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Endodontics > Test questions > Flashcards

Test questions Flashcards

1
Q

Reversible Pulpitis

A
  • Pain
  • Cold- exaggerated/non-lingering
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2
Q

Symptomatic Irreversible Pulpiitis

A
  • Pain
  • Cold- Hyperesponsive/ Lingering
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3
Q

Asymptomatic Irreversible Pulpitis

A
  • No pain
  • Responds to cold with no-lingering pain
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4
Q

Necrotic Pulp

A
  • Non responsive to cold
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5
Q

Symptomatic Apical Periodontitis

A
  • Pain
  • Painful during
    • Bitting
    • Percussion
  • May or may not have a RL
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6
Q

Asymptomatic Apical Periodontitis

A
  • No response to anything
  • RL
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7
Q

Acute Apical Periodontits

A
  • Pain
  • Swelling
  • Painful to
    • Palapation
    • Bitting
    • Percussion
  • Radio
    • WNL
    • PARL
  • Inflammatory reaction to pulpal infection and necrosis
  • rapid onset, spontaneous pain, pus formation
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8
Q

Chronic Apical Periodontitis

A
  • Sinus tract
  • PARL
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9
Q

A-beta and A-delta fibers

A
  • Myelinated
  • Located in pulp and DENTIN
  • Sharp pain, stabbing, pricking
  • Low threshold
  • Stimulated by hot/cold/air/drilling
  • Warning sign, not neccesarily associated with tissue damage
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10
Q

C fibers

A
  • Non-myelinated
  • Centrally located throughout pulp
  • Dull burning, aching prolonged pain
  • High threshold
  • May not be stimulated by hot/cold
  • Usually associated with tissue damage w/i pulp
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11
Q

Prognosis for Vital pulp

A

95% prognosis

No bacteria

no infection, inflammation could be present

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12
Q

Non vital/necrotic prognosis

A

85% prognosis

bacteria and infection present

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13
Q

Antibiotics

A
  • Very seldomly used
  • Only RX if systemic indications
    • Temp, swelling, cellulitis, malaise, trismus
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14
Q

T/F

An acute apical abcess will not respond to pulp vitality tests

An acute apical abcess is only observed in association with a necrotic pulp

A

T

T

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15
Q

Pt present with swelling, non-vital tooth

A
  • Periapical dx
    • Acute apical abcess
  • Pulpal dx
    • Non-vital tooth pulpal necrosis
  • If no PARL does not mean there is not an abcess, could be very new due to rapid onset and just hasnt shown up on radio yet
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16
Q

What is a RL telling us?

Micro of tooth and number of species

A
  • RL indicates presence of an inflammatory response and steoclast activity (bone resorption)
  • 10-30 species 90% obligate anaerobes
  • Mixed community
  • Planktonic (free floating)
  • Gram negative predominate
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17
Q

Case: swelling, spontaneous pain

No RL or might be RL

Negative EPT and cold

A
  • Non-vital/Necrotic pulp
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18
Q

Put a cold pellet on tooth

Explain how A fibers are stimulated

A
  • Hydrodynamic theory
    • movement of fluid in tubules stimulates fibers
    • Fluid within tubules directly act on pulpal nerves
    • Fluid movement is result of capillary force
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19
Q

Younger vs older patients

cells and collagen diff

A
  • Younger
    • More cells and fewer collagen, less calcified
  • Older
    • Less cells more collagen more calcified
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20
Q

Pulp development

A
  • Pulp develops from Dental Papilla (along with dentin)
    • Dental papilla is ectomesenchymal origin (neural crest cells with local mesenchyme)
    • Outer layer of dental papilla will differentiate into odontoblasts (dentin)
21
Q

CDJ

What 2 soft tissues are present at CDJ

A
  • Pulp to PDL transition
  • Where youu want to end your working length
    • .5-1mm coronal to radio apex
  • Pulp and PDL are present at CDJ
    *
22
Q

EPT

A
  • Provides no diagnostic value with vital pulp pathosis
    • Not indicated for teeth which respond to thermal challenge
  • Indicates only pulp vitality or necrosis
    • yes or no
    • Device output numbers are insignificant
  • EPT Vitality measures vascular supply
  • Cold measures nerve response
  • 0-79 vital
  • 80+ necrotic
23
Q

As you get closer to the pulp how do the numbers and size of dentinal tubules change

A

Increase in size, diameter and number

24
Q

What dx test reflects the histologic status of pulp

A

NONE

25
Q

Why do we do a pulp test when pt has trauma initially

A

Baseline

26
Q

Can you test a crowned tooth with endo ice

How to test crown with EPT

A
  • Yes can endo ice test crowned teeth
  • To use an EPT on a crown need recession to contact natural tooth
27
Q

Dentin and nerve hypersensitivity, what nerve fiber is involved

A

A delta fibers are associated with dentin hypersensitivity

If lingering pain–>C

28
Q

Apexogenesis

A

A vital pulp therapy to encourage continued physiologic development and formation of the root end

Need vital pulp to allow root to develop

29
Q

Apexification

A
  • Process where a non-vital immature permanent tooth which has lost ability to further develop is induced to form a calcified barrier at the root terminus
  • This barrier forms a matrix against which a root canal filling can be compacted with length control
30
Q

How long for pulpal anesthesia to set in

A

10-15 mins

Vitality by performing pulp test

Cant verify by soft tissue

31
Q

Restoring an endo tx tooth

max 2nd molar

what are the exceptions

A
  • When is a post not necessary
    • If tooth has 3-4mm of tooth structure coronally with good wall thickness remaining
  • Ferrule- a crown that surrounds healthy tooth strcture 360
  • When not to restore a prev endo tx tooth
    • Perio probing depth
    • Fracture
    • If tx was not succesful and cant dx the problem
32
Q

Post length, diameter, ferrule

A
  • Short posts more likely to fracture
  • Posts dont strengthen teeth themselves, only increase retention
  • Bigger diameters make it more likely to fracture
  • Ferrule keeps everything nice and tight, interlocking notch, also increases retention
33
Q

Avulsion open apex

A
  • Under 60 mins
    • Revascularization recall every 3-4wks
    • Rinse
    • Soak in doxycyclin or coat in minocycline/tetracycline
    • reimplant
  • Over 60 mins open apex
    • Start apexification at 2nd visit
    • Acid 5 min
    • Stannous flouride
    • Extraoral endo
    • Submerge by decoronation
  • can use systemic AB
34
Q

PDL damage vs pulp damage

A
  • PDL
    • intrusion
    • avulsion
    • lateral luxation
  • Pulp necrosis
    • Avulsion
    • Intrusion
    • Lateral luxation
35
Q

CDJ

A
  • 1mm from anatomical apex
  • Apical foramen to CDJ- 0.5-1mm
  • Apical constriction does not equal CDJ
  • This is where the PDL meets the pulp
  • Cant be located radiographically
  • CDJ not clinically evident in all teeth
    *
36
Q

aging teeth/necrotic and their relationship with CDJ

A
  • Necrotic
    • Root canal filling will be closer to the apex
    • may be due to root resorption
  • Aging
    • As cementum gets deposited over time at the apex of the tooth, the canal appears to elongate
    • The CDJ does not change position
    • Bc of this depositon of cementum it seems the canal is being elongated apically
    • Prec RCT may seem short of anatomical apex
37
Q

Most accurate way to find CDJ

A

Apex locator 95% accurate

38
Q

When will PDL be useless

A

1 hr after avulsion

39
Q

Indications for internal bleaching

A
  • Indications
    • Pulp necrosis, trauma, pulp tissue remnants, endo materials
  • Ready to restore
    • 2 weeks
    • Immediate bonding of composite to bleached tooth results in sig reduction of adhesive bond strength
    • wait 1-3 weeks to place permanent restoration
40
Q

When does the apical area of the tooth form?

In a newly erupted tooth when does the root form?

A

2-3 years after eruption

41
Q

Endodontic therapy definition

A

Prevention or tx of apical periodontitis

42
Q

Testing an older pt that doesnt respond to cold due to calcification

A
  • EPT
43
Q

Can devitalized pulp cause apical periodontits

A

No

Pulp does not cause apical periodontitis, bacteria stimulate inflammatory responses within the pulp which then activates osteoclasts leading to appical periodontits

44
Q

Pulpotomy

A
  • Vital tooth
  • If pt presents with irreversible pulpitis with negative percussion (normal apex)
    • no need for pulpectomy bc apex is not affected
45
Q

Full Pulpectomy

A
  • Non-vital tooth
  • If pt presents with irreversible pulpitis with positive percussion (abnormal apex)
    • Complete a pulpectomy since apex is not affected
46
Q

ells involved in chrnic lesion

A

Lymphocytes macrophages plasma cells

47
Q

Caries is a

A

Chronic inflammation process

48
Q

What should you never use to stop bleeding

A

Formocresol, hemostatic agents, can cause resorption

Instead you want it to stop bleeding on its own bc it indicates healthy pulpal tissue

49
Q

Emergency tx for a tooth you need to know dx

A
  • Irreversible pulpitis
    • with percussion
    • Pullpectomy
  • Irreversible pulpitis
    • with negative percussion
    • Pulpotomy
  • Reversible pulpitis
    • no tx or direct/indirect pulp cap
  • Necrotic pulp
    • Pulpectomy

Endodontics (5 decks)

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