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BDS2 CDS > Care of the Pulp (endodontics) > Flashcards

Care of the Pulp (endodontics) Flashcards

1
Q

what cells found within the pulp help to form the tooth?

A

ODONTOBLASTS

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2
Q

what type of tissue is the pulp?

A

a VITAL TISSUE

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3
Q

what is meant by a vital tissue?

A
  • regenerative material

- responds to stimuli

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4
Q

what are the functions of the pulp?

A
  • nutritive
  • protective
  • sensory
  • formative
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5
Q

what is meant by the PROTECTIVE function of the pulp?

A

it forms tertiary dentine during reparative healing

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6
Q

what is involved in the SENSORY function of the pulp?

A
  • temperature
  • pressure
  • pain
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7
Q

what is meant by the FORMATIVE function of the pulp?

A

it forms secondary dentine (part of the ageing process of the tooth)

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8
Q

explain the size of the pulp in a young person?

A

LARGE

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9
Q

explain how the pulp changes as a person ages?

A

pulp gets narrower and narrower over time due to laying down of SECONDARY DENTINE

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10
Q

what can injure the pulp?

A
  • caries
  • cavity prep
  • restorative materials
  • trauma
  • toothwear
  • periodontal pathology
  • orthodontic treatment
  • radiation therapy
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11
Q

how can cavity/crown prep damage the pulp?

A
  • the high speed burr moves very fast which generates heat !
  • type of burr used may damage pulp
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12
Q

how to avoid damaging the pulp when using the high speed hand-piece?

A

always have the water spray on !

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13
Q

what is meant by RDT?

A

remaining dentine thickness

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14
Q

what is important about RDT?

A
  • a low RDT may cause damage to pulp
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15
Q

why may a low RDT cause damage?

A
  • dental tubules more permeable

- restorative material can be toxic

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16
Q

how can a restorative material damage the pulp?

A
  • toxic
  • heat of setting reaction
  • water absorption
  • poor marginal adaption/seal
  • cementation of restoration
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17
Q

explain the dentine tubules as they get closer to pulp?

A
  • increase in number

- increase in diameter (closer together)

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18
Q

the DEEPER THE CAVITY….

A

the GREATER THE DENTINE PERMEABILITY

- easier for substances to reach pulp

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19
Q

what travels through dental tubules?

A
  • bacterial substances
  • polysaccharides
  • antibodies
  • immune complexes
  • complement proteins
  • tissue destruction products
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20
Q

what BACTERIA can be found in dental tubules?

A
  • endotoxins
  • exotoxins
  • enzymes
  • peptides
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21
Q

what is DENTAL PAIN caused by?

A

the activation of ALPHA FIBRES and C-FIBRES

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22
Q

explain the myelination of alpha fibres:

A

myelinated

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23
Q

explain the myelination of C-fibres:

A

non-myelinated

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24
Q

what type of pain is caused by activation of alpha fibres?

A

SHARP PAIN

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25
Q

what type of pain is caused by activation of C-fibres?

A

DULL/ACHING PAIN

26
Q

when are C-fibres stimulated in the pulp?

A
  • when pulpal blood flow is increased

- when pulpal pressure is increased (dentine and enamel doesn’t swell)

27
Q

what different ways can a pulp be diagnosed?

A
  • healthy pulp
  • reversible pulpitis
  • irreversible pulpitis
  • necrotic pulp
28
Q

describe a healthy pulp:

A
  • vital

- free of inflammation

29
Q

describe a pulp that has reversible pulpitis:

A
  • vital
  • inflamed pulp
  • regular response to sensibility tests
30
Q

describe a pulp that has irreversible pulpitis:

A
  • vital
  • inflamed
  • pulpal inflammation cannot heal
31
Q

treatment options for irreversible pulpitis?

A
  • pulpectomy required then RCT

- extraction

32
Q

how to tell the difference between reversible and irreversible pulpitis in reference to PAIN:

A

REVERSIBLE = pain to cold, lasts a shot time

IRREVERSIBLE = spontaneous pain, intermittent pain, sleep disturbance, pain to HOT (unresponsive to cold)

33
Q

how to tell the difference between reversible and irreversible pulpitis in reference to PULPAL BLOOD FLOW:

A

REVERSIBLE = no change in pulp blood flow

IRREVERSIBLE = increase in pulp blood flow

34
Q

how to tell the difference between reversible and irreversible pulpitis in reference to NERVE FIBRES ACTIVATED:

A

REVERSIBLE = A-fibres

IRREVERSIBLE = C-fibres

35
Q

explain a necrotic pulp:

A
  • non-vital pulp
  • partial or total necrosis
  • pulp full of dead nerve tissue and blood vessels
36
Q

what is the treatment for a necrotic pulp in mature teeth?

A
  • root canal treatment

- extraction

37
Q

what is the treatment for a necrotic pulp in immature teeth?

A
  • pulpotomy
  • pulpectomy then RCT
  • extraction
38
Q

what is the difference between mature teeth and immature teeth?

A

mature teeth have CLOSED APICES

immature teeth have OPEN APICES

39
Q

what is meant by an OPEN APICE?

A

richer blood flow

40
Q

explain what you would find on examination of NORMAL PERIAPICAL TISSUE?

A
  • not sensitive to percussion or palpation

- radiographically = lamina dura intact & PDL space is uniform

41
Q

explain what you would find on examination of SYMPTOMATIC PERIAPICAL PERIODONTITIS?

A
  • inflammation of the apical periodontium
  • pain when: BITING, PERCUSSION, PALPATION
  • may have periapical radiolucency
42
Q

explain what you would find on examination of ASYMPTOMATIC PERIAPICAL PERIODONTITIS?

A
  • inflammation and destruction of the apical periodontium (of pulpal origin)
  • appears as an apical radiolucency
  • no present clinical symptoms (no pain on palpation/percussion)
43
Q

what is an acute apical abscess?

A

inflammatory reaction to pulpal infection & necrosis with a RAPID ONSET

44
Q

what occurs in an acute apical abscess?

A
  • rapid onset & spontaneous pain
  • pus formation and swelling
  • may be no radiographic signs of destruction
45
Q

explain the symptoms experienced when you have an acute apical abscess?

A
  • extreme tenderness to pressure
  • malaise and fever
  • lymphadenopathy
46
Q

what is lymphadenopathy?

A

lymph nodes are abnormal in size/consistency

47
Q

what is meant by percussion of the teeth?

A

press around the teeth

48
Q

what is meant by palpation of the teeth?

A

tap on tooth

49
Q

what is a chronic apical abscess?

A

inflammatory reaction to pulpal infection and necrosis with a GRADUAL ONSET

50
Q

explain the symptoms of a chronic apical abscess?

A
  • little or no discomfort experienced

- periapical/periradicular radiolucency

51
Q

what is condensing osteitis?

A

a localised bony reaction to a low-grade inflammatory stimulus

52
Q

explain the radiographic findings of condensing osteitis

A
  • diffuse radiopaque lesion

- usually seen at apex of tooth

53
Q

what are the signs of a non-vital tooth?

A
  • discolouration
  • sinus
  • gross caries
  • large restoration
  • radiographic evidence
54
Q

what may a yellow tooth suggest?

A

obliteration of dental tubules

55
Q

what may a grey tooth suggest?

A

blood breakdown in the tooth

56
Q

what may a pink tooth suggest?

A

resorptive process occurring

57
Q

what are some sensibility tests?

A
  • electric pulp tests
  • thermal tests
  • test drilling
58
Q

describe the problems with sensibility tests:

A
  • they stimulate nerve fibres (no correlation to vital blood supply)
  • do not indicate state of blood supply
  • teeth can be partially necrotic
59
Q

what determines if a tooth is vital?

A
  • related to BLOOD SUPPLY NOT NERVE STIMULATION
60
Q

do nerve fibres in pulp correlate to vital blood supply?

A

no

61
Q

what is involved in an electric pulp test?

A
  • electric current used to stimulate sensory nerves at the pulp-dentine junction
62
Q

describe the response of fibres during an ELECTRIC PULP TEST:

A
  • A-delta fibres stimulated

* C-fibres may or may not respond

BDS2 CDS (8 decks)

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