Endodontics "សូមមេត្តាកុំចែកចាយ Link ដោយគ្មានការអនុញ្ញាត"
In molars, when should cast post/core be considered?
Be always considered
Be considered when the root canals are larges as this would be easy to prepare a post space.
Be considered only when no coronal tooth structure remains
Be considered when there are some tooth structures remained but with a small pulp chamber.
Using a conservative approach, what is the restoration of choice for a small class I cavity in a posterior root-treated tooth with limited functional and lateral stresses?
Direct composite or inlay
GIC filling
Overlay
Amalgam filling with cuspal coverage
Using a conservative approach, what is the restoration of choice for a small class II MO/OD cavity in a posterior root-treated tooth with limited functional and lateral stresses?
Direct composite or inlay
GIC filling
Overlay
Amalgam filling with cuspal coverage
Using a conservative approach, what is the restoration of choice for a small class II MOD cavity in a posterior root-treated tooth with limited functional and lateral stresses?
Direct composite or inlay
GIC filling
Overlay
Amalgam filling with cuspal coverage.
What is the restoration of choice for a large class II MOD cavity in a posterior root-treated tooth with limited functional and lateral stresses?
Direct composite or inlay
GIC filling
Overlay
Full crown
What is the restoration of choice for a large class II MO/OD cavity in a posterior root-treated tooth with limited functional and lateral stresses?
Direct composite or inlay
GIC filling
Overlay
Full crown
Using a protective approach, what is the restoration of choice for a large class I cavity in a posterior root-treated tooth with limited functional and lateral stresses?
Direct composite or inlay
GIC filling
Overlay
Full crown
What is the restoration of choice for any cavity types in a posterior root-treated tooth with increased functional and lateral stresses?
Direct composite or inlay
GIC filling
Overlay
Full crown
What is the conservative approach to restore a posterior tooth with a large decay but with more than half of the tooth structure remained and no esthetic concern?
Direct composite
Endocrown
Composite core + full crown
Post and core + full crown
What is the restoration of choice for a posterior tooth with a large decay and esthetic concern but with more than half of the tooth structure and more than 4 mm of ferrule remained?
Direct composite
Endocrown
Composite core + full crown
Post and core + full crown
What is the restoration of choice for a posterior tooth with a large decay and less than half of the tooth structure remained?
Direct composite
σ� Endocrown
Composite core + full crown
Post and core + full crown
Which type of post should be used when more than ½ coronal tooth structure is lost (reduced wall height)?
No post is needed
Fiber or ceramic post
Metal post
Cast gold post
Which type of post should be used when more than ½ crown height remains?
No post is needed
Fiber or ceramic post
Metal post
Cast gold post
Which type of post should be used when more than 2/3 coronal tooth structure is lost (reduced wall height)?
No post is needed
Fiber or ceramic post
Metal post
Cast gold post
Which type of post should be used when more than3/4 coronal tooth structure is lost (reduced wall height)?
No post is needed
Fiber or ceramic post
Metal post
Cast gold post
What is not an advantage of build-up without post?
Additional weakening of the root is avoided
Danger of root perforation is minimized
Load transmission to the root is less uniform
Fracture mode is more favorable in case of failure.
Why do we need a ferrule in restoring teeth with small amount of tooth structure remained?
The ferrule can help preventing biological width violation
The ferrule can help preventing a gum recession
The ferrule can help preventing a black line of a ceramic crown
The ferrule can help preventing root fracture
To prepare the post space, what should we use to initially remove the GP?
Heated instrument
Gates-Glidden burs
Hand files
Peeso reamers
In which case should an antibiotic be prescribed?
Irreversible pulpitis
Pulp necrosis without swelling
Pulp necrosis with localized swelling
Pulp necrosis with diffuse swelling
Which is the antibiotic of choice for endodontic infection?
Clindamycin
Penicillin VK
Amoxicillin
Azithromycin
What is the loading dose of penicillin VK?
300 mg
500 mg
600 mg
1000 mg
What is the dosage of penicillin VK?
Loading dose of 1000 mg followed by 500 mg every 6 hours for 7 days
Loading dose of 500 followed by 250 mg every 6 hours for 7 days.
Loading dose of 1000 followed by 500 mg every 8 hours for 7 days.
Loading dose of 500 followed by 250 mg every 8 hours for 7 days
If the patient is allergic to penicillin, which antibiotic should be used as an alternative?
Amoxicillin
Clindamycin
Metronidazole
Augmentin
If the infection is life-threatening, which antibiotic should be used?
Amoxicillin
Clindamycin
Azithromycin
Augmentin
For patients with severe endodontic infections but not life-threatening and given that they are not allergic to penicillin, which antibiotic should be used?
Amoxicillin
Clindamycin
Azithromycin
Augmentin
What is the dosage of amoxicillin?
Oading dose of 1000 mg followed by 500 mg every 6 hours for 7 days
Loading dose of 500 mg followed by 250 mg every 6 hours for 7 days.
Loading dose of 1000 mg followed by 500 mg every 8 hours for 7 days.
Loading dose of 500 mg followed by 250 mg every 8 hours for 7 days
When should metronidazole be prescribed in addition to penicillin?
When the patient is allergic to Augmentin
When there is only a mild indication of systemic antibiotic therapy
When the patient’s condition is not improving after 72 hours of taking only penicillin.
Whenever possible.
What is the usage dose of metronidazole?
150 mg every 6 hours for 7 days
300 mg every 6 hours for 7 days
500 mg every 6 hours for 7 days
300mg every 8 hours for 7 days
An example of life-threatening conditions is Ludwig angina, which is:
A diffuse swelling involving submental and submandibular spaces
A diffuse swelling involving submental, submandibular and sublingual spaces
A diffuse swelling involving submental and sublingual spaces
A diffuse swelling involving submandibular and sublingual spaces
What is the dosage of clindamycin?
Loading dose of 1000 mg followed by 500 to 1000 mg every 6 hours for 7 days
Loading dose of 600 mg followed by 300 to 600 mg every 6 hours for 7 days.
Loading dose of 300 mg followed by 150 to 300 mg every 6 hours for 7 days.
Loading dose of 250 mg followed by 125 to 250 mg every 8 hours for 7 days
When should clarithromycin be prescribed?
When the patient is allergic to clindamycin and there is relatively mild indication for systemic antibiotic therapy.
When the patient is allergic to penicillin and there is relatively mild indication for systemic antibiotic therapy.
When the patient is allergic to clindamycin and there is relatively strong indication for systemic antibiotic therapy.
When the patient is allergic to penicillin and there is relatively strong indication for systemic antibiotic therapy.
When should azithromycin be prescribed?
When the patient is allergic to clindamycin and there is relatively mild indication for systemic antibiotic therapy.
When the patient is allergic to penicillin and there is relatively mild indication for systemic antibiotic therapy.
When the patient is allergic to clindamycin and there is relatively strong indication for systemic antibiotic therapy.
When the patient is allergic to penicillin and there is relatively strong indication for systemic antibiotic therapy.
What is the dosage of clarithromycin?
125 to 250 mg (with or without meal) every 12 hours for 7 days.
250 to 500 mg (with or without meal) every 12 hours for 7 days.
125 to 250 mg (with or without meal) every 8 hours for 7 days.
250 to 500 mg (with or without meal) every 8 hours for 7 days
What is the dosage of azithromycin?
1 hour before or after meal, loading dose of 500 mg followed by 250 mg daily for 5 to 7 days.
1 hour before or after meal, loading dose of 1000 mg followed by 500 mg daily for 5 to 7 days.
1 hour before or after meal, loading dose of 500 mg followed by 250 mg every 12 hours for 5 to 7 days.
1 hour before or after meal, loading dose of 1000 mg followed by 500 mg every 12 hours for 5 to 7 days.
Which analgesics should be used for mild pain?
Ibuprofen alone
Combination of ibuprofen and hydrocodone
Combination of acetaminophen and codeine
Combination of acetaminophen and oxycodone
The incidence of endodontic flare-ups range from:
2% to 20%
20% to 40%
40% to 50%
50% to 60%
Which may not be one of the risk factors of endodontic flare-ups?
Patient’s age
Tooth type
Retreatment cases
Preoperative pain
Most of endodontic flare-ups can be managed by:
Antibiotics
Analgesics
Incision and drainage
Intervention by the clinician
If the endodontic flare-up may be caused by incomplete instrumentation, what should be done?
Just prescribe analgesics
Do nothing; the problem will be solved by itself.
Complete the instrumentation
Just reopen the tooth and leave it open for a few days.
Why shouldn’t a tooth with necrotic pulp and some swelling be left open between appointments?
Because the patient usually does not like his/her tooth to be left open
Because there is a risk of root canal contamination with other new microorganisms which might be harder to be killed
There are more risks of fracture if the access cavity is not temporarily sealed.
Because this will cause endodontic flare-ups
If severe endodontic flare-ups occur despite the complete instrumentation in an irreversible pulpitis case, what should we usually do?
Just reassure the patient and prescribe strong analgesics
Do nothing; the problem will be solved by itself.
Reopen the tooth and leave it open for a few days.
Reopen the tooth and re-instrument.
If the canals are already obturated, and a severe endodontic flare-up (with no evidence of acute apical abscess though) occurs despite an adequate prior treatment, what should be done?
Retreatment is necessary
Apical surgery
Reassure the patient and prescribe strong analgesics.
Incision and drainage
Which condition is best managed by a specialist?
Irreversible pulpitis
Pulp necrosis without swelling
Pulp necrosis with localized swelling
Pulp necrosis with diffuse swelling
Which condition always requires incision and drainage?
Irreversible pulpitis
Pulp necrosis without swelling
Pulp necrosis with localized swelling
Pulp necrosis with diffuse swelling
How to incise for drainage?
Horizontally
Vertically
Obliquely
Either one of the above direction
The preferable type of drain is:
Penrose drain
T drain
1 2-inch iodoform gauze
I drain
How long do we usually leave the drain in place?
1 to 2 days
2 to 3 days
3 to 5 days
5 to 7 days
Regardless of the swelling and if the time and condition permit, the emergency treatment of pulp necrosis case should be:
Just to open the tooth and leave it open for a few day
Open the tooth and partially instrument the root canals and dressing with eugenol
Complete debridement of the root canals, and incision and drainage whenever possible.
Just do incision and drainage and prescribe antibiotics.
In case of pulp necrosis without swelling and limited time, the emergency treatment should be:
Just to open the tooth and leave it open for a few day
Partial debridement by lightly instrumenting to the estimate working length and sealed with dry cotton and temporary restoration.
Complete debridement of the root canals, then leave the tooth open for some times.
Just prescribe analgesics.
After an endodontic emergency treatment, the pain is:
Gone immediately
The same as before treatment for a few days
Usually there, but should gradually subside within a few days
Relieved but take a few weeks to be completely gone.
In case of pulp necrosis with localized swelling, how can we do to induce the drainage through the root canals if it does not occur spontaneously?
Aspirate using a syringe with a small needle
Penetrate the apical foramen with small files (up to 25).
Press the swollen area to force the pus out through the root canals
Ask the patient to rinse with warm salt water for a few minutes.
If the canals are weeping, what shall we do?
Leave the tooth open and dismiss the patient
Sit the patient up for a while until the drainage stop then continue the treatment
Just ignore that, and continue with the treatment in a usual manner
Aspirate the drainage with a syringe to speed up the process
In which case can the treated-tooth be left open?
When there is a diffuse swelling
When the pulp is necrosis but there is no any swelling
When the drainage through the canal does not stop at all even after sitting the patient up for a while.
When the time is limited
Among all types of electronic apex locator, which type is the less reliable and accuracy?
The first generation
The second generation
The third generation
The fourth generation
Which condition shouldn’t an electronic apex locator be used?
Root perforation
Immature apex
Teeth with apical root resorption due to apical lesion
Obliterated cannals
Which of the followings is not one of the methods used to determine the working length?
Moisture on a paper point
Tactile sense
MRI
σ� Radiograph
Which method is helpful in determine the working length of an immature tooth?
Tactile sense
Moisture on a paper point
Electronic apex locator
The use of anatomical averages and knowledge of anatomy
The tactile sensation technique should not be used to determine working length in which of the following conditions?
By an experienced clinician
In sclerotic canals
In canals with a single constriction
In necrotic cases
A major determinant for the desired final apical diameter preparation is:
The technique of preparation
The initial canal size
The curvature of the roots
The root canal instruments whether they are flexible or not.
Which one is a benefit of narrow apical preparation?
Ideal for lateral compaction
Less compaction of hard tissue debris in canal spaces
Adequate removal of infected dentin
Access of irrigants and medications to apical third of root canal is greatly improved.
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