Explain the following to the patient:

It must be freely given and all terms must be presented in a language that the patient understands.

Conditions for it to be informed:

HEART CONDITIONS: Key recommendations (AHA. 2017 Guidelines)

Antibiotic prophylaxis should be administered in a ______ dose before the procedure.

However, in the event that the dosage of antibiotic is inadvertently not administered before the procedure. May be administered up to ______ the procedure.

Identify letter A and B.

Identify C and D.

Identify E and F.

Identify G and H.

Identify I and J.

Identify K and L.

Identify M and N.

Identify O and P.

Cephalosporins should not be used in an individual with a history of anaphylaxis, angioedema, or urticaria with ______ or ______.

If behavioral solutions are not feasible and effective in a particular case.

Pharmacologic approaches include the need for good local anesthetic technique:

Oral sedation:

Due to extrusion of small amounts of pulp tissue remnants and dentin fillings during root canal cleaning and shaping.

Non-steroidal anti inflammatory drugs (NSAIDs), such as ________ mg of ibuprofen, ______ minutes before the procedure.

The clinician must strive for a “painless” local anesthetic injection technique.

Contribute information important for the diagnosis and the various treatment phases and Help evaluate the success or failure of treatment.

Advantages of paralleling technique:

Bisecting technique:

Problems when taking radiographs during RCT:

Primary radiograph used in endodontics.

It is used to identify abnormal conditions in the pulp and periradicular tissues and used to determine the number of roots and canals, location of canals,, and root curvatures.

Major limitation of periapical radiograph:

PERIAPICAL RADIOGRAPH: At least ____ mm of bone at apex of tooth

It needs vertical or horizontal angulation and should depict the tooth in the center of the film.

It indicates the relationship of remaining tooth structure to the crestal height of bone, a supplemental film and has less distortion.

BITEWING RADIOGRAPH: Provides critical information about the anatomic crown of the tooth

Rubber dam is mandatory in RCT.

No rubber dam = No RCT

Six principles of rubber dam isolation aside from:

1) Soft tissues are retracted and protected

2) The clinician is protected from litigation

Its thickness vary depending on the manufacturer and has shiny and dull sides. It may also be latex or non-latex.

Sizes: 5x5 or 6x6

It maintains border of rubber dam in position and supports the rubber dam sheet.

Classifications of rubber dam frame:

It is used to produce clean-cut holes in the rubber dam sheet.

It has notches near the tips of their beaks in which to locate the holes of a rubber dam clamp.

It allows a range of rotation for the clamp so that it may be positioned on teeth that are mesially or distally angled.

It has stabilizers that prevent the clamp from rotating on the beaks.

It limits the use of these forceps to teeth that are within a range of normal angulation.

The distance between the holes is equal to the distance from the center of one tooth to the center of the adjacent tooth, at the level of gingival tissue. Approximate distance is ___ mm.

It is used to stretch the jaws of the rubber dam clamp open in a controlled manner during placement and removal.

It provides convenience in marking the dam for punching.

It is used to hold rubber dam in place.

May be winged or wingless, metal or plastic, and single or double.

CLAMP SELECTION: Will impinge the soft tissues

CLAMP SELECTION: Will not properly grasp the tooth surface, unstable

Clamp selection should maintain 4 contact points.

Use clamps with subgingival designed jaws

➢ 2a, 8a, 14a

For preparation involving distal surface of clamped tooth.

In clamp placement, buccal jaws applied first to the tooth surface.

Clamp placement is positioned below the highest point on the lingual contour of the tooth.

- Position the bow of the clamp through the hole in the dam and place the rubber over the wings of the clamp (a winged clamp is required).

- The forceps stretch the clamp to maintain the position of the damp in the dam.

- The dam is attached to the plastic frame, allowing for the placement of the dam, clamp, and frame in one motion

- Once the clamp is secured on the tooth, the dam is teased under the wings of the clamp with a plastic instrument.

- Place the clamp, usually wingless, on the tooth.

- Then stretch the dam over the clamped tooth

- Place the frame

May be used to isolate anterior teeth without using a rubber dam clamp and useful when there is insufficient crown structure.

Prevents the possibility of the jaws of the clamp chipping the margins of teeth restored with porcelain crowns or laminates.

For teeth with _____ restorations: Ligation with dental floss is recommended as an alternative method to retract the dam and tissues, or the adjacent tooth can be clamped.

In split dam technique, dental floss helps carry the dam down around the gingiva.

If the dam has a tendency to slip, a _____ may be used on a tooth distal to the three isolated teeth or even on an adjacent tooth.

Small holes can be blocked with:

- Proper selection and placement of the clamp

- Sharply punched, correctly positioned holes

- Use of a dam of adequate thickness

- Inversion of the dam around the tooth

Excessive salivation can be reduced with an ______, such as atropine sulfate, propantheline bromide (Pro-Banthine), methantheline (Banthine), or glycopyrrolate.

Anticholinergic drugs:

Therapeutic doses of ______ for adults range from 0.3 to 1 mg per os, 1 to 2 hours before the procedure.

Propantheline bromide for an adult is ______ mg taken orally 30-45 minutes before the appointment.

These include partially erupted teeth, teeth prepared for crowns, and teeth fractured or broken down to the extent that their margins are subgingival.

Management for unusual tooth shapes or positions that cause inadequate clamp placement:

Must first determine whether the tooth is periodontally sound and restorable and may consider clamping of the attached gingiva and alveolar process.

Once a tooth is deemed restorable but the margin of sound tooth structure is subgingival, using a clamp with prongs inclined apically or using an _______, should be attempted.

These are cemented over the remaining natural crown in restorative procedures.

Disadvantages of restorative procedures:

The uses of preformed copper band, a temporary crown, or an orthodontic band include:

Post placement then Crown after R.C.T.

Presence of gingival tissue results of excessive crown destruction or incomplete eruption.

Periodontal procedures include:

If the electrode contacts bone, significant destruction of bone can occur.

It is not recommended when the distance between the crestal level of bone and the remaining tooth structure is minimal.

It is done on tooth with margin below the crestal bone.

ORTHODONTIC EXTRUSION: To erupt the tooth to provide ____ mm of root length _____ crestal bone level.