Iran Dental Specialty Board - Endodontics flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Reversible pulpitis

Provoked pain of short duration that resolves after removal of the stimulus, with a vital pulp and no spontaneous pain; treatment is removal of the cause and conservative restoration rather than root canal treatment.

Irreversible pulpitis

Spontaneous or prolonged pain, often worse on lying down, indicating inflammation that will not heal; root canal treatment or pulp extirpation is indicated.

Radicular cyst

An epithelium-lined cavity at the apex arising from inflammatory stimulation of epithelial rests of Malassez; diagnosis requires histology because radiographs cannot reliably distinguish it from a granuloma.

Condensing osteitis

A localized area of dense reactive bone at the apex of a tooth with low-grade chronic pulpitis, most common in young patients and mandibular posterior teeth; it resolves after endodontic treatment.

External cervical resorption

Resorption initiated in the cervical region below the epithelial attachment, often asymptomatic and misdiagnosed as caries; CBCT is the imaging method of choice for mapping its extent.

Cold test

Application of a refrigerant to the buccal surface to assess pulp sensibility; a prolonged response suggests irreversible pulpitis, and no response suggests necrosis, though false negatives occur in calcific metamorphosis.

Electric pulp test

A vitality test that stimulates nerve fibers in the pulp; it confirms vitality but gives false negatives in immature, recently traumatized, or calcified teeth, so it is used with cold testing.

Cracked tooth syndrome

Sharp pain on release of biting, often not reproduced by percussion; diagnosis uses transillumination, bite tests, and CBCT to localize the fracture before deciding on treatment.

Restorability assessment

Evaluation of remaining tooth structure, ferrule, fracture extent, and periodontal support to determine whether endodontic treatment is justified; an unrestorable tooth should be extracted.

Enterococcus faecalis

A gram-positive facultative anaerobe frequently recovered from failed root canal treatment; it tolerates high pH, invades dentinal tubules, and can persist as a monoinfection.

Sodium hypochlorite

The only common irrigant that dissolves organic tissue and has broad antimicrobial activity; it is consumed by tissue, so it must be replenished, and extrusion causes severe tissue injury.

EDTA irrigation

A 17% chelating solution that removes the smear layer and opens dentinal tubules; it is used as a final rinse before a NaOCl rinse and must not be mixed with chlorhexidine.

MB2 canal

The second mesiobuccal canal of the maxillary first molar, present in roughly 50-70% of cases; it is located under the mesiobuccal cusp and should be actively sought during access.

Radix entomolaris

An additional distolingual root most commonly found in mandibular first molars, with higher prevalence in East Asian populations; it must be identified on preoperative radiographs or CBCT.

Dens invaginatus

An invagination of enamel and dentin into the pulp chamber, most common in maxillary lateral incisors; Type III can communicate with the periodontal ligament and cause a periapical lesion in a vital tooth.

Electronic apex locator

A device that determines working length by measuring electrical impedance between the file and the periodontal ligament, with accuracy within about 0.5 mm; it is confirmed radiographically.

Glide path

A smooth pathway created with small hand files to the working length before rotary instrumentation; it reduces the risk of ledging and instrument separation in curved canals.

Cyclic fatigue

Fracture of nickel-titanium instruments from repeated flexural stress in curved canals, distinct from torsional fracture caused by excessive apical pressure; it is reduced by limiting reuse.

Irrigant activation

The use of sonic or ultrasonic energy, negative pressure, or manual dynamic agitation to improve irrigant exchange in the apical third and into isthmuses compared with syringe irrigation alone.

Ferrule effect

A circumferential band of at least 1.5-2 mm of dentin above the crown margin that improves fracture resistance of endodontically treated teeth; its absence is a risk factor for failure.

Post space preparation

Preparation of the coronal canal after sealer set, preserving at least 4-5 mm of apical gutta-percha; posts provide retention for the core and do not strengthen the root.

Coronal seal

The quality of the restoration that seals the root canal from oral fluids; a well-adapted coronal restoration is strongly associated with periapical healing after endodontic treatment.

Nonsurgical retreatment

The first choice for most endodontic failures, involving removal of the previous root filling and reinstrumentation; it is indicated for persistent apical periodontitis and inadequate previous fill.

Separated instrument

A fractured file within the canal; management includes bypassing with a small file, ultrasonic retrieval under magnification, or surgery if the fragment cannot be removed and the tooth is restorable.

Avulsion management

Replant as soon as possible, store in milk or saline, do not scrub the root, splint flexibly for 2 weeks, and consider systemic antibiotics; dry time over 60 minutes worsens prognosis.

Regenerative endodontics

A procedure for immature necrotic teeth with open apices using minimal instrumentation, disinfection with NaOCl and EDTA, and induction of a blood clot to promote root development.

Cvek pulpotomy

Partial pulpotomy of an immature traumatized tooth with a pulp exposure, using calcium hydroxide or MTA to preserve vitality and allow continued root development.

Root-end resection

Surgical removal of about 3 mm of the root apex with a shallow bevel to eliminate the apical delta; it is followed by ultrasonic root-end preparation and a bioceramic retrofill.

Endodontic microsurgery

Periradicular surgery using an operating microscope, ultrasonic retrotips, and bioceramic retrofilling materials; it has higher success rates than traditional surgical techniques.

Combined endo-perio lesion

A lesion with both pulpal and periodontal involvement; endodontic treatment is done first, followed by periodontal treatment and reassessment over 3-6 months to determine prognosis.

Articaine

A 4% local anesthetic with good bone penetration, effective for mandibular infiltration; it is metabolized in plasma and has a short half-life, with a maximum dose of about 7 mg/kg.

Antibiotic indications

Systemic antibiotics are indicated for spreading infection, fever, cellulitis, or immunocompromised patients, not for irreversible pulpitis or pulp necrosis without systemic involvement.