Flashcards in Periodontal-Endodontic Interrelationships Deck (24):
What are three ways in which pulp vitality is put at risk?
1. deep caries
2. trauma (accident)
3. Restorative Procedures (overheating for example)
Cell ____ is an immune response to deep caries.
Why do bacteria thrive in "dead pulp?"
blood supply is cut off (usually by inflammation)
True or False: In periodontal-endodontic interrelationships, neutrophils become overwhelmed by bacteria.
How does the host response attempt to "wall-off" infection in periodontal-endodontic infections?
Inflammatory infiltrate forms DENSE connective tissue around the infection (usually root apex)
True or False: Periodontal-endodontal interrelationships are characterized by abscesses that spread from the apex, through PDL space, and toward the marginal level.
How can you tell whether the infection is beginning at the pulp or the periodontium?
Periodontium = no pain
Endo (Pulp) = throbbing pain
There is an anatomical connection between the pulp and PDL via ______ foramen, ______ canals, and _______ tubules.
Frequency of accessory canals increase toward the _____.
True or False: There are more accessory canals near the crown of a tooth.
False, more near the apex
Accessory canals travel in multiple directions in the _____ areas.
The dentinal tubules connect the pulp to the PDL. This if very important in the _____ area.
If a periodontal-endodontic interrelationship begins in the pulp, will there be increased probing depths?
no! probing depths do not increase and swelling does not increase
Which is treated first, the endo or perio problem?
Treat endo FIRST! Why?
-Potential for "two for one" = most perio problems will self correct if the pulp is resolved
-sometimes endo is not successful and you need to take different approach
If the tooth is vital, the primary lesion is ______ origin. If the tooth is non-vital, the primary lesion is ______.
vital = Periodontal
non-vital = endodontic
If a tooth is vital (aka: pulp is not the cause) but the periodontal lesion reaches the apex, what would be the effect of SRP?
scaling at the root apex would involve the pulp...now endo treatment is needed
What are the three possible sequences of events for periodontal-endodontic interrelationships?
1. endo first
2. perio first
3. occur independently and then combine
Describe the sequence of events if endo occurs first.
Necrotic pulp--> disease extends to periodontal tissues
Describe the sequence of events if perio occurs first.
Pulp is vital.
Periodontal lesion-->bacteria spread to pulp-->necrosis
Describe a "true combined lesion."
Pulpal and periodontal pathologies initiate independently and then coalesce
Why does Dentin Hypersensitivity occur most easily at the CEJ?
Scaling and Root planing in this area = extreme sensitivity because the cementum is thinnest at the CEJ
Dentin hypersensitivity can occur in response to what kind of stimuli?
hot, cold, acid, sweetness, touch, air flow
True or False: Dentin Hypersensitivity peaks during the first week and then subsides.