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SP2 Dentistry > Lecture 4 4/8/25 > Flashcards

Lecture 4 4/8/25 Flashcards

(51 cards)

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1
Q

What are the components of the endodontic system?

A

dentin and pulp complex

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2
Q

What are the characteristics of dentin?

A

-major mineral component of tooth
-vital and sensitive
-produced by odontoblasts which line pulp cavity
-covered by enamel or cementum

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3
Q

What are the characteristics of pulp?

A

-soft tissue nucleus of tooth
-composed of odontoblasts, blood vessels, nerves, fibroblasts, and undifferentiated mesenchymal cells

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4
Q

What is the structure of dentin?

A

-70% mineral, 30% non-mineral
-porous structure with dentin tubules surrounded by peritubular dentin
-tubules contain odontoblastic process and fluid

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5
Q

What are the types of dentin?

A

-primary: produced by odontoblasts before tooth eruption
-secondary: produced by odontoblasts after eruption for the life of the tooth
-tertiary: produced in response to stimuli

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6
Q

What are the subtypes of tertiary dentin?

A

-reactionary: produced by pre-existing odontoblasts
-reparative: produced by newly differentiated odontoblasts after death of original odontoblasts

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7
Q

When does the tooth apex fully form?

A

around 12 months of age

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8
Q

What are the characteristics of pulpitis?

A

-recruitment of inflammatory cells and mediators
-can be reversible or irreversible
-can be acute or chronic
-reversibility and duration vary based on level of stimuli/insult, age, and pre-existing conditions

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9
Q

What are the characteristics of reversible pulpitis?

A

-stimuli is removed
-pulp is protected through production of tertiary dentin or a restoration
-pulp stays vital and tooth continues to mature

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10
Q

What are the characteristics of irreversible puplitis?

A

-insult causes irreversible damage to the pulp
-results in necrosis and death of pulp tissue
-maturation of tooth ceases
-tooth becomes nidus for infection and pain

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11
Q

What are the results of irreversible pulpitis?

A

-periapical periodontitis
-inflammatory response of periodontium surrounding the apex
-osteomyelitis

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12
Q

What are the signs of chronic periapical periodontitis?

A

-chronic inflammatory infiltrates
-granulation tissue
-pain
-radiographic lucency
-irreversible

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13
Q

What are the presentations of lesions related to pulpitis?

A

-suborbital abscess resulting from pressure build-up
-parulis/gumboil/fistulous tracts

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14
Q

What is a radicular cyst?

A

very round and distinct cyst structure secondary to pulpitis; stimulated epithelial cells produce fluid or keratin-filled cyst

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15
Q

What is internal tooth resorption?

A

osteoclast activity inside the pulp cavity eats away at tooth from inside out; secondary to pulpitis

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16
Q

What are the characteristics of intrinsic staining?

A

-pink/purple/gray coloring of tooth
-secondary to RBC components getting stuck in the dentinal tubules
-associated with irreversible pulpitis
-hemorrhage and swelling may cause strangulation of vascular supply, leading to irreversible pulpitis

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17
Q

What are the causes of endodontic disease?

A

-caries
-abrasion/attrition
-dental fractures
-dentoalveolar fractures

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18
Q

What are the characteristics of caries?

A

-“rotting” of the teeth
-not common in dogs and cats
-bacteria consume sugars and produce lactic acid byproduct
-tooth structure is demineralized

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19
Q

What are the components needed for caries to develop?

A

-tooth surface
-bacteria
-fermentable sugars
-time

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20
Q

How are caries diagnosed?

A

-yellow to brown leathery dental structure
-radiolucent area of tooth
-periapical dz

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21
Q

What is the treatment for caries?

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A

-removal of carious tissue
-restoration of lost tissue
-root canal or extraction if pulp is involved

22
Q

How can caries be prevented?

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A

-oral hygiene
-dietary modification
-control of confounding diseases
-fluoride

23
Q

What are the pulpal responses to caries?

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A

-reactionary dentin produced by existing odontoblasts that is well organized
-reparative dentin produced by reserve mesenchymal cells that is poorly organized

24
Q

What are the characteristics of attrition?

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A

-tooth loss from contact with another tooth
-physiologic
-occurs with malocclusion
-same lesion as abrasion, which occurs from contact with other objects

25
How does the attrition/abrasion lesion differ between slow and fast development?
slow: -retreating pulp -tertiary dentin production to protect pulp fast: -pulp exposure and pulpitis
26
How is dental wear diagnosed?
-yellow to brown, hard, glassy tooth structure -probing for pulp penetration -if slow development, no signs of decreased dentin or periapical dz
27
What is the treatment for dental wear?
-none needed if tertiary dentin and no pulp exposure -root canal or extraction if pulp exposure
28
How is dental wear prevented?
-treatment of confounding diseases -changes in chew toys and habits
29
What are the characteristics of enamel infraction?
-incomplete fracture without loss of tooth substance -presents with visible craze lines -dentin is not exposed -no treatment needed
30
What are the characteristics of enamel fracture?
-no dentin exposure -uncommon in dogs and cats -treated by smoothing rough enamel margins with a burr
31
What are the characteristics of an enamel-dentin fracture/uncomplicated crown fracture?
-exposure of dentin without exposure of pulp cavity -painful due to nerve ending exposure -bacteria can penetrate tubules -may develop pulpitis and have tertiary dentin production -treatment involves smoothing roughened tooth structure, restoration to close exposed tubules, and monitoring for necrosis
32
What are the characteristics of enamel-dentin pulp fracture/complicated crown fracture?
-exposure of dentin and pulp cavity -penetration of bacteria into pulp cavity will cause irreversible pulpitis if not treated -treatment options include extraction or endodontic therapy -not recommending treatment or not giving client all options should be considered malpractice
33
What are the pros of tooth extraction?
-one and done treatment -no need for follow up -less expensive -widely available
34
What are the pros of root canal therapy?
-preservation and continued use of tooth structure -less traumatic -less painful -lower complication rate
35
What are the potential complications of root canal therapy?
-failed treatment -restoration breakdown -pain -tooth fracture -instrumentation error -reaction to irrigant
36
What are the characteristics of root canal therapy?
-total pulpectomy; remove pulp tissue and necrotic debris -best for use in mature teeth and pulp exposure over 48 hours in duration
37
What are the three main steps of root canal therapy?
*biomechanical separation -pulp cavity is accessed and instruments are used to remove pulp tissue and create a remaining canal shape *microbial control -instruments are used to remove infected tissue and clean canal walls -irrigants like bleach are used to "sterilize" canal and remove debris *obturation of canal -canal is filled with inert material to prevent penetration or release of bacteria/toxins -access site is restored
38
What are the characteristics of vital pulp therapy?
-partial pulpectomy; removal of infected pulp portion only leaves the tooth vital so that development can continue -best for immature teeth and pulp exposure less than 48 hours in duration
39
What are the steps to vital pulp therapy?
-remove 6 mm of exposed pulp tissue -control hemorrhage -place a mild pulp irritating cement to induce formation of dentinal bridge -place a restoration
40
What are the characteristics of endodontic therapy follow up?
-recheck with radiographs at 6 months and then yearly -root canal therapy has a 94% success rate -vital pulp therapy has an 85% success rate -want to see shrinkage of previous abscesses OR no development of new abscesses
41
What are the characteristics of uncomplicated crown-root fracture?
-fracture of crown and root that does not expose pulp -creates a plaque-retentive surface -promotes periodontal dz
42
What are the treatment options for uncomplicated crown-root fractures?
-adjust periodontal tissue apical to the fracture line; apically repositioned flap and alveoloplasty -odontoplasty -restoration +/- crown therapy -extraction
43
What are the treatment options for complicated crown-root fractures?
-endodontic therapy -adjust periodontal tissue apical to the fracture line; apically repositioned flap and alveoloplasty -odontoplasty -restoration +/- crown therapy -extraction
44
What re the characteristics of root fractures?
-vertical root fractures are difficult to treat; should recommend extraction -horizontal root fractures are treatable -fractures in the apical third have little to no mobility, do not need treatment, and have the best prognosis for healing -fractures in the middle third have increased mobility, fair to good prognosis, and may benefit from splinting -fractures in the cervical third have significant mobility, poor prognosis, and should be extracted
45
What are the characteristics of concussive injuries?
-blunt trauma to tooth -often so no visible signs of injury and go undiagnosed -typically have no long-term consequences -severe trauma can lead to internal hemorrhage, intrinsic staining, and irreversible pulpitis -ability to respond to injury is age dependent; young animals do better
46
What are the characteristics of subluxation?
-injury leads to "loosening" of PDL -no crown or root fracture -no periodontal dz -contusion of PDL +/- concussion
47
How does the mobility of a subluxation affect treatment?
-minor mobility requires no treatment; monitor for signs of concussive injury -significant mobility requires splinting; monitor for signs of concussive injury
48
What are the types of luxation injury?
-intrusion: tooth moves further into socket; typically maxillary canine into nasal cavity -extrusion: uncommon; tooth is extruded partially out of alveolus -lateral: accompanying alveolar fracture, typically maxillary canine tooth
49
What is the treatment for luxation injuries?
-stabilize tooth with soft tissue injury repair, wire, and acrylic splint -perform root canal therapy in two weeks -extraction is also possible
50
What are the characteristics of avulsion?
-complete loss of tooth out of alveolus -apical pulpal supply and entire PDL are severed -typically canine tooth
51
How can an avulsed tooth be saved?
-must be done within 1 hr -tooth must be placed in milk, saline, or saliva to maintain vitality of periodontal lig. fibroblasts -flush alveolus with saline -stabilize with wire and acrylic splint -perform root canal therapy

SP2 Dentistry (6 decks)

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