First Quizz

Question 1

What’s necessary to confirm a preliminary dx?

Answer 1

Clinical and rx examinations with periodontal evaluation and clinical testing

Question 2

Which are the 6 things to take into account for an endo dx?

Answer 2

1. Medical-dental history
2. Chief complaint (queja ppal)
3. Clinical exam (Exploración física)
4. Clinical pulpal/periapicaltesting
5. Rx analysis
6. Additional tests

Question 3

what is a normal pulp considered?

Answer 3

Pulp without syntoms and normal response to pulp testing

Question 4

what is considered a reversible pulpitis?

Answer 4

present discomfort at cold/hot stimulus but goes away seconds after removing it

Question 5

what is considered a symptomatic irreversible pulpitis?

Answer 5

• Sharp pain upon thermal stimulus
• Lingering pain (30+ secs after removing the stimulus)
• spontaneity
• referred pain
  (sometimes doesn’t bother percussion)

Question 6

What is considered an asymptomatic irreversible pulpitis?

Answer 6

• no symptoms
• normal response to thermal testing
• Had trauma or deep caries exposing the pulp

Question 7

what is considered a pulp necrosis?

Answer 7

• causes apical periodontitis as long as tha canal is infected
• Tooth does not respond

Question 8

what is considered a normal apical tissue?

Answer 8

• non sensitive to percussion or palpation testing
• the lamina surrounding the tooth is intact
• the periodontal ligament space is uniform

Question 9

what is considered a symptomatic apical periodontitis?

Answer 9

• presents inflammation of the apical periodontium
• painful response to biting and/or to percussion or palpation
• may or not be accompanied by rx changes

Question 10

what is considered a asymptomatic apical periodontitis?

Answer 10

inflammation & destruction of the apical periodontium that has a pulp origin
- no clinical symptoms
-apical radiolucency

Question 11

what are the characteristics of a chronic apical abscess?

Answer 11

• inflammatory reaction to pulpal infection and necrosis
• litte o no discomfort
• intermittent discharge of pus through a sinus tract

Question 12

what is an Acute apical abscess?

Answer 12

inflammatory reaction to pulpal infection and necrosis characterized by rapid onset, spontaneous pain, sensitivity of the tooth to pressure, pus formation and swelling of associated tissues
-malaise, fever and lymphadenopathy

Question 13

What is considered a condensing osteitis?

Answer 13

diffuse radiopaque lesion as a localized bony reaction to a low-grade inflammatory stimulus

Question 14

Which are the three main avenues of communication of the pulp and the periodontum?

Answer 14

1. exposed dentinal tubules
2. small portals of exit
3. the apical foramen

Question 15

which are the small portals of exit ?

Answer 15

lateral & accessory canals

Question 16

when is a pulp severely affected by a periodontal disease?

Answer 16

when the periodontal disease has caused a recession that has opened a lateral or accessory canal to the oral environment

Question 17

what happens once the pulps becomes infected?

Answer 17

most likely to get a perirradicular lesion and inflammation in the apical tissues

Question 18

what bacteria has been well identified as a root canal presence?

Answer 18

spirochetes

Question 19

what are the contibuting factors for a pulp and periodontal inflammation?

Answer 19

1. poor endodontic treatment
2. poor restoration
3. trauma
4. resorption
5. perforations
6. developmental malformations

Question 20

What information is necessary to gather pior any treatment when a dental trauma has occurred?

Answer 20

1. px’s name, age, sex, contact #
2. CNS symptoms after the trauma
3. px’s gral health
4. WHEN, WHERE & HOW
5. tx px received elsewhelre
6. history of previous dental injuries
7. disturbances in the bite
8. tooth reactions to thermal changes o sensitivity
9. if teeth are sore to touch/eating
10. if there’s spontaneous pain

Question 21

what has to be done in the case of avulsion and tooth being out of its socket?

Answer 21

place the tooth in physiological solution, milk or saline

Question 22

which are the symptoms of a possible intracranial hemorrhage or a serious cerebral concussion after a head injury?

Answer 22

loss of consciousness
post traumatic amnesia
Nausea or vomiting
fluids from ear/nose
situational confusion
blurred vision
uneven pupils
dificulty to speech

Question 23

what might happen to the response of the tooth after a trauma?

Answer 23

the pulp might be non responsive for several weeks due to the trauma

Question 24

what’s the aim of treating a dental trauma?

Answer 24

mantain or regain pulpal vitality in traumatized teeth

Question 25

which are the two groups in which the dental trauma is divided?

Answer 25

fractures & luxation injuries

Question 26

which are the types of fractures

Answer 26

crown crown-root root fractures

Question 27

what's a complicated fracture?

Answer 27

when the pulp is exposed

Question 28

what's an uncomplicated fracture?

Answer 28

when the pulp is NOT exposed to the oral environment

Question 29

what's the most esthetically solution in a crown fracture?

Answer 29

to look for the broken-off tooth fragment and rebond it to the tooth

Question 30

If there is at least 0.5 mm of the dentin remaining covering the pulp in a crown fracture

Answer 30

there's no need to cover it with a protective liner

Question 31

If there is less than 0.5 mm of the dentin remaining covering the pulp in a crown fracture

Answer 31

it's necessary to cover the pulp with a cavity liner

Question 32

when a crown-root fracture is presented what has to be done?

Answer 32

the fracture margin has to be exposed around the tooth or crown to properly restore the tooth

Question 33

what has to be done when there's a fracture line is in the sulcus

Answer 33

a gingivectomy to expose the fracture line and restore it appropiately

Question 34

what other treatments can be done to expose the fracture line when its further than the sulcus

Answer 34

extrude the tooth with orthodontic forces or repositionated surgically

Question 35

a crown fracture where the pulp is exposed

Answer 35

it has to be protected with a liner

Question 36

A lack of response to vitality tests after a trauma

Answer 36

doesn't always indicate the need of a root canal treatment and it's advisable to look for at least another signs of pulpal necrosis

Question 37

what other signs besides no reponse to vitality tests can indicate pulpal necrosis

Answer 37

vestibule swelling, periapical lesions and or a dramatic color change of the crown

Question 38

if there's no other signs besides no response to vitality tests for pulpal necrosis what has to be done?

Answer 38

continue to monitor the px at regular appointments every three months up to 1 year

Question 39

what's affected in all root fractures

Answer 39

the pulp

Question 40

in a root fracture if there's enough approximation between the fragments what's the thing most likely to occur?

Answer 40

the pulp will revascularize itself across the fracture

Question 41

T or F: All luxation injuries will cause some damage to the periodontal ligament and in some cases the pulp as well

Answer 41

True

Question 42

what's the immediate treatment when a luxation occurs

Answer 42

limit further damage to the pdl

Question 43

what late complications can occur due to the luxation?

Answer 43

internal or external root resorptions

Question 44

In this case the tooth is still in its original location but its tender to percussion

Answer 44

concussion

Question 45

In this case the tooth is still in its original location but its tender to percussion and has increased mobility

Answer 45

subluxation

Question 46

what's the treatment for a subluxation

Answer 46

depends on how much the tooth has moved out of its normal position

Question 47

When an immature tooth is intruded up to 7 mm

Answer 47

it is recommended to wait 3 weeks and watch for signs of re-eruption

Question 47

When an immature tooth is intruded up to 7 mm and shows no signs of re-eruption

Answer 47

can initiate orthodontic repositioning

Question 47

For intrusion of more than 7 mm

Answer 47

surgical or orthodontic repositioning should be performed within three weeks

Question 47

In the case of an intruded tooth with a closed apex, there is a possibility of reeruption if

Answer 47

if the tooth is slightly intruded (less than 3 mm) and the patient is younger than 17 years old

Question 47

what's the risk of all the intrusions after a luxation

Answer 47

the ankylose of the tooth in the infraposition

Question 48

Splinting of a luxated tooth is only recommended for teeth that

Answer 48

are still mobile after repositioning

Question 48

In all types of trauma cases, a splint must allow

Answer 48

for physiological movement

Question 48

in a luxation trauma, if the apex is still open

Answer 48

there is a chance that the pulp will survive the trauma or revascularize allowing the growth of the tooth

Question 49

in a luxation trauma, If the apex is closed

Answer 49

endodontic treatment is likely needed

Question 50

what can occur if the necrotic pulpal tissue becomes infected when there's an injury to the pdl

Answer 50

a rapid inflammatory root resorption

Question 51

For mature teeth diagnosed with necrotic pulps what is recommended to place for two to four weeks prior to obturation

Answer 51

calcium hydroxide

Question 52

what should we wait for before placing calcium hydroxide prior an endodontic treatment

Answer 52

allow the pdl to heal

Question 53

in the case of luxation, what is recommended for teeth with open apices

Answer 53

apexification or revascularization

Question 54

In the case of avulsion what are the conditions to have a fairly good prognosis after replanting the tooth

Answer 54

replacing no more than 30mins after o having kept it in a physiological solution of specialized media or milk for a few hrs

Question 55

in the case of avulsion, If the tooth has been dry for more than 1 hour, the periodontal ligament cannot be expected to survive and the tooth will likely become ankylosed

Answer 55

true

Question 56

in the case or avulsion, once the teeth has been reimplanted what do we use to stabilize them

Answer 56

a physiological splint for 2 weeks

Question 57

If the avulsed tooth has an open apex and was reimplanted within the hour, there is a possibility that the pulp will revascularize

Answer 57

true

Question 58

in the case of avultion and a tooth with a closed apex there's no revascularization going to happen, so what's the treatment that has to be done?

Answer 58

endodontic treatment

Question 59

in the case of a tooth with a closed apex when it's time to do the endodontic treatment after the reimplantation of the tooth?

Answer 59

2 weeks after the reimplantation and prior to the removal of the splint

Question 60

early treatment or manipulation of the tooth inmmediately after reimplantation can cause

Answer 60

damage to the pdl

Question 61

placing calcium hydroxide immediately after reimplantation

Answer 61

will promote inflammation that will lead to pdl damage

Question 62

in the case of avulsion, if the tooth has been kept dry longer than 60 mins what has to be done prior to replantation

Answer 62

canal treatment