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Flashcards in Pulp Deck (54)
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1

Which pulp tissue becomes inflamed first, middle and last?

first: pulp horn
second: coronal pulp
third: radicular pulp

2

T/F
Pulp regeneration is similar in the deciduous dentition compared to the permanent dentition? Reference

T
Rodd 2009

3

Which feature of enamel breakdown indicates the degree to which the pulp is inflamed?

marginal ridge breakdown.

with increase in marginal ridge breakdown the pulpal inflammation is more widepsread

4

Which caries, proximal or occlusal, shows the greatest amount of pulp inflammation? Reference

proximal

Kassa et al 2009

5

What are the four potential pulp statuses?

Healthy
Reversible pulpitis
Irreversible pulpitis
Pulp Necrosis

6

What is the pulp response to caries?

initially tertiary dentine is laid down
following this, if the lesion is allowed to progress this leads to irreversible pulpitis and necrosis

7

What is the most reliable method for diagnosing pulp status?

Histological analysis

8

Why do we need to determine the pulp status correctly?

To determine the most appropriate treatment option

9

What are the challenges with regards to diagnosing pulp statuses in children?

lack of correlation between clinical signs and symptoms
unreliable tests

10

What to we use to diagnose the pulp status?

symptoms
clinical findings
special investigations

11

What are the symptoms of irreversible pulpitis?

Spontaneous pain
constant
long duration
not always relived by analgesics
dull throbbing ache
sleep disruption

12

What are the symptoms of reversible pulpitis?

provoked pain
disappears on removal of stimulus
shorter duration
relieved with analgesia
sharp pain

13

What clinical findings suggest pulp involvement?

sinus
swelling
clinical extent of caries

14

Which features on the radiographs can be use to assess pulp status?

extent of caries
radiolucency interadicular
Resorption (internal/external, physiological)

15

Which special investigations can be performed to investigate pain?

Mobility (normal vs abnormal)
TTP (distinguish between food impaction and peri-radicular resorption)

16

Which 4 factors about the patient will indicate whether or not the tooth should be extracted or restored?

medical factors
social
dental
pulp

17

Which medical factors would make you more inclined to retain the tooth?

bleeding disorders
patients at risk from GA

18

Which medical factors would make you more inclined to extract the tooth?

Immune compromised
cardiac disorders

19

Which social factors would you consider when considering treatment options?

attendance
motivated
dental awareness
co-operation and compliance
age of the child

20

Which dental factors would affect treatment decisions?

gross dental neglect
restorability
acute infection/pathology
time to exfoliation: if due to exfoliate within one year/advanced root resporption: provisional restoration or extract
If more than one year: retain
hypodontia
value of the tooth?
effect on developing dentition?

21

What are the two treatment options for vital pulp therapy?

Pulp cap (direct or indirect)
Pulpotomy (vital or desensitising)

22

What are the two treatment options for non-vital pulp therapy?

Pulpectomy
Extraction

23

What are the requirements for a vital pulp therapy?

Restorable Crown
Vital Pulp (no history of spon pain, reversible pulpitis, no sinus)
No radiographic pathology (resorption)

24

What is a pulp cap?

a method of maintaining pulp vitality by placing a dressing directly or indirectly over the exposed pulp or onto residual dentine left over a nearly exposed pulp

25

What is the purpose of a pulp cap?

To promote pulp healing

26

When is an indirect pulp cap indicated?

symptom free tooth with deep caries where full caries removal would lead to pulp exposure

27

What is the process of indirect caries removal?

All margins free from caries
remove as much of the softened caries from the margins as possible
place CaOH ontop (setting)

28

What can be used to help locate where the infected dentine is?

dyes
eg 0.5% fuschin dye

29

According to Welbury 2012 which type caries, proximal or occlusal should indirect pulp cap be avoided?

proximal since Kassa 2009 showed that caries proximally causes much more wide spread inflammation than occlusal. deep proximal lesions should be restpred with a pulpotomy first.

30

How effective are direct pulp caps in deciduous teeth? and why?

not very (welbury 2012)
this is because the medicament is less likely to stimulate reparative dentine in the inflamed area