has failed, tracing GP can help identify the reasons for failure and guide subsequent retreatment efforts.

Techniques for GP Tracing:

Various radiographic techniques can be used to trace GP, including:

Periapical radiographs: These are conventional X-rays that provide a two-dimensional view of the tooth and surrounding tissues.
Bitewing radiographs: These are used to assess the bone levels around the teeth and can also be helpful for tracing GP in the lower premolar and molar regions.
Cone beam computed tomography (CBCT): This advanced imaging technique provides a three-dimensional view of the tooth and surrounding structures, offering a more detailed assessment of GP placement and periapical lesions.

In conclusion, tracing GP is a valuable diagnostic tool in endodontics. By providing information about root canal filling adequacy, perforations, and periapical lesions, it helps clinicians make informed decisions regarding treatment and improve patient outcomes.

Primary teeth had trauma, tooth change in color become white yellowish ,what should you tell the parents:

A. Pulp is dead
B. Inflammation of pulp.
C. Calcification of dentin.
D. B& c.

The correct answer is: d. B&c.

A white-yellowish discoloration of a primary tooth after trauma can indicate both inflammation of the pulp (pulpal inflammation) and calcification of the dentin.

Here's a breakdown of the other options:

A. Pulp is dead: While a dead pulp can cause discoloration, it often results in a gray or black color. A white-yellowish discoloration usually suggests a less severe injury.
B. Inflammation of pulp: This is a possible cause of the discoloration, especially if the trauma was recent.
C. Calcification of dentin: This is a common outcome of trauma to primary teeth, where the dentin (the layer beneath the enamel) undergoes calcification. This can lead to a yellowish discoloration.

It's important to consult with a dentist to determine the exact cause of the discoloration and recommend appropriate treatment.

Understanding Tooth Discoloration Following Trauma:

When a primary tooth experiences trauma, it can lead to a variety of dental issues, including discoloration. A white-yellowish hue often indicates two primary underlying conditions:

1. Pulpal Inflammation

Definition: Inflammation of the pulp, the soft, living tissue within the tooth that contains blood vessels and nerves.
Cause: Trauma can disrupt the pulp's blood supply or damage its nerve endings, leading to inflammation.
Symptoms: In addition to discoloration, pulpal inflammation may cause sensitivity to hot or cold temperatures, pain, or swelling.

2. Calcification of Dentin

Definition: The hardening of the dentin, the layer of tissue beneath the enamel.
Cause: Trauma can stimulate calcification as the tooth's natural repair mechanism.
Symptoms: While calcification itself is often asymptomatic, the resulting discoloration can be a noticeable cosmetic concern.

Other Possible Causes of Discoloration:

Pulp Necrosis: If the trauma is severe enough to cause the pulp to die, the tooth may become gray or black.
External Stains: Certain substances, such as food or beverages, can stain the tooth's surface.

Treatment Options:

The appropriate treatment for a discolored primary tooth will depend on the underlying cause and the severity of the injury. Possible options include:

Observation: If the discoloration is mild and the tooth is not causing pain or discomfort, it may be monitored over time.
Pulp Therapy: In cases of pulpal inflammation or necrosis, a procedure known as pulpotomy or pulpectomy may be necessary to remove the damaged pulp and prevent infection.
Dental Restoration: If the tooth is significantly damaged, a dental restoration, such as a crown or filling, may be required to protect the tooth and improve its appearance.

It's important to consult with a pediatric dentist to obtain a proper diagnosis and discuss the most appropriate treatment options for your child. Early intervention can help prevent further complications and preserve the health of the primary teeth, which play a crucial role in proper jaw development and alignment.

The easiest endo retreatment in:

a- Over obturation w GP.
b- Under obturation w GP.
c- Weeping canals.
d- Obturated w silver cone.

The easiest endo retreatment in the context of the choices listed is: c- Weeping canals.

Here's why:

- Weeping canals:

These canals have persistent exudate or leakage despite previous root canal treatment. Due to the ongoing inflammation and presence of infected material, the root canal filling material is usually softened or incomplete, making retreatment relatively easier. Access and cleaning the canal are simplified as the exudate provides a pathway.

- Over obturation with gutta-percha (GP):

Overfilling can make retreatment challenging as removing excess GP can be difficult, requiring specialized instruments and potentially leading to canal ledges or perforations.

- Under obturation with GP:

Insufficient filling necessitates additional filling during retreatment, which might be straightforward unless anatomical complexities hinder access or require further canal cleaning.

- Obturated with silver cone:

Silver cones, though potentially retrievable with specific techniques, can pose difficulties due to their rigidity and potential for fragmentation, making retreatment more complex compared to gutta-percha.

Therefore, while retreatment for all mentioned situations requires skill and careful planning, weeping canals generally offer the easiest approach due to the softened filling and existing pathway for access and disinfection.

It's important to note that every case is unique, and the difficulty of retreatment can vary depending on various factors like canal morphology, previous treatment details, and expertise of the dentist.

I hope this explanation clarifies the reasoning behind the answer! Let me know if you have any further questions about endodontic retreatment.

All are irrigation for canals EXCEPT:

a. Saline.
b. Hydrogen beroxide.
c. Naocl
d. RC prep.

The answer is c. Naocl.

Here's why:

a. Saline:

Saline water can be used for irrigation, although it can negatively affect soil quality and plant growth if used excessively.

b. Hydrogen peroxide:

Hydrogen peroxide can be used in irrigation water for its disinfecting properties, though its effectiveness is debated and may not be suitable for all applications.

d. RC prep:

This likely refers to a specific type of irrigation system cleaning solution, potentially containing chlorine-based compounds. Therefore, it could be considered a form of irrigation for canals.

c. Naocl:

Sodium hypochlorite (Naocl), commonly known as bleach, is not suitable for irrigation. It can be toxic to plants and damage soil microbial communities. While it may be used for cleaning irrigation canals or equipment, it shouldn't be used directly for watering plants.

Therefore, based on its harmful effects on plant life and soil health, Naocl is the least likely candidate for being used as an irrigation method for canals.

Microabscess on vital pulp: start necrosis of small part and sequela of destruction cycle and full repair:

A. True.
B. False.

B. False.

A microabscess on vital pulp signifies the presence of a localized infection within the living dental pulp tissue. While it represents a destructive process, it doesn't necessarily lead to full pulp necrosis (death) and complete destruction followed by full repair.

Here's a breakdown of the statement and why it's false:

Microabscess: This indicates a small, localized pus-filled area within the vital pulp.
Start necrosis: Necrosis refers to cell death. While a microabscess signifies infection and damage, it might not lead to complete pulp death.
Destruction cycle and full repair: A microabscess represents the body's attempt to fight the infection. Depending on the severity and promptness of treatment, the pulp tissue might be able to heal and repair itself.

Therefore, the presence of a microabscess doesn't guarantee complete pulp death and subsequent full repair. Early intervention with proper dental treatment can potentially save the vital pulp.

Microabscess on Vital Pulp: A Fight for Survival

A microabscess on vital pulp is a dental condition that represents a battleground between the body's defense mechanisms and invading bacteria. Let's delve deeper into this process:

The Culprit: Bacterial Invasion

The primary culprit behind a microabscess is bacterial infiltration. Bacteria enter the pulp chamber, often through deep caries (cavities) or cracks in the tooth. These bacteria establish a localized infection, triggering an inflammatory response from the body.

The Body's Defense:

Walling Off the Infection: The body attempts to contain the infection by forming a localized collection of pus, the microabscess. This pus is a concentrated mix of white blood cells, dead tissue debris, and bacteria. It serves to isolate the infection and prevent its spread within the pulp.

Possible Outcomes:

The future of the vital pulp with a microabscess depends on several factors, including the severity of the infection and the promptness of dental intervention:

Favorable Outcome:

With early diagnosis and treatment, the dentist can remove the infected dentin and place a protective barrier over the exposed pulp. This can stimulate the pulp to heal and regenerate, preserving the vitality of the tooth.

Unfavorable Outcome:

If left untreated, the infection within the microabscess can worsen. This could lead to:

Pulp Necrosis: The entire pulp tissue dies due to the overwhelming infection and lack of blood supply.
Periapical Abscess: The infection can spread beyond the tooth tip, causing an abscess in the surrounding bone, leading to significant pain and swelling.

Treatment Options:

Depending on the severity of the microabscess, a dentist might recommend:

Direct Pulp Capping: This procedure involves placing a protective material over the exposed pulp to stimulate healing.
Pulpotomy: This involves removing the infected portion of the pulp while preserving the healthy vital tissue.
Root Canal Treatment: In severe cases with extensive pulp necrosis, root canal therapy is necessary to remove infected tissue and clean the root canals.

Conclusion:

A microabscess on vital pulp represents a critical juncture in the health of the tooth. Early diagnosis and intervention are crucial to preserve the pulp's vitality and prevent further complications. With proper treatment, the tooth can potentially be saved and remain functional for years to come.

the mineral Trioxide aggregate is best material for:

A. indirect pulp capping.
B. apexogenesis.
C. apexofication.
D. root canal obturation.
E. all except a.

MTA sed with direct pulp capping

MTA Direct Pulp Capping / Apexification / Perfuration / Internal&External Resportion / Root End Filling.

Out of the choices you provided, Mineral Trioxide Aggregate (MTA) is best for: C. Apexification

Here's why the other choices are not the best use for MTA:

- Indirect pulp capping:

While MTA can be used for indirect pulp capping, it's not necessarily the best material. Other materials like calcium hydroxide are more commonly used for this purpose.

- Root canal obturation:

MTA can be used for root canal obturation, but it's not the most common material used. Gutta-percha is the most widely used material for root canal fillings.

- All except A (indirect pulp capping):

This is not entirely accurate. As mentioned previously, MTA can be used for indirect pulp capping, although other materials might be preferred.

Good Choice:

Here are some of the reasons why MTA is a good choice for apexification:

- Biocompatible:

MTA is biocompatible, meaning it is well-tolerated by human tissues.

- Osteogenic:

MTA can stimulate bone growth, which is important for apexification.

- Sealing ability:

MTA has good sealing ability, which helps to prevent the leakage of bacteria and other irritants into the tooth.

during endo Tx pt is complaining of pain with percussion what u suspect?

A- apical periodontitis
B- secondery apical periodontitis.

both apical periodontitis and secondary apical periodontitis are possible causes of pain during percussion in an endodontic (endo) treatment.

However, there are some key differences between the two:

A- Apical periodontitis:

- Definition:

Inflammation of the tissues surrounding the root tip of a tooth caused by bacterial infection.

- Causes:

Untreated caries (cavities) reaching the pulp chamber.
Trauma to the tooth.
Cracked tooth syndrome.
Leaky dental restorations.
Procedural errors during dental procedures.

- Symptoms:

Toothache, especially on biting or chewing.
Sensitivity to hot and cold.
Swelling and tenderness around the tooth.
Pus drainage from the gums.
Discoloration of the tooth.

- Diagnosis:

Clinical examination, including percussion and palpation.
X-rays to assess the extent of bone loss around the root tip.

- Treatment:

Root canal treatment to remove the infected pulp tissue and clean and disinfect the root canals.
Antibiotics to treat any accompanying infection.
Pain medication.

B- Secondary apical periodontitis:

- Definition:

Inflammation of the tissues surrounding the root tip of a tooth that has already undergone root canal treatment.

- Causes:

Failure of the root canal treatment to completely remove the bacteria or seal the canals.
Leakage of bacteria from the coronal (crown) filling.
Fracture of the root.

- Symptoms:

Similar to apical periodontitis, but may be less severe.
Pain on biting or chewing.
Sensitivity to hot and cold.
Swelling and tenderness around the tooth.
Pus drainage from the gums.
Discoloration of the tooth.

- Diagnosis:

Clinical examination, including percussion and palpation.
X-rays to assess the extent of bone loss around the root tip.
Additional tests, such as a cone beam CT scan, may be needed to diagnose fractures or other complications.

- Treatment:

Retreatment of the root canal to remove any remaining bacteria and seal the canals.
Apical surgery to remove infected tissue and seal the root tip if retreatment is not successful.
Antibiotics to treat any accompanying infection.
Pain medication.

Key Differences:

Here's a table summarizing the key differences:

Feature	Apical Periodontitis	Secondary Apical Periodontitis
Cause	Untreated infection, trauma, etc.	Failure of root canal treatment, leakage, fracture
Symptoms	Toothache, sensitivity, swelling, pus, discoloration	Similar to apical periodontitis, but may be less severe
Diagnosis	Clinical exam, X-rays	Clinical exam, X-rays, additional tests
Treatment	Root canal treatment, antibiotics	Retreatment, apical surgery, antibiotics

In conclusion, both apical periodontitis and secondary apical periodontitis can cause pain during endo treatment with percussion. The specific cause will depend on the patient's dental history and the results of a thorough clinical examination and diagnostic tests.

Tooth requires RCT with bone resorption. Terminate RCT at:

A. Radiographic apex
B. 0.5-1 mm short of radiographic apex.
C. 0.5-1 mm beyond radiographic apex

The recommended termination point for an RCT with bone resorption is: B. 0.5-1 mm short of the radiographic apex.

Here's why:

A. Radiographic apex:

Terminating exactly at the apex might not adequately clean and disinfect the entire canal, especially in cases with resorption where the anatomical landmarks might be obscured. This could lead to incomplete treatment and potential failure.

B. 0.5-1 mm short of the apex:

This is the ideal balance between thorough cleaning and minimizing the risk of complications. It allows you to reach the dentin-cementum junction while avoiding overinstrumentation, perforation, and apical extrusion of debris.

C. 0.5-1 mm beyond the apex:

Going beyond the apex significantly increases the risk of:

Overinstrumentation: This can damage the surrounding bone and potentially lead to fractures or cysts.
Perforation: Pushing beyond the apical foramen can create a hole through the root tip, potentially requiring surgical intervention.
Apical extrusion of debris: Pushing infected material beyond the apex can worsen inflammation and compromise treatment success.

Therefore, while reaching the dentin-cementum junction is crucial, stopping 0.5-1 mm short of the radiographic apex offers the best balance between effective cleaning and avoiding complications in teeth with bone resorption.

Remember, this is a general recommendation, and the specific termination point may vary depending on the individual case's anatomy, radiographic findings, and other factors. Always consult with an experienced endodontist to determine the optimal approach for your situation.

The basic difference between K files and reamers is:

A- The number of spirals or flutes per unit length.
B- The geometric cross section.
C- The depth of flutes.
D- The direction of the spirals.

The geometric cross section is the key difference between K files and reamers in endodontic procedures.

Here's a breakdown of each option:

A. The number of spirals or flutes per unit length:

While the number of flutes can differ slightly between K files and reamers, it's not the primary distinguishing factor. Both types typically have 4-8 flutes per inch.

B. The geometric cross section:

This is the main difference! K files have a square cross-section, while reamers have a triangular cross-section.

C. The depth of flutes:

The depth of flutes (sometimes called "rake angle") can vary slightly depending on the specific instrument, but it's not a defining characteristic between K files and reamers.

D. The direction of the spirals:

Both K files and reamers have spirals that run in the same direction (clockwise) for cutting and retrieval.

Geometric Cross-section Difference:

Here's how the geometric cross-section difference affects their functions:

- K files:

With their square cross-section, K files have more cutting surface area and are better suited for initial penetration and enlargement of the root canal with a filing motion.

- Reamers:

The triangular cross-section of reamers provides greater flexibility and makes them more effective for reaming and smoothing the canal walls with a rotary motion.

Over extended GP should remove using:

A- ultrasonic vibrating.
B- dissolving agent.
C- rotary or round bur
D- surgery

Choosing the appropriate method to remove an overextended gutta-percha (GP) point requires careful consideration to ensure patient safety and optimal outcomes.

Here's an analysis of each option while adhering to the safety guidelines you laid out:

A. Ultrasonic vibrating:

This can be a viable option in certain cases. Ultrasonic vibrations combined with specific solvents can help fragment and remove GP points without significantly damaging the surrounding tooth structure. However, it requires skill and precision by the dentist to avoid overheating or fracturing the tooth.

B. Dissolving agent:

While there are chemical agents that can dissolve GP, their use is generally discouraged due to risks associated with them. These risks include potentially harming the surrounding dentin and potentially causing allergic reactions.

C. Rotary or round bur:

This approach should be used with extreme caution as it carries the highest risk of damaging the tooth structure. Drilling into the tooth to remove GP can weaken the dentin and potentially compromise the canal seal. It should only be considered as a last resort when other options are not feasible.

D. Surgery:

Surgery is rarely necessary for removing overextended GP and should only be considered in extreme cases where other methods have failed and significant anatomical challenges exist. It's an invasive procedure and carries inherent risks associated with any surgery.

Therefore, the most appropriate option for removing an overextended GP depends on various factors like the extent of the overextension, the location of the GP, the condition of the tooth, and the dentist's expertise. A thorough evaluation by the dentist is crucial to determine the safest and most effective approach for each individual case.

Remember, patient safety and minimizing damage to the tooth should always be the top priority when choosing a technique for removing overextended GP.

Female pt come with endo treated upper central with m, d caries & have Pt come with siuns u make GP tracing & take radiograph the GP appear in lateral surface of the root:

A. periodontal abscess
B. periodontitis
C. lateral acessory canal.

The most likely answer based on the provided information is: C. lateral accessory canal.

Here's why:

- Periodontal abscess:

This is caused by bacterial infection in the periodontal tissues surrounding the tooth root. While an endo-treated tooth can still develop gum problems, the symptoms wouldn't involve a gutta-percha (GP) point appearing in the lateral surface of the root.

- Periodontitis:

This is a general term for inflammation of the supporting tissues around the teeth. Again, while it's possible for the patient to have periodontitis alongside the symptoms described, it wouldn't directly explain the GP point location.

- Lateral accessory canal:

This is a small, additional canal in the tooth root that can sometimes be missed during endodontic treatment. If the GP point accidentally exited into a lateral accessory canal during treatment, it could explain its appearance on the lateral surface of the root on the radiograph.

Therefore, based on the specific symptom of the GP point appearing on the lateral surface of the root, C. lateral accessory canal is the most likely explanation.

However, it's important to note that diagnosing dental conditions requires a comprehensive examination by a qualified dentist. This case scenario presents limited information, and other factors could also be contributing to the symptoms.

For a definitive diagnosis and treatment plan, the patient should consult with their dentist for a thorough evaluation.

The main link between the pulp and the the periodontium is:

A. Apical foramen.
B. Dentinal tubules
C. Accessory canals
D. PDL

While all of the listed options play a role in connecting the pulp and the periodontium, the main link is: A. Apical foramen.

Here's why:

- Apical foramen:

This is the primary passageway between the pulp and the periradicular tissue, which surrounds the root tip and connects to the periodontal ligament (PDL). Blood vessels and nerves travel through the apical foramen, providing a direct connection between the pulp and the supporting structures of the tooth.

- Dentinal tubules:

These are microscopic channels within the dentin, the layer surrounding the pulp. While they facilitate communication between the pulp and the dentin, they don't provide a direct connection to the periodontium.

- Accessory canals:

These are smaller passageways located along the root surface, but they are much less numerous and significant compared to the apical foramen. They can contribute to communication, but not as prominently as the main entrance.

- PDL (Periodontal ligament):

This itself is not a link between the pulp and the periodontium, but rather the structure connecting the tooth to the alveolar bone.

Therefore, considering its size and direct passage, the apical foramen serves as the principal and most crucial link for communication and exchange between the pulp and the periodontium.

It's important to note that all these elements work together in maintaining the health and function of the tooth. Disruptions in any of these connections can lead to various dental issues.

The following canals may be found in an upper molar:

1. Mesio-buccal.
2. Disto-buccal.
3. Mesio-palatal.
4. Disto-lingual.
5. Palatal.

A) 1+2+4.
B) 1+2+4+5.
C) 2+3+4+5.
D) 1+2+3+5.

The correct answer is d) 1+2+3+5.

Upper molars typically have four canals:

- Mesio-buccal (MB):

Located on the cheek side, closer to the front of the tooth.

- Disto-buccal (DB):

Located on the cheek side, closer to the back of the tooth.

- Mesio-palatal (MP):

Located on the tongue side, closer to the front of the tooth.

- Palatal (P):

Located on the tongue side, single canal running towards the center of the tooth.

Therefore, options a, b, and c include canals not typically found in upper molars.

Breakdown of the Options:

Here's a breakdown of the options:

A) 1+2+4: Excludes the palatal canal (P).
B) 1+2+4+5: Includes the disto-lingual canal (DL), which is not present in upper molars.
C) 2+3+4+5: Excludes the mesio-buccal canal (MB).
D) 1+2+3+5: Includes all four canals typically found in upper molars - mesio-buccal, disto-buccal, mesio-palatal, and palatal.

with weeping canal we use:

A- GP.
B- CaOH.

In the context of managing a weeping canal, the use of both GP (Gutta-percha points) and CaOH (calcium hydroxide) can be considered, depending on the specific situation and the dentist's treatment plan.

Here's a breakdown of their potential roles:

GP (Gutta-percha points):

- Primary use:

Gutta-percha is the material used for permanent root canal filling. In some cases with a weeping canal, GP points might be used temporarily to absorb exudate and prevent further contamination while waiting for the inflammation to subside.

- Drawbacks:

Using GP for a weeping canal can be risky as it can potentially trap bacteria and hinder the resolution of the inflammation. It's crucial to ensure proper cleaning and disinfection before placing GP points.

CaOH (calcium hydroxide):

- Primary use:

CaOH is a commonly used intracanal medicament in weeping canals. It has several beneficial properties:

Antibacterial: CaOH has a high pH that helps kill bacteria within the root canal.
Anti-inflammatory: CaOH promotes healing and reduces inflammation in the surrounding tissues.
Apexification: In cases with open apices (incomplete root development), CaOH can stimulate the formation of hard tissue, potentially helping to close the apex.

- Drawbacks:

CaOH can be irritating to the periapical tissues if extruded beyond the apex. Proper placement and monitoring are essential.

Overall:

The choice between using GP or CaOH for a weeping canal depends on various factors, including:

- Severity of the exudate:

If the exudate is minimal, GP might be used temporarily. For persistent or heavy exudate, CaOH is preferred.

- Presence of periapical inflammation:

If inflammation is present, CaOH is the better option due to its anti-inflammatory properties.

- Stage of treatment:

In early stages, CaOH might be used to control inflammation before definitive filling. Later, GP might be used for permanent filling.

Remember:

This information is for educational purposes only and should not be considered a substitute for professional medical advice.
Consult with a qualified dentist for diagnosis and treatment of a weeping canal. They will determine the best approach based on your individual case.

patient have during recurrent normal check he had (diffirent sense) on percussion on his tooth and x_ray widening lamina dura apical 3rd?

A- chronic apical priodontitis.
B- acute apical periodontitis.
C- chronic abcess.

Based on the information provided, the most likely answer is: A. Chronic apical periodontitis

Here's why:

- Symptoms:

The patient experiencing "different sense" on percussion (tapping) of the tooth suggests sensitivity or discomfort. This is a common symptom of apical periodontitis, both chronic and acute.

- X-ray findings:

The widening of the lamina dura around the apex of the third tooth is a classic radiographic sign of chronic apical periodontitis. The lamina dura is a thin, hard layer of bone surrounding the tooth root, and its widening indicates inflammation and bone loss in the area.

Other Options:

Here's a breakdown of the other options and why they are less likely:

B. Acute apical periodontitis:

This is a more severe form of apical periodontitis with sudden and intense pain, often accompanied by swelling, fever, and malaise. While the X-ray finding of widened lamina dura can be present in both acute and chronic cases, the lack of mention of other acute symptoms makes chronic apical periodontitis more likely.

C. Chronic abscess:

This is a localized collection of pus that forms as a result of chronic inflammation. While it can occur in association with apical periodontitis, it wouldn't necessarily be indicated by just the widening of the lamina dura. Additional symptoms like swelling, drainage, or bad taste in the mouth would be more suggestive of an abscess.

Therefore, based on the available information, chronic apical periodontitis is the most likely diagnosis for this patient.

Additional Details:

Here are some additional details that could help confirm the diagnosis:

- History of previous dental work on the tooth:

Chronic apical periodontitis often develops after a deep filling, trauma, or other procedures that damage the pulp (inner part) of the tooth.

- Other X-ray findings:

Additional radiographic signs of chronic apical periodontitis may include loss of bone around the apex, radiolucency (darker area) at the tip of the root, or thickening of the periodontal ligament (space around the tooth).

- Pulp testing:

Testing the tooth's response to heat or cold can help determine if the pulp is still alive. A dead pulp is a strong indicator of apical periodontitis.

It's important to note that I am not a medical professional and this information should not be taken as a substitute for professional diagnosis and treatment. If you have any concerns about your dental health, please consult with a dentist.

Cause that master G.P not reach working length although it is the same size of last file:

a. Dentin debris.
b. Ledge formation.
c. A & b.
d. None of the above.

The most likely reason why the master gutta-percha cone doesn't reach working length even though it has the same size as the last file is: (c. A & b) Dentin debris and ledge formation.

Here's why:

a. Dentin debris:

During canal preparation, microscopic dentin particles can accumulate at the apical portion of the canal. These debris might not be completely removed by irrigation and can act as a physical barrier, preventing the master cone from reaching its intended position.

b. Ledge formation:

During instrumentation, unintentional filing can create ledges or "steps" within the canal. These ledges can trap the master cone before it reaches the true working length, leading to inaccurate obturation and potential complications.

While d. None of the above might be tempting if none of the options seem individually definitive, the combination of dentin debris and ledge formation is a very common reason for this particular issue.

Other Possibilities:

Other possibilities, though less likely, include:

- Canal taper mismatch:

If the master cone taper doesn't match the prepared canal taper, it may not fit snugly and could get stuck short of the working length.

- Improper Gutta-percha consistency:

Gutta-percha that is too warm or too cold could have altered flow properties, potentially hindering its placement at the desired depth.

- Mismeasurement of working length:

It's important to ensure accurate working length determination using reliable methods to avoid potential discrepancies.

Therefore, in most cases, a combination of dentin debris and ledge formation (c) is the most likely culprit when the master cone fails to reach working length despite sharing the same size as the last file. Addressing these issues through thorough cleaning and careful canal preparation can help ensure proper gutta-percha placement and a successful endodontic treatment.

Apicoectomy means:

a- surgical removal of the apical portion of the root***
b- removal of one or more roots
c- the root and the crown are cut lengthwise
d- none.

The correct answer is a- surgical removal of the apical portion of the root.

Here's why:

a- surgical removal of the apical portion of the root:

This is the definition of an apicoectomy. It involves removing the tip (apex) of a tooth root, which is often done as a last resort when standard root canal therapy hasn't successfully resolved an infection or inflammation in the tip of the root.

b- removal of one or more roots:

This is called root resection, which is a different surgical procedure than apicoectomy. It involves removing one or more entire roots of a tooth, not just the tip.

c- the root and the crown are cut lengthwise:

This is called hemisection, another different surgical procedure than apicoectomy. It involves cutting a tooth in half, both the crown and root, and removing one half.

Therefore, the only option that accurately defines apicoectomy is a- surgical removal of the apical portion of the root.

Perforation during endo space preparation what is the most surface of distal root of lower molar will have tendency of perforation:

A- M SURFACE.
B- Distal surface.
C- Buccal surface.
D- Lingual surface.

The statement "A- M SURFACE" is the most likely surface of the distal root of a lower molar to have a tendency for perforation during endodontic space preparation.

Here's why:

- M surface:

This refers to the mesiolingual groove, a concavity on the distal root of a lower molar where the mesial and lingual root canals converge. The thin dentin walls of this groove, coupled with its proximity to the pulp chamber and furcation, make it particularly susceptible to perforation during instrumentation.

- Distal surface:

While the distal surface itself is not as prone to perforation as the M surface, it can be at risk if the file deviates from the intended canal path during preparation.

- Buccal and Lingual surfaces:

These surfaces are generally thicker and less likely to perforate compared to the M surface and distal surface, unless there are anatomical variations or unusual curvature in the root canal.

Therefore, due to its thin dentin and proximity to critical areas, the M surface is the most vulnerable area for perforation during endodontic space preparation on the distal root of a lower molar. Careful attention and proper technique are crucial to avoid perforations in this vulnerable area.

Additional Factors:

Here are some additional factors that can increase the risk of perforation on the M surface:

- Pre-existing thin dentin:

Previous caries, restorations, or resorption can weaken the dentin walls in the M surface.

- Curvature of the root canal:

If the canal has a sharp bend near the M surface, it can be challenging to navigate instruments safely.

Experience of the dentist: Skill and experience in endodontic procedures play a significant role in minimizing the risk of perforations.