Lesson 6 Flashcards
1
Q
ZONES OF THE PULP
A
-› mature dentin
-› odontoblastic zone
-> cell-free zone
cell-rich zone
-› central zone
2
Q
reaction of tooth
A
stimuli
3
Q
explains tooth sensitivity even when pulp tissue is not diseased
A
HYDRODYNAMIC THEORY
4
Q
HYDRODYNAMIC THEORY BY?
A
BRANNSTROM
5
Q
stimulation of A-delta fibers
A
HYDRODYNAMIC THEORY BY BRANNSTROM
6
Q
an external stimuli causes movement of dentinal fluid found inside the tubules causing an outward flow
A
HYDRODYNAMIC THEORY BY BRANNSTROM
7
Q
nerve fibers extend into the dentinal tubules (______) and respond to the stimuli or movement
A
A-delta fibers
8
Q
_______are found mainly in the central zone of the pulp
A
C fibers
9
Q
formation of sclerotic dentin and formation of reparative or tertiary dentin
A
MILD INJURY
10
Q
no pulp inflammation
A
MILD INJURY
11
Q
no formation of sclerotic or reparative dentin
A
SEVERE PROLONGED INJURY
12
Q
stimulus continues to act on pulp tissue developing into inflammation and furthermore pulp disease
A
SEVERE PROLONGED INJURY
13
Q
pulp cannot repair and odontoblasts are damaged
A
SEVERE PROLONGED INJURY
14
Q
a complex sequence of vascular and cellular changes of tissues in response to injury that subsides only after the effects of the causative factors have been eliminated and the damaged tissue is repaired or returned to a healthy state
A
PAIN DUE TO INFLAMMATION
15
Q
rubor
A
Redness
16
Q
calor
A
Heat
17
Q
Tumor
A
Swelling
18
Q
dolor
A
Pain
19
Q
function laesa
A
Loss of function
20
Q
irritant /stimulus
transient vasoconstriction
vasodilation due to release of inflammatory mediators
increased vascular permeability
transudation/exudation
edema
increased pulpal tissue pressure
compression of blood circulation
increased blood viscosity
stasis of blood flow
localized pulp inflammation
A
VASCULAR RESPONSE
21
Q
The ________ occurs first as it is what brings the inflammatory cells to the area of injury.
A
vascular response
22
Q
margination
diapedesis
chemotaxis
phagocytosis
A
CELLULAR RESPONSE
23
Q
inflammatory cells move into side of blood vessels
A
Margination
24
Q
movement through endothelial lining of the blood vessel
A
Diapedesis
25
attraction to the irritant
Chemotaxis
26
removal of irritant or stimulus
Phagocytosis
27
INFLAMMATION ACCORDING TO ONSET
Acute
Chronic
28
exudative or immediate
response of tissue to
neutralize injurious agent
Acute
29
> increase of PMNL
-> rapid course
Acute
30
-> sudden and intense
short onset
Acute
31
-> proliferative phase
• > persistent or long-standing
Chronic
32
-May follow an acute phase or may develop from onset
- (-) pain
Chronic
33
FEATURES OF THE PULP THAT PLAY A ROLE IN PULP INFLAMMATION
1. LOW COMPLIANT ENVIRONMENT
2. RESILIENT CONNECTIVE TISSUE (GROUND SUBSTANCE)
3. PRESENCE OF ARTERIO-VENOUS ANASTOMOSES (AVA'S)
34
> the pulp is a soft tissue surrounded by hard tissue (dentin)
when there is presence of inflammation, vasodilation causes increased flow into the area, edema, and increase in intracellular fluid leading to an increase in blood volume
-> because of that, the pulp cannot expand and there is an increase in pressure causing some sort of pain to the patient
LOW COMPLIANT ENVIRONMENT
35
the ground substance is a gel-like material that becomes watery when damaged
RESILIENT CONNECTIVE TISSUE (GROUND SUBSTANCE)
36
in its gel-like state, it is able to stop or control the immediate spread of inflammation but when the irritant is too strong, it damages the gel-like consistency leading to further spread of inflammation
RESILIENT CONNECTIVE TISSUE (GROUND SUBSTANCE)
37
direct connections between arterioles and venules; no capillary bed
PRESENCE OF ARTERIO-VENOUS ANASTOMOSES (AVA'S)
38
open up to bring blood to the area of inflammation in order to decrease pressure in the pulp
PRESENCE OF ARTERIO-VENOUS ANASTOMOSES (AVA'S)
39
FACTORS CAUSING INJURY TO THE PULP
BACTERIA
PHYSICAL, THERMAL, MECHANICAL,
40
-direct pulp invasion via carious -lesion bacterial toxins
BACTERIA
41
anachoresis
BACTERIA
42
-trauma
-iatrogenic
**etched dentin: washed and overdried
**desiccation: collapsed collagen layer
**vibration or heat
PHYSICAL, THERMAL, MECHANICAL, CHEMICAL, ELECTRICAL CAUSES
43
-> regressive changes
-> barodontalgia or aerodontalgia
PHYSICAL, THERMAL, MECHANICAL, CHEMICAL, ELECTRICAL CAUSES
44
galvanism
PHYSICAL, THERMAL, MECHANICAL, CHEMICAL, ELECTRICAL CAUSES
45
increase of pressure to pulp tissue because of high altitude levels
barodontalgia or aerodontalgia
46
contact of metal restorations
galvanism
47
radiograph:
clearly delineated canals
(-) periapical radiolucency, resorption, calcifications
NORMAL PULP (PULP DISEASE)
48
-› asymptomatic
-> mild or moderate response to thermal test or stimuli
-> (-) percussion, palpation, mobility
NORMAL PULP (PULP DISEASE)
49
mild transient localized inflammatory response of the pulp
REVERSIBLE PULPITIS
50
non-spontaneous pain or pain that occurs only when there is stimuli
REVERSIBLE PULPITIS
51
quick, sharp pain to cold, less to hot
REVERSIBLE PULPITIS
52
(-) percussion, palpation, tooth mobility
REVERSIBLE PULPITIS
53
> less current with the electrical >pulp (EP) test recent dental treatment
REVERSIBLE PULPITIS
54
RADIOGRAPHIC FEATURES
-› normal PDL and lamina dura
REVERSIBLE PULPITIS
55
-> slight disruption of odontoblastic layer and inflammatory cell infiltration adjacent to area of irritation
REVERSIBLE PULPITIS
56
-> pulp hyperemia
-> inflammatory cell infiltrates
REVERSIBLE PULPITIS
57
TREATMENT
-> removal of damaged dentin >placement of liner or base
REVERSIBLE PULPITIS
58
IRREVERSIBLE PULPITIS are:
ACUTE IRREVERSIBLE PULPITIS
CHRONIC ULCERATIVE PULPITIS
CHRONIC HYPERPLASTIC PULPITIS
59
irreversible condition characterized by intense inflammatory response
ACUTE IRREVERSIBLE PULPITIS
60
-> pain
Moderate to severe
Spontaneous
Intermittent
Continuous
ACUTE IRREVERSIBLE PULPITIS
61
sharp (A-delta fibers)
dull and throbbing (C filers)
localized or referred
ACUTE IRREVERSIBLE PULPITIS
62
-> thermal response:
immediate response to hot stimuli but may be relieved with cold stimuli
immediate response to cold stimuli
ACUTE IRREVERSIBLE PULPITIS
63
immediate response to hot and cold stimuli but cold causes more pain than hot
ACUTE IRREVERSIBLE PULPITIS
64
reacts to low levels of current with the electric pulp test
ACUTE IRREVERSIBLE PULPITIS
65
-> may be (+) percussion
-> (-) palpation and tooth mobility
ACUTE IRREVERSIBLE PULPITIS
66
RADIOGRAPHIC FEATURES
-> deep caries
>extensive restorations thickened or widening apical portion of PDL
ACUTE IRREVERSIBLE PULPITIS
67
HISTOLOGIC FEATURES of
ACUTE IRREVERSIBLE PULPITIS
Early Phase
Late Stage
68
What phase?
> odontoblasts near the cause are destroyed
Early phase
69
What phase?
increased inflammatory cell infiltration
Early Phase
70
What phase?
vascular dilation and edema
Early Phase
71
What phase?
-> destruction of pulp zones
Late Stage
72
What phase?
inflammation involves entire pulp
Late stage
73
What phase?
inflammatory cells fill pulp
Late Stage
74
TREATMENTof ACUTE IRREVERSIBLE PULPITIS
RCT or pulpectomy
75
FORMATION OF PULP ABSCESS
ischemia
necrosis
degeneration of leukocytes
release of lysosomal enzymes
abscess formation
76
persistent inflammatory reaction of the pulp characterized by the presence of granulation tissue over the exposed pulp surface
CHRONIC ULCERATIVE PULPITIS
77
CLINICAL FEATURES
-> presence of carious lesion on either as a closed carious lesion or a cavity
CHRONIC ULCERATIVE PULPITIS
78
-> in an open carious lesion, pain is present when lesion is packed with food
CHRONIC ULCERATIVE PULPITIS
79
› possible (+) percussion
-> varied thermal response
CHRONIC ULCERATIVE PULPITIS
80
RADIOGRAPHIC FEATURES
-› near pulp exposure or presence of pulp exposure
CHRONIC ULCERATIVE PULPITIS
81
HISTOLOGIC FEATURES
-> localized excavation of the pulp surface
-> (+) of ulcer on the pulp surface
CHRONIC ULCERATIVE PULPITIS
82
-> plasma cell infiltration
> drainage of the inflammatory exudate through necrotic dentin
-> inflammation remains localized because drainage prevents build-up of pressure
CHRONIC ULCERATIVE PULPITIS
83
TREATMENT
-> RCT or extraction depending on the severity of crown involvement or restorability of the tooth
CHRONIC ULCERATIVE PULPITIS
84
-> hyper means "increase"; plastic means "tissue"
CHRONIC HYPERPLASTIC PULPITIS
85
excessive and exuberant overgrowth of a chronically inflamed dental pulp outside the pulp chamber
CHRONIC HYPERPLASTIC PULPITIS
86
complete exposure of pulp tissue which responds by growing or increase in terms of number and size
CHRONIC HYPERPLASTIC PULPITIS
87
-> the overgrowth of tissue is called a pulp polyp
CHRONIC HYPERPLASTIC PULPITS
88
common on young immature teeth
CHRONIC HYPERPLASTIC PULPITS
89
TREATMENT
> depends on restorability of the tooth
-> RCT or extraction
CHRONIC HYPERPLASTIC PULPITS
90
epithelial cells from surrounding oral tissue can fall into this growing granulation tissue to form lining epithelium of polyp
PULP POLYP WITH STRATIFIED SQUAMOUS EPITHELIUM
91
- plasma cell infiltration
- granulation tissue with delicate CT, filers and blood vessels
PULP POLYP WITH STRATIFIED SQUAMOUS EPITHELIUM
92
True or false
early polyps without stratified squamous lining will bleed while mature polyps with the lining will not
True
93
end stage of pulp inflammation
PULP NECROSIS
94
with or without crown discoloration
>>as the pulp breaks down, products of the cells release and cause discoloration
PULP NECROSIS
95
-› can be partial or total necrosis
-> no presence of blood vessels in pulp
-> root canal will appear radiolucent
PULP NECROSIS
96
TREATMENT
-> RCT or extraction
-depends on restorability of the tooth
PULP NECROSIS
97
Bacteria from another part of the body
Anachoresis
98
No capillary bed
Arterio-venous anastomoses
