Pathogenesis and Periapical Diseases

Question 1

Endo

Answer 1

within

Question 2

dontics

Answer 2

tooth

Question 3

What resides within the tooth chamber with rigid walls?

Answer 3

unique connective tissue with vascular, lymphatic and nervous elements

Question 4

What does the connective tissue contain?

Answer 4

odontoblasts

Question 5

What does the pulp contain?

Answer 5

fibroblasts, undifferentiated mesenchymal cells, collagen type I and II, proteoglycans, glycoproteins, and water

Question 6

What two dental tissues function as a unit?

Answer 6

pulp and dentin

Question 7

where are odontoblasts located?

Answer 7

in the periphery of the pulp tissue, with extensions into the inner part of the dentin.

Question 8

Dentin is the result of what process

Answer 8

odontoblast

Question 9

How long does it take for a root to fully develop?

Answer 9

2-3 years (mainly 2)

Question 10

How long does inflammation take to be felt by the patient?

Answer 10

48 hours

Question 11

antibiotics take how long to kick in?

Answer 11

48 hours

Question 13

Aδ fibers innervate what area

Answer 13

periphery

Question 14

C fibers innervate what area

Answer 14

the central pulp

Question 15

Aδ fibers characteristics

Answer 15

Sharp response to thermal change

extend between the odontoblasts

lose their myelin sheath (slows down the nerve transmission as they die)

extend to a distance of 100 to 200 μm into the dentinal tubules

Question 16

C fibers characteristics

Answer 16

unmyelinated

dull ache that affects patients with symptomatic irreversible pulpitis

Question 17

When a tooth first erupts, the root apex is _____ with _____ blood supply.

Answer 17

immature; ample

Question 18

the older a tooth gets, the ____ the pulp is able to withstand irritation.

Answer 18

less

Question 19

As a tooth matures what happens to the apices

Answer 19

it closes

Question 20

What dictates the type and duration of a stimulus?

Answer 20

dental pulp and irritants

Question 21

How can you classify irritants?

Answer 21

non-living = mechanical, thermal, or
chemical
living = microbial

Question 22

what increases pulp irritation

Answer 22

more dentin is removed during deep cavity preparations

Question 23

where is dentinal permeability is greater ?

Answer 23

closer to the pulp

removal of tooth structure without proper cooling

deep scaling a curettage

Question 24

Periapical tissues can be mechanically irritated by

Answer 24

impact injuries
hyper-occlusion
over-instrumentation of root canals
perforation of the root, and over-extension of root canal fillings materials

Question 25

under normal conditions, what isolates the the pulp and dentin from microorganisms?

Answer 25

enamel and cementum

Question 26

what is the most common cause of pulp exposure

Answer 26

caries

Question 27

What are a few antimicrobial agents?

Answer 27

silver nitrate, phenol with and without camphor, and eugenol

Question 28

What can ca inflammatory changes in the underlying dental pulp?

Answer 28

cytotoxicity

Question 29

What are some irritants that will cause an inflammatory change?

Answer 29

cavity cleansers, such as alcohol, chloroform, hydrogen peroxide, and various acids; chemicals present in desensitizers, cavity liners and bases; and temporary and permanent restorative materials.

Question 30

What is the initial reaction of a pulp?

Answer 30

immune response

Question 31

What is the most significant cause of inflammation?

Answer 31

microbial

Question 32

early response to caries results in focal accumulation of what?

Answer 32

chronic inflammatory cells, such as macrophages, lymphocytes, and plasma cells

Question 33

Pulpal inflammation may remain inflamed for a long time or undergo rapid necrosis based on what factors?

Answer 33

virulence of the microorganisms ability to circulate inflammatory fluids to avoid a marked increase in intrapulpal pressure host resistance, including genetic variations amount of circulation lymphatic drainage

Question 34

What is the path of travel for micro-organisms and their byproducts?

Answer 34

canal to periapical region

Question 35

Pulpal and periapical pathoses do not develop without the presence of ?

Answer 35

bacterial contamination

Question 36

What is the goal of root canal treatment?

Answer 36

to remove microorganism from the root canal system

Question 37

What is biofilm?

Answer 37

Microcolonies of bacteria that irreversibly attach to a substratum, to an interface like dentin, and to each other

Question 38

(T/F) Can all areas of the infected root canal system harbor microbial cells organized as highly variable biofilm structures

Answer 38

true

Question 39

What is the main microbial agent that causes endodontic infection?

Answer 39

lactobacilli, gramnegative bacteria,

Question 40

(T/F) primary root canal infects cannot harbor a multispecies population of facultative and strict anaerobic gram-positive and gram-negative bacteria, spirochetes, yeasts, etc.

Answer 40

false

Question 41

What major virus is associated with irreversible pulpitis?

Answer 41

Epstein-Barr virus

Question 42

How can microorganism enter the canal between appointments?

Answer 42

Cracked tooth Tooth left open Other reasons: Not using a rubber dam Caries left in tooth Delay in getting a permanent restoration