Endodontics I.
Questions with the framework
1. Characterization and morphology and of the endodont.
What is endodont, pulp chamber, root canals and their variety, apex, apical foramen, apical
constriction, periodontal space, ramifications, histology of dental pulp, dentin, cementum and
periodontium. Macro and micro canal system.
2. Dental pulp and its healing potential, importace of calcium hydroxide.
Primary, secondary and tertiary dentin, reparative dentin, characterization, intratubular dentin,
dentinal sclerosis, role of calcium hydroxide.
3. Pulpal response to irritation, pulpitis.
The reaction of dental pulp is non specific inflammation – description of inflammation from
hypereamia to total pulpitis. Degeneration of dental pulp, denticles.
4. Classification of pulpitis, reasons
Histopathological and clinical classification. Reversible and irrereversible changes, diferential
diagnosis. Microbiological and chemical reasons, ways of the infection.
5. Symptomatology of pulpitis, principles of the treatment.
Description of symptoms of pulpitis, remember spontaneous pain, treatment.
6. Diferential diagnosis of pulpitis
Papillitis, apical periodontitis, headeache,
7. Apical periodontitis – reasons, classification
Mostly infection and chemical irritation, classification acc to course and pathology.
8. Symptomatology of acute periodontitis, principles of the treatment.
Heavy pain, esp. for percussion and warm and hot well located. Decompression – opening of
the root canal system, RCT (= root canal treatment) afterwards.
9. Symptomatology of chronic periodontitis, principles of the treatment
Almost no symtoms, in the case of the acute exacerbation the same symtoms like in acute
periodontitis. X–ray picture.
10. Diagnosis and diferential diagnosis of acute periodontitis
Pulpitis, papillitis, periodontal abscess (parodontitis)
11. Necrosis and gangreana of dental pulp, their reasons, symptoms and principles of the
treatment.
Histopathology and clinical symtomatology (almost no symptoms, in case of gangreana pain
on warm and hot, special smell), RCT.
12. Internal and external resorption – reasons, principles of the treatment.
Internal resosption – a form of chronic pulpitis, external resorption – from periodontium. In
early stages is possible to use calcium hydroxide and RCT afterwards. X-ray picture
13. Calcium hydroxide and medicaments in endodontics.
Esp. short, middle and long term action of calciumhydroxide in the root canal)
14. Diagnosis in endodontics, case selection and treatment planning.
Patiens history, importace of the tooth, local investigation – depht of the carious lesion,
condition of the supportive tissues, morphology of roots and root canals. Size of the periapical
lesion.
15. Phases of the endodontic treatment, importace of X-ray investigation, working length.
Access to the pulp chamber, opening of the root canals, cathetrization with thin instrument,
negotiation of the working length, root canal shaping, root canal cleaning, canal filling. X- ray
for diagnosis, working length, control.
16. Access to the pulp chamber – instruments, step by step procedure, location and form
of endodontic cavities.
Dia trepans, Batt´s instruments (burs and diamonds with the blunt, safe ended tips), form and
location of the endodontic cavity in all teeth.
17. Root canal shaping – instruments, techniques of instrumentation
Reamer, K- file and modification, C- file, H-file. Description and principles of the
instrumentation.
18. Root canal shaping – methods
Circumferential filing, balanced force technique, reaming action.
19. Irrigation of the root canal
Principles and importance of irrigation, irrigants, instruments. Lubrication.
20. Root canal filling – materials
Guttapercha, sealers – resin based, kalcium hydroxide based, cement –based. Solid, semisolid,
pastes.
21. Root canal filling – preconditions for the filling, methods, instruments.
Preconditions: Shaping (at lest 3 sizes bigger in comparison to first apical size), dry root canal
without bleeding and exsudation, no clinical symptoms. Filling methods: Cold: Single cone
technique, lateral condensation. Warm: warm laterál condensation, vertical condensation,
injection, thermafill and similar techniques, MC Spadden technique. (Warm technics – only
overview)
22. Complications of the endodontic treatment.
Local (ledge, stripping, zip and elbow effect, transportation, perforation, fracture of the root
canal instrument, overfilling), regional (necrosis, damage of gingiva, mucosa etc), systemic:
allergy, aspiration or swollow of the instrument.Safety in endodontics.