e

Question 1

effect of periodontal disease on pulp

Answer 1

1) inflammatory alteration of pulp
2) pulp will not become necrotic from periodontal disease unless it reaches the apices
3) it appears that perio disease as well as period treatment have a negligible effect on the pulp
4) bone height was maintained equally well around root filled teeth and vital teeth
5) bone loss progresses at a faster rate for teeth with active periapical lesions
6)risk from a pulpless tooth must be negligible

Question 2

endoperiod ideases

Answer 2

1) pulpal disease causing perio disease
2) peridontal disease causing pulpal disease
3) perforation
4) concurrent disease
5) etc.

Question 3

endodontic lesions

Answer 3

1) primary endo
2) secondary perio
3) true combined

Question 4

periodontitis associated with endodontic lesions

Answer 4

1) with root damage (prognosis is poor)
- root fracture
- perforation
- external root resorption
2) without root damage
- in periodontitis site (grade 1-3)
- in nonperiodontitis sire (grade 1-3)

Question 5

grades

Answer 5

1 )grade 1: narrow deep pocket in one tooth
2) grade 2: wide deep pocket in one tooth
3) grade 3: deep pockets in > 1 tooth surface

Question 5

wide 7mm PD on distal with narrow 12mm PD within

Answer 5

1) without root damage in periodontitis site, grade 2

Question 6

endoperio diagnosis

Answer 6

1) history of symptoms
2) radiographic analysis
3) vitality testin
4) diagnostic probing
5) gutta percha tracing
6) percussion testing

Question 7

history of symptoms

Answer 7

1) type of pain
- endo pain is more severe than perio pain
2) swelling?
3) location and duration
4) what elicits pain response

Question 8

radiographic analysis

Answer 8

1) crestal bone loss
- tell you if there is a history of perio
2) apical radiolucency
3) deep caries
4) deep restoration
5) perforation
6) pins approaching pulp
7) furcation involvement
8) GP points
9) fracture?

Question 9

vitality testin

Answer 9

1) measures neural response
2) most helpful with necrotic pulp
3) false positives with multi rooted teeth

Question 10

periodontal etiology

Answer 10

1) wide broad pockets

Question 11

endodontic eitiology

Answer 11

1) deep, narrow defect
2) no detectable calculus (deep)
3) may not have generalized periodontal pockets
4) deep, narrow defect can also be associated with palatal groove, vertical fracture, sinus tract, or enamel projection/pearl

Question 12

percussion testing

Answer 12

1) doesnt really help distinguish between endo and perio

Question 13

primary endo lesion

Answer 13

1) endo therapy first
2) avoid root instrumentation initially
3) reevaluate periodontal status (2-3 mo)
4) chronicity of periodontal lesion an issue

Question 14

chronic perio lesion

Answer 14

1) prognosis depends on periodontal outcome
2) prognosis is poor if apex involved
3) consider extraction with implant or restorative
4) endo therapy first

Question 15

perforations

Answer 15

1) pulpal floor or root
2) prevention is best
3) treatment can be to seal perforation
- MTA, GIC, amalgam, Ca hydroxide, etc
4) hemisection/root amputation (upper
5) extract

Question 16

hemisection

Answer 16

1) cut teeth in half
2) cannot do it if both roots are BAD
3) short root trunks
4) make strategic sense
5) consider extraction with implant replacement option
6) concavity maintenance

Question 17

resection

Answer 17

1) cannot do hemisection with maxillary molar
2) cut off distal root
3) adequate support on remaining roots
4) short root trunk
5) make sure roots are not fused at the apex
6) maintenance (end-tuft brush)

Question 18

fractured cusp

Answer 18

1) prognosis depends on where the bottom of the fracture ends
2) evaluate extent of fracture and restorability
3) often do not require endo
- may require crown lengthening

Question 19

cracked tooth/split tooth

Answer 19

1) tend to run mesiodistally
2) mand molars and max premolars
3) generally toward center of tooth
5) may have thermal sensitivity
6) Tx may include RCT or extraction
7) for split teeth, usually take out whole tooth

Question 20

vertical root fracture

Answer 20

1) begin in the root
2) work from apical to coronal
3) extraction or removal of fractured root for a multirooted tooth
4) usually history of RCT

Question 21

resorption

Answer 21

1) inflammatory and noninflammatory components initiates in the periodontium
- ex. trauma, ortho, bleaching
2) internal resorption starts with the pulp
- multinucleated giant cell activity
- affects internal dentin surface primarily

Question 22

dentin hypersensitivity

Answer 22

1) sharp pain from stimuli
2) cannot be ascribed to any other form of dental defect or pathology

Question 23

hydrodynamic theory

Answer 23

1) fluid flow evoked by stimuli
1) activates a-delta intradental nerves
3) mechanoreceptor response
4) larger tubes more associated with sensitivity
- typically a CEJ phenomenon

Question 24

dentin hypersensitivity criteria

Answer 24

1) dentin needs to be exposed and dentin tubule system has to be opened and patent to the pulp

Question 25

differential dignosis

Answer 25

1) caries
2) cracked teeth
3) new restoration
4) occlusal trauma
5) bleaching
6) others

Question 26

management of DH

Answer 26

1) desensitizing toothpaste
- potassium nitrate will desensitize nerves
2) oxalate
3) arginine and calcium carbonate
4) fluoride
5) delivery trays
6) restorative materials
7) surgical root coverage
8) lasers
9) endodontic therapy
10) extraction