1. Care of the Pulp

Question 1

Pulp composition (5)

Answer 1

Cells
Nerves
BVs
Vital tissue
Parts of dentine-pulp complex

Question 2

Functions of the pulp (4)

Answer 2

Nutrition
Sensory
Protective
Formative

Question 3

Pulpal injuries (8)

Answer 3

Caries
Cavity prep
Restoration
Trauma
Tooth wear
Periodontal pahtology
Orthodontic treatment
Radiation therapy

Question 4

Restorative material pulp injury due to (8)

Answer 4

Toxicity
pH of water
Water absorption
Heat of reaction
Poor marginal adaptation/seal
Cementation of restoration
Impression making
Agents for treating dentine

Question 5

Relationship between cavity depth and dentine permeability

Answer 5

Deeper the cavity, greater the dentine permeability

Question 6

Dentine permeability is affected by (6)

Answer 6

Bacteria substances
Polysaccharides
Antibodies
Immune complexes
Complement proteins
Tissue destruction products

Question 7

Cause of dental pain (2)

Answer 7

A-fibres

C-fibres

Question 8

Pulpal diagnoses (6)

Answer 8

Healthy pulp
Reversible pulpitis
Irreversible pulpitis (symptomatic/asymptomatic)
Necrotic pulp
Previously treated
Previously initiated therapy (RCT not finished)

Question 9

Periapical diagnoses (5)

Answer 9

Normal
Periapical periodontitis (symptomatic/asymptomatic)
Acute apical abscess
Chronic apical abscess
Condensing osteitis

Question 10

Clinical definition of healthy pulp (2)

Answer 10

Vital

Free of inflammation

Question 11

When would a healthy tooth be removed

Answer 11

If endo treatment is indicated for elective/prosthetic purposes

Question 12

Clinical definition of reversible pulpitis (3)

Answer 12

Vital
Pulpal inflammation
Demonstrates a regular response to sensibility tests

Question 13

Clinical definition of irreversible pulpitis (3)

Answer 13

Symptomatic/asymptomatic
Occurs in vital tooth
Pulpal inflammation

Question 14

Treatment options for irreversible pulpitis (2)

Answer 14

Pulpectomy, RCT

Extraction

Question 15

Difference between reversible or irreversible pulpitis (2)

Answer 15

Depends on clinical symptoms
Reversible pulpitis - pain to cold, lasts a short time; hydrodynamic expression (microleakage)
Irreversible pulpitis - spontaneous pain, negative to cold (pain to hot), increase in plural blood flow

Question 16

Types of necrotic/non-vital pulp (2)

Answer 16

Partial

Total

Question 17

Treatment options for necrotic pulp (2)

Answer 17

RCT/extraction (mature teeth)

Pulpotomy, RCT/extraction (immature teeth)

Question 18

Definition of pulpotomy

Answer 18

Partial removal of dead pulp

Question 19

Definition of pulpectomy

Answer 19

Full removal of pulp

Question 20

Features of normal periodical tissue (2)

Answer 20

Not sensitive to percussion/palpation

Normal radiograph

Question 21

Features of symptomatic periodical periodontitis (3)

Answer 21

Inflammation of apical periodontium
Pain caused by biting, percussion, palpation
Periodical radiolucency radiographically

Question 22

Features of asymptomatic periodical periodontitis (3)

Answer 22

Inflammation and destruction of apical periodontium (of plural origin)
Periodical radiolucency radiographically
No present clinical symptoms

Question 23

Features of acute apical abscess (4)

Answer 23

Inflammatory reaction to plural infection and necrosis
Rapid inset, results in spontaneous pain
Extremely tender to pressure, results in swelling and pus formation
Malaise, fever, lymphadenopathy

Question 24

Features of chronic apical abscess (4)

Answer 24

Inflammatory reaction to plural infection and necrosis
Gradual onset, little/no discomfort
Intermittently discharge pus through sinus tract
Results in radiographic periodical/periradicular radiolucency

Question 25

Features of condensing osteitis (3)

Answer 25

Localised bony reaction to a low-grade inflammatory stimulus Seen at apex of tooth Diffuse radiopaque lesion

Question 26

Signs that a tooth may be non-vital (5)

Answer 26

``` Discolouration (yellow/grey/pink) Sinus Gross caries Large restorations Radiographic evidence (periapical/periradicular radiolucency) ```

Question 27

Primary function of a sensibility test

Answer 27

To differentiate vital from non-vital pulp

Question 28

Types of sensibility test (3)

Answer 28

EPT Thermal tests (hot/cold) Test drilling

Question 29

Types of thermal test (2)

Answer 29

Cold test - ethyl chloride | Hot test - hot gutta percha stick

Question 30

Associated clinical factors when considering pulp care and treatment (4)

Answer 30

Carious pulp exposure Age Periodontal disease Previous pulpal insult/trauma

Question 31

Previous pulpal insult includes (4)

Answer 31

Caries Caries removal Restorative procedures Involves tubular occlusion

Question 32

Function of CaOH

Answer 32

Encourage tertiary dentine formation. It has bactericidal/bacteriostatic action, but is cytotoxic

Question 33

Treatment of plural damage (4)

Answer 33

Placing an indirect pulp cap/stepwise excavation Direct pulp cap Partial plural removal (pulpotomy) Full plural removal (pulpectomy and then RCT)