NERB/CDCA Endo failure Question-Please help

[scrs]

Dear Fellow dental students

I have taken the NERB/CDCA recently and failed it because of a perforation on the posterior access.
I have a question for those who have worked on the "ACADENTAL" typodont teeth.

1.When you prepare the access on # 14- are you expected to get the Access as per guidelines/measurements ( the triangle ) or are you suppose to go in to till the CEJ.I noticed that there was no red wax when I worked on Columbia Typodonts.In my school we were only required to get the access right and remove the pulp( mushy wax) in the chamber.While I took the test with the Acadental tooth- there was red wax simulating the pulp.After I prepared the access per specifications,I noticed red wax below the pulp chamber.
I am not sure if that is was caused the failure.I was under the impression that I would have to be able to demonstrate the 3 openings with red wax .
PLEASE HELP WITH WHAT IS EXPECTED.I AM RETAKING THE BOARD SOON.

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[Bis-GMA111]

Dear Fellow dental students

I have taken the NERB/CDCA recently and failed it because of a perforation on the posterior access.
I have a question for those who have worked on the "ACADENTAL" typodont teeth.

1.When you prepare the access on # 14- are you expected to get the Access as per guidelines/measurements ( the triangle ) or are you suppose to go in to till the CEJ.I noticed that there was no red wax when I worked on Columbia Typodonts.In my school we were only required to get the access right and remove the pulp( mushy wax) in the chamber.While I took the test with the Acadental tooth- there was red wax simulating the pulp.After I prepared the access per specifications,I noticed red wax below the pulp chamber.
I am not sure if that is was caused the failure.I was under the impression that I would have to be able to demonstrate the 3 openings with red wax .
PLEASE HELP WITH WHAT IS EXPECTED.I AM RETAKING THE BOARD SOON.

i'm pretty positive that this does not relate to what typodont tooth you have...but if you're making the access, you're supposed to do just that..make an access, and have the ability to navigate the 3 canals without ledging. yes you will see red wax below the chamber....you don't touch that, because you are just making an access preparation. if you do, you would have perforated, and if it was a real tooth you would have destroyed it.

i did not have an acadental typodont, but i did take the nerb recently and passed by the way

 

[DrCarabelli]

Hi all,
I also need help with the opening question. I took the CDCA Endo last week with the Acadental typodont and was totally caught off guard with the Endo teeth. Is the pulpal floor black on the exam teeth? And what is the deal with the red material? Is it bad to see red in the pulpal floor or does it signify a canal orifice? Are the exam teeth different from the teeth they sell on their website, because the one's I bought to practice on had no black floor or red material of any kind? I've only worked with the Columbia teeth in the past and am totally lost and need to retake the endo portion again. $1200 down the tube for the retake, I don't want to make it $2400. Please help with info on what I should be looking for. Thank you.

 

[scrs]

The new Acadental teeth on the website have the red wax to mimic the pulp.If you had the older version of the teeth,there was no red stuff in it.I had a mix of both teeth when I was practicing.
Also,you see the red stuff when you enter the pulp chamber.The black area could be the roof of the chamber.
As long as you have 3 openings without removing too much of the red stuff, you should be ok.Remember you can not go beyond 10 mm in depth....
I totally understand how you feel....you will get it next time..good luck!!
Did you get your results already??
I took it last week too...

 

[DrCarabelli]

SCRS thank you so much for your info. It helped me visualize what I saw- I think I got nervous because of the unfamiliar dark gray/black color (which I now understand to be the roof of the pulp chamber) and the red wax (pulp tissue) and didn't go deep enough. Just a couple questions if you wouldn't mind helping with:

(1) Are you supposed to leave as much of the red pulpal wax as possible, or remove it with a spoon excavator to "clean the pulp chamber?"
(2) I noticed the disto-buccal canal is really distal, but we are not supposed to get closer than 2 mm to the oblique ridge for acceptable access. Do you measure the distance to the oblique ridge from the top of the ridge or from the base of the slope leading to the top of the ridge? I worry about this because the file will be at quite an angle (preventing straight-line access) if I stay 2 mm away from the base of the ridge.
(3) When you are checking for straight line access, are your files straight up and down when they are inserted into the canals, or do they have some tilt to them? I worry I will make the access too large if I try to have straight up/down files.

I've been out of school for a while (am a specialist who doesn't do these procedures) and can't ask these questions from anyone like when I was in school, so I really appreciate your help. I haven't received the results yet, but know I failed that section this time. Official report should be in next week according to what the chief said.

 

[scrs]

I can totally relate to what you are feeling. I feel the same way too.
1. You do not have to remove all the red wax. This is the answer I got from CDCA. As long as you can see 3 access openings you are good
2 &3. I have these questions in my mind too. My DB opening - I would not call that straight. I could feel the access opening with an endo explorer. This was not straight. It was at an angle though. I also felt like I would encroach on the oblique ridge if I went further to get it straight. Also I was told to measure the ridge- the elevated pointy ridge only. Not the end of the slope. I don't think we would be 2mm away if we used that as a guide line.Also I think the file would be at a tilt for my DB opening.
You can email me at [email protected]. I'll send you some pictures

 

[ljcesar]

for #14 you are just doing access, so just remove the roof of the chamber and make sure all 3 canals are accessible. easier said then done. I took exam on an acadental last year and passed and teeth had no red dye. make sure not to encroach on the oblique ridge. also leave at least 2mm of the mesial marginal ridge or its an automatic fail.

on these teeth i noticed the MB and DB canals are literally on top of each other. the MB canal can easily be confused for the DB canal and some students end up extending the access to the mesial in an attempt to find a canal. the DB canal is literally right next to the MB canal except it is angled under the oblique ridge, and your DG-16 explorer wont go very deep. the Palatal canal is pretty easy to find and it obviously will be angled toward the palatal side. Good luck!