Pulp Therapy Flashcards

1
Q

Morphology of tooth and pulp?

A
  1. Increased number of accessory canals
  2. Root canals more ribbon like
  3. Filamentous pulp system
  4. More difficult canal debridement
  5. Increased potential of root perforation
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2
Q

If tooth has a third or more of the marginal ridge broken down most likely what?

A

Irreversible pulpitis

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3
Q

What would be carried out for irreversible pulpitis?

A

Pulpotomy however more commonly now is the hall technique

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4
Q

Symptoms of varies exposure?

A

Similar to irreversible pulpitis

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5
Q

What can exposed caries lead to?

A

Pulp polyp

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6
Q

What is a pulp polyp?

A

Chronic hyperplastic pulpitis - inflammatory hyperplasia

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7
Q

Pulp therapy contraindications?

A
  1. Tooth is unrestorable
  2. No patient cooperation
  3. Medically compromised
  4. Orthodontic extractions
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8
Q

Pulp therapy got VITAL teeth?

A
  1. Pulp capping
  2. Pulpotomy
  3. Desensitising pulp therapy
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9
Q

Is indirect pulp capping an option for primary teeth?

A

Yes

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10
Q

Is direct pulp capping suitable for primary teeth?

A

No

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11
Q

What happens during direct pulp capping?

A

Dressing is placed directly over exposed pulp

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12
Q

What happens during indirect pulp capping?

A

A thin layer of dentine is left over the pulp and dressing placed on top (not directly on pulp)

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13
Q

What is a pulpotomy?

A

Removing the diseased coronal portion of pulp only and applying medicaments to the remaining pulp tissue - allows tooth to keep functioning

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14
Q

Pulpotomy contraindications?

A
  1. Abccess (inflamed RADICULAR pulp)
  2. Excessive bleeding (inflamed RADICULAR pulp)
  3. No bleeding
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15
Q

What is formocresol?

A
  1. Very effective medicament
  2. Guidelines advice that it is no longer used in conjunction with pulp therapy (2004)
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16
Q

Properties within formocresol?

A
  1. Tricesol - antiseptic
  2. Formalin - tissue fixative
  3. Acts by binding with bacterial and pulp tissue proteins
17
Q

Formocresol side effects?

A
  1. Carcinogenic properties
  2. If extruded via apical foramen results in damage to permanent tooth germ
18
Q

Using formocresol?

A
  1. Use small amount
  2. Blot
  3. Isolation important
  4. We’ll sealed margins to prevent leakage
19
Q

What is ferric sulphate?

A
  1. Great haemostatic agent
  2. Alternative to formocresol
  3. NOT a fixative agent
  4. Applied to pulp stump for 15 seconds
20
Q

What is Gluteraldehyde?

A
  1. Aqueous solution
  2. Fixative agent
  3. Toxic effects discovered
  4. Ineffective compared to formocresol
  5. Unlikely to be used
21
Q

What is calcium hydroxide?

A

1.Ruled out for primary teeth due to the effect of internal resorption
2. Equal efficiency with formocresol
3. No toxic side affects known

22
Q

Properties of calcium hydroxide?

A
  1. Encourages new dentine
  2. Dentine bridge is formed
  3. Pulp now has effective barrier against bacterial invasion
  4. Heals the pulp
23
Q

How to carry out pulpotomy?

A
  1. LA + isolate
  2. Outline form + remove caries
  3. Large access cavity to access pulp horns
  4. Remove entire roof of pulp chamber
  5. Remove contents with excavator
  6. Once pulp tissue exposed do not use 3 in 1 (emphysema)
  7. Irrigation
  8. Apply medicament 15 seconds
  9. Restore
24
Q

What is desensitising pulpotomy?

A

Reduces pulpal inflammation

25
Q

Desensitising pulpotomy technique?

A
  1. Open and gain access to pulp chamber
  2. Cotton pledger with ledermix directly over exposed site
  3. Place a well sealed temp dressing
  4. Review in 2 weeks
26
Q

After desensitising?

A

Extraction or pulpectomy