Endodontics | PRACTICE QUESTIONS | INBDE, ADAT

Ryan introduces the video as a bonus focusing on practice questions for the endodontics section of the National Board Dental Exam Part 2. He outlines the high-yield topics covered in the series and encourages viewers to watch the entire series on Eddie'd Onyx. The video includes questions from old release practice books and questions modeled after the actual exam. Ryan also discusses the unreliability of EPT (Electric Pulp Test) for vitality testing after a traumatic injury and emphasizes percussion as the most reliable method.

The video continues with a discussion on the best treatment for a horizontal fracture in the apical third of the root, highlighting the importance of conservative treatment options. It also covers the anatomy of a maxillary first molar and the ideal access opening shape for its canals. Furthermore, Ryan explains the concept of referred pain, particularly how pain from mandibular molars can radiate to the ear due to shared innervation.

Ryan introduces the concept of cracked tooth syndrome, detailing its signs, symptoms, and diagnostic approaches. He explains that while radiographs may not be effective in detecting cracks, transillumination and the use of a tooth sluice can be more helpful. The video also covers treatment options for cracked teeth, which may include splinting with an ortho band or root canal treatment and crowning, depending on the health of the pulp.

The video discusses the clinical hallmark of a chronic peri radicular abscess, which is the presence of a sinus tract. It also addresses which tissues within a tooth can regenerate after a root canal treatment, noting that odontoblasts, responsible for dentin production, are lost during the procedure, thus inhibiting the tooth's ability to produce tertiary dentin.

Ryan talks about procedural complications during non-surgical endodontic therapy, particularly when a ledge is detected. He advises against leaving the ledge untreated or using a round bur to remove it, as this could be impractical or cause further issues. The recommended action is to use a smaller file to renegotiate the natural canal and bypass the ledge.

The video touches on the importance of distinguishing between endodontic and periodontal problems. It outlines different periapical diagnoses and emphasizes the need to treat endodontic issues before addressing periodontal concerns in cases of combined lesions. The discussion highlights the significance of symptoms like pain upon percussion and palpation, which can indicate the nature of the problem.

Ryan explains that endodontic infections are typically polymicrobial, with Bacteroides being the predominant type of microorganism found in teeth requiring endodontic therapy. He also notes the importance of reading questions carefully, as the presence of different words like 'therapy' versus 'retreatment' can lead to different answers.

The video addresses the danger zone for perforations during canal instrumentation in mandibular molars, highlighting the distal area of the mesial root as the most susceptible to strip perforations. It also discusses the composition of gutta-percha points, clarifying that zinc oxide is the main ingredient rather than gutta-percha itself.

Ryan covers the manufacturing process of K-type hand instruments, confirming that they are made from stainless steel. The video also presents a case-based question about the best treatment protocol for an emergency patient with symptomatic irreversible pulpitis and symptomatic apical periodontitis, advocating for a pulpectomy as the ideal initial treatment.

The final part of the video discusses the use of EDTA (ethylene diamine tetraacetic acid) in endodontics. Ryan explains that EDTA is a chelating agent used to dissolve inorganic material like the smear layer of dentin, making it an essential component alongside sodium hypochlorite for effective endodontic treatment.