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Endotontics > Apexogenesis, Apexification, and Regeneration > Flashcards

Apexogenesis, Apexification, and Regeneration Flashcards

1
Q

apexogenesis main concept with it

A

maintain the pulp vitality

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2
Q

goal of apexogenesis

A

preservation of vital pulp tissue so that continued root development with apical closure may occur

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3
Q

when can you do apexogensis

A

addressing the shortcomings involved with capping the inflamed detnal pulp of an INCOMPLETELY DEVELOPES

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4
Q

what are two components you consider with these therapies

A
  1. PULP VITALITY
  2. AGE OF PATIENTS
  • same clinical picture
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5
Q

choice of tx with necrotic 10 years old vs necrotic and 25 years old

A
  1. 10 years – regeneration

2. 25 years – apexification

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6
Q

apexification procedure aims to do what

A

form a plug at the apex

  1. induce a hard tisssue barrier in a tooth with an open apex
  2. or the continued apical developmment of an incomplete root in teeth with apical periodontisis
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7
Q

pulp reaction to caries

A

poor tolerance to injury

large volume of tissue with a small volume of blood supply

terminal circulation (collateral vessels?)

confined in calcified tissue

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8
Q

carries progressiuon what radiograph ? what is the bacterial penetration

A

BITEWING

bacterial penetration that is less than .75 mm away from the pulp

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9
Q

carries progressiuon what radiograph ? what is the bacterial penetration

A

BITEWING

bacterial penetration that is less than .75 mm away from the pulp

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10
Q

vital pulp therapy example

A

apexogenesis

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11
Q

clincial procedure of apexogenesis is basically a

A

a deep pulpotomy

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12
Q

how do you apexogeneis (3)

A
  1. direct pulp capping
  2. indirect pulp capping
  3. pulpotomy
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13
Q

indirect

A

still some dentin between pulp and p

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14
Q

direct

A

right into the pulp

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15
Q

pulpotomy

A

resecting coronal part

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16
Q

indications for vital pulp therapy

A
  1. truamatic injuries
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17
Q

mm for indirect vs direct pulp cap

A

less than 2mm – can do a DIRECT PULP CAP

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18
Q

material of choice for pulpotomoy

A

MTA (or a bioceramic)

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19
Q

follow up after pulp capping and pulpotomy

A

should be seen periodically for the next 2-4 years

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20
Q

evidence that an apexogenesis was successful?

A

continued root formation/ development (length and wall thickness) and calcific batterir formation in response to the dressing

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21
Q

apexification is what?

A

root-ended closure, whereby a NON-VITAL, IMMATURE, PERMANENT tooth has LOST the ability for further root development is induced to form a calcified barrier at the root terminus

22
Q

what will apexification NOT cause

A

will NOT CAUSE further root development in terms of length or wall thickness

23
Q

apexification acts as a?

A

barrier so your root canal filling can be compacted with length control
- considered a last resort treatment

24
Q

why apexificatoin instead of conventional RCT?

A
  1. open apex
  2. blunderbuss canals
  3. thin and fragile canal walls
  4. absolute dryness of canals diffult to achieve
25
Advantages of MTA/ bioceram with apexification
1. reduction in tx time 2. biocompatible material 3. osteo-inductive properties 4. moisture compatibility 5. No CaOH disadvantages
26
Advantages of MTA/ bioceram with apexification
1. reduction in tx time 2. biocompatible material 3. osteo-inductive properties 4. moisture compatibility 5. No CaOH disadvantages
27
regeneration advantages
1. root elongation 2. thickening of roots 3. formaiton of morphologic apex
28
flow chart that reaches regeneration
pulp exposure -- non-vital pulp-- open apex (immature) --young patient -- regeneration
29
rely on what in regeneration
apical stem cells | apical dental papilla
30
if successful what does regeneration allow for
continued root development, thicker dentin walls, longer root length, and a closed apex, thus reducing the risk of fracture, in immature and structurally vulnerable teeth
31
biological principles of regeneration (3 aspects that are required)
1. scaffold 2. progenitor or stem cells 3. growth factors
32
what differentiation do you need
stem cells capable of differentiating into an odontblast
33
adult stem cells are what type? | describe
multipotent - divide and create another cell like itself, also a cell more differentitated than itself ability to divide into other cell types is more limited
34
adult stem cells are what type? | describe
multipotent - divide and create another cell like itself, also a cell more differentitated than itself ability to divide into other cell types is more limited
35
scaffold describe and give examples
provides support for cell organization, proliferation, differentiation and vascularization mostly utalized scaffolds are dentin or blood clot others - platalet rich plasma - biodegradable or permanent or syntehtic scaffolds
36
can you intrsument a regeneration case?
NO -- you will get rid of the growth factors! previously instrumented is no good for regeneration
37
can you intrsument a regeneration case?
NO -- you will get rid of the growth factors! previously instrumented is no good for regeneration
38
age range for regeneration recommended by ADA
6-18 years old
39
step 1 for regeneration
everything youd do for access and irrigate with diluted hypochloride 1.2-2.25?
40
what happens if leave calcium hydroxide in tooth for 4 weeks
it can weaken the dentin
41
how long doyou leave calcium hydroxide in teh tooth for
2-3 weeks
42
do you use epinephrine in regeneratin? why?
NO | - rely on scaffolding and need the bleeding so we do not want to lose the scaffolding
43
LA use for regeneration
mepivicaine 3%
44
step 2 do you use sodium hypochloride?
NO -- only EDTA
45
step 2 do you use sodium hypochloride?
NO -- only EDTA
46
three goals for regenration? set by? | general
primary secondary tertiary
47
primary goal of regenration
elimination of symptoms and evidence of bony healing
48
secondary goal
increased root wall thickness and/or increased root length
49
tertiarty goal
positive response to vitality testing
50
ultimate goal of regeneration*
histologic confirmation of functional dental pulp (with an intact odontoblastic layer)

Endotontics (21 decks)

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