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ABE Oral Board Review > Pulpal and Periapical Pathology > Flashcards

Pulpal and Periapical Pathology Flashcards

(68 cards)

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1
Q

Single greatest influence on pulpal and periapical disease.

A

Bacteria and their byproducts

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2
Q

Proximity of caries to the pulp for mild chronic vs severe acute inflammation

Author

A

1.1mm vs 0.5mm
Reeves and Stanley

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3
Q

Associated with both chewing discomfort and unexplained thermal sensitivity.

A

coronal fractures
Cameron

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4
Q

Why a cracked tooth hurts

A

Fluid movement within the crack, bacterial ingress

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5
Q

Restorative treatment can cause pulpal inflammation both _____ and ______

A

immediately and many years later.

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6
Q

Cumulative effect of restorative procedures on pulp tissue over time

A

Stressed pulp syndrome
Abou-Rass

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7
Q

Displacement of odontoblastic nuclei and pulpal inflammation following dry restorative procedures are usually reversible after ______ days

A

180
Cotton and Siegel

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8
Q

Remaining dentin thickness of ______ or greater is necessary to avoid pulpal injury

A

0.5mm
Murray et al

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9
Q

Reactionary dentin formation occurs with _____ of remaining dentin thickness

A

0.77mm
Murray et al

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10
Q

Any material placed within ______ of the pulp caused significant and irreversible lesions

A

0.5mm
Stanley

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11
Q

______ and ______ may promote tissue healing when placed in direct contact with pulp tissue

A

RMGI
MTA

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12
Q

Teeth restored with resin are ______ times more likely to require RCT compared to amalgam

A

1.9
Kwang

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13
Q

% of crowned teeth that require RCT

A

8% at 10 years
17% at 25 years
19% in general (Saunders)
32% if abutment for FPD

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14
Q

Heat and ice tests pose no threat to pulpal health

A

Ice - dowden
heat - Rickoff

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15
Q

temperature increase of ______ (preparation without coolant) will cause irreversible damage

A

5.6 C
Zach and Cohen

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16
Q

Orthodontic treatment may have _____ effect on pulp tissue

A

transient

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17
Q

During ortho treatment, altered response to _______ and decrease in _______

A

EPT - Cave
Pulp size by CBCT - Venkatesh

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18
Q

Levels of pulpal ______ increase when teeth are subjected to severe orthodontic forces

A

CGRP

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19
Q

Relationship between ortho and ______ processes is well documented

A

resorptive
Heithersay - ICR
Reitan - external (precementum and predentin are protective)

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20
Q

Argument against perio affecting endo

A

Seltzer and bender - perio exposes lateral canals without pulp necrosis

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21
Q

Argument for perio affecting endo

A

Giovanella - lower pulpal oxygen saturation rates in teeth with perio

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22
Q

Occlusal forces have no effect on pulpal ________

A

Histology

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23
Q

Acute occlusal trauma leads to increase in substance P levels in both _______ and ______

A

pulp and PDL

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24
Q

_______ reduces post operative pain in vital pulps with percussion sensitivity

A

occlusal reduction
Rosenberg

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25
The theory that blood borne bacteria are attracted to areas of chronic inflammation
Anachoresis Gier and Mitchell
26
Discredited anachoresis
Delivanis -- bacteremia did not colonize unfilled root canals in cats
27
A focus of microorganisms can lead to systemic dissemination of infection
Focal infection theory Weston Price
28
Discredited focal infection theory
Easlick
29
Hollow tubes within the body collect circulatory elements and lead to inflammation
Hollow tube theory Rickert and Dickson
30
Discredited hollow tube theory
Torneck and Wenger Hollow tubes implanted in tissue did not cause inflammation
31
Pulpal irritants activate both ______ and ______ immune systems
Innate and Acquired
32
Components of innate immune system (5)
Physical barriers phagocytes inflammation mast cells basophils
33
Components of acquired immune system
B cells and T cells
34
Stimuli transferred via _______ activate a delta and C fibers
fluid movements
35
C fibers conduct signals and ________
release neuropeptides
36
Pulpal blood flow is ______ in nature
Biphasic
37
Cellular immunity within the pulp provided by
Leukocytes macrophages lymphocytes
38
humoral immunity within the pulp provided by
immunoglobulins prostaglandins cytokines
39
Pulp tissue necrosis via ______ Author
coalescing of micro-abscesses Langeland
40
Correlation between symptoms/clinical diagnosis with histology
Normal and reversible diagnoses are correct 96% of the time Irreversible is correct 84% of the time Ricucci
41
Predominant immune cell in development of apical periodontitis
Lymphocytes
42
T cell involved in active lesion development
T helper
43
T cell involved in chronic lesions
T surpressor cells
44
Predominant immunoglobulin in apical periodontitis
IgG
45
Increase in circulating antibodies in patients with _____ and ________
AAA and flare-ups
46
Prostaglandins are byproducts of _____ formed via the ________
Arachidonic acid Cyclooxygenase pathway
47
Symptomatic lesions have higher _______ activity
Prostaglandin
48
Cytokines are produced by ______ when ______ becomes activated by pathogens
Macrophages toll-like-receptor 4
49
_______ has 15 times bone resorption potency
IL-1 B
50
Cytokines including _____, _____, and ______ promote the fusion of osteoclast precursor cells which cause subsequent bone resorption
IL-1, TNF-a, and leukotrienes
51
Bone resorption process
cytokines stimulate production of RANKL which stimulate osteoclasts
52
The presence of live bacteria in periapical lesions is _______
controversial
53
Diagnosis of granuloma vs cyst cannot be based on _______
radiographs
54
Periapical granulomas are composed of _______ tissue and _______ inflammation
Granulation Chronic (not granulomatous)
55
Predominant immunoglobulin in granulomas
IgG
56
Periapical cysts posses an _________
epithelial lining
57
Torabinejad's immunologic theory of cyst formation is that
inflammation stimulates epithelial rests of Mallasez to proliferate
58
Two types of periapical cysts
true cyst -- not connect to apex (more common) bay cyst -- communicate with periapex
59
Of non-endodontic lesions, ______ were benign and ____ were malignant
66% 29%
60
Most common benign lesions
ameloblastoma, nasopalatine duct cyst
61
Most common malignant lesions
metastatic lesions, carcinomas
62
Specimens are ______% granulomas, ______% abscesses, and _____% cysts
50% 35% 15%
63
Post-operative exacerbation of symptoms
Endodontic flare-up
64
Incidence of flare-up
5.8% of teeth with lesions Yu 8.4% Tsesis
65
Flare-up factors (5)
female sex pre-operative pain and swelling dx of pulpal necrosis retreatment history of allergies
66
Flare-up cannot be prevented with abx
Walton and Fouad
67
Abx can be used to control flare-up once initiated
Seltzer
68
Flare-up is not associated with treatment failures
de Chevigny

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