s10 -midterms- Deep caries / Pulp

Question 1

What are the two types of pain considered in diagnosing deep carious lesions?

Answer 1

Provoked pain and spontaneous pain.

Question 2

Why is history of pain less reliable in children compared to adults?

Answer 2

Children’s perception and reporting of pain can be inconsistent.

Question 3

What does provoked pain indicate in a primary tooth?

Answer 3

It suggests the pulp is vital and protected by a thin layer of dentin.

Question 4

What does spontaneous pain typically indicate?

Answer 4

Advanced pulp damage and potential pulp necrosis.

Question 5

Why is tooth mobility assessed during a clinical examination?

Answer 5

Abnormal mobility may indicate advanced pulp disease affecting periodontal ligaments.

Question 6

What does a positive response to percussion imply?

Answer 6

Possible apical or pulpal inflammation.

Question 7

What are signs of an irreversibly diseased pulp in the mucobuccal fold?

Answer 7

Swelling, sinus, draining fistula, or chronic abscess.

Question 8

Why is the size of the exposure and amount of pulpal bleeding significant?

Answer 8

Small pinpoint exposure with controlled bleeding is favorable for vital pulp therapy.

Question 9

Why can radiographic interpretation be challenging in children?

Answer 9

Incomplete root formation, normal root resorption, and superimposition of permanent teeth.

Question 10

What are radiographs used to assess in deep carious lesions?

Answer 10

Periapical changes, rarefaction of bone, and presence of calcified masses.

Question 11

Why are sensitivity tests considered unreliable in children?

Answer 11

Children’s responses can be inconsistent, and pulp vitality tests may not reflect disease severity accurately.

Question 12

Why should systemic health be considered before pulp therapy?

Answer 12

Serious systemic conditions may compromise pulp healing or increase infection risk.

Question 13

What is the purpose of indirect pulp capping?

Answer 13

To maintain pulp vitality by placing a protective material over the remaining carious dentin.

Question 14

When is indirect pulp capping indicated?

Answer 14

In deep caries where complete caries removal may result in pulp exposure.

Question 15

What material is typically used in indirect pulp capping?

Answer 15

Calcium hydroxide (Ca(OH)₂).

Question 16

How is success of indirect pulp capping evaluated?

Answer 16

No pain, no sensitivity to percussion, no radiographic pathology, and intact restoration.

Question 17

What is direct pulp capping?

Answer 17

Application of a protective material directly onto an exposed pulp to maintain vitality.

Question 18

Why is direct pulp capping not recommended for primary teeth?

Answer 18

Primary pulp ages early, has fewer undifferentiated cells, and is prone to internal resorption.

Question 19

What are the main indications for pulpotomy?

Answer 19

Vital exposed pulp with limited inflammation and no advanced radiographic changes.

Question 20

What materials are used for pulpotomy in young permanent teeth?

Answer 20

Calcium hydroxide for apexogenesis and formocresol for primary teeth.

Question 21

What is the difference between calcium hydroxide and formocresol pulpotomy?

Answer 21

Calcium hydroxide promotes reparative dentin formation, while formocresol fixates pulp tissue.

Question 22

How is hemorrhage controlled during pulpotomy?

Answer 22

With a sterile cotton pellet for about 4 minutes.

Question 23

Why is a stainless steel crown often placed after pulpotomy?

Answer 23

To protect the weakened, brittle tooth structure post-treatment.

Question 24

What is a partial pulpectomy?

Answer 24

Removal of coronal pulp tissue and partial removal of radicular pulp.

Question 25

When is partial pulpectomy indicated?

Answer 25

In vital primary molars with hyperemia but no advanced necrosis.

Question 26

What is a pulpectomy in primary anterior teeth typically used for?

Answer 26

Devitalized primary anterior teeth due to caries or trauma.

Question 27

What materials are used for filling in pulpectomy for primary teeth?

Answer 27

Resorbable materials like calcium hydroxide or zinc oxide-eugenol.

Question 28

What are contraindications for performing pulpectomy in primary teeth?

Answer 28

Severe root resorption, extensive bone loss, or compromised patient cooperation.

Question 29

Why should pulpectomy be done cautiously in young permanent teeth?

Answer 29

To avoid trauma to developing roots and permanent tooth buds.

Question 30

What is the recommended filling material for pulpectomy in primary molars?

Answer 30

Zinc oxide-eugenol or oxypara.

Question 31

How does zinc oxide-eugenol affect the pulp?

Answer 31

It can cause chronic inflammation, abscess formation, and liquefactive necrosis.

Question 32

What is the effect of calcium hydroxide on the pulp?

Answer 32

It creates a superficial necrosis that stimulates a calcific barrier, promoting healing.

Question 33

Why is calcium hydroxide considered effective for pulp capping?

Answer 33

Its high pH (alkalinity) stimulates odontoblastic activity and dentin bridge formation.

Question 34

What is the initial pulp reaction to formocresol?

Answer 34

Surface fibrous fixation followed by inflammatory response deeper into the pulp.

Question 35

Why is formocresol controversial in pediatric dentistry?

Answer 35

Its potential systemic toxicity and link to internal resorption have raised concerns.

Question 36

What are the three zones observed under formocresol-treated pulp?

Answer 36

Fixation (acidophilic), atrophy (pale), and inflammation (deep layer).

Question 37

What is the most common sign of failure after pulpotomy?

Answer 37

Internal resorption visible on radiographs.

Question 38

What typically causes internal resorption after pulpotomy?

Answer 38

Osteoclastic activity stimulated by inflammation or irritation from capping materials.

Question 39

How can alveolar abscesses occur after pulp therapy?

Answer 39

Due to undetected pulp necrosis or inadequate sealing of the pulp chamber.

Question 40

Why is pulp therapy contraindicated in primary teeth near exfoliation?

Answer 40

The natural resorption of roots can lead to treatment failure.

Question 41

What are general contraindications for pulp treatment in primary teeth?

Answer 41

Poor patient cooperation, severe decay, or significant systemic health issues.

Question 42

What is the principle of electrosurgery pulpotomy?

Answer 42

Non-chemical devitalization through heat-induced pulp cauterization.

Question 43

Why is laser pulpotomy preferred over electrosurgery?

Answer 43

It creates a superficial coagulative necrosis while preserving underlying pulp tissue.

Question 44

What is a significant advantage of laser pulpotomy in children?

Answer 44

Minimal bleeding and reduced postoperative discomfort.

Question 45

Why are advanced pulpotomy techniques not widely adopted in all settings?

Answer 45

They require specialized equipment and may have higher costs.

Question 46

What is the goal of apexogenesis?

Answer 46

To maintain radicular pulp vitality and allow root development to completion.

Question 47

Which material is commonly used for apexogenesis?

Answer 47

Calcium hydroxide.

Question 48

Why is periodic radiographic evaluation important in apexogenesis?

Answer 48

To confirm root closure and absence of pathologic changes.

Question 49

What is apexification?

Answer 49

Inducing calcific closure of the root apex in non-vital young permanent teeth.

Question 50

What material is preferred for apexification?

Answer 50

Calcium hydroxide to stimulate calcific barrier formation.

Question 51

Why is careful follow-up essential during apexification?

Answer 51

To replace the calcium hydroxide if it washes out before closure.