Test Two Materials Flashcards
(110 cards)
1
Q
What are the three pulpal irritants?
A
- Microbial, 2. Mechanical and 3. Chemical
2
Q
What is the term used that means the prevention of infection penetration into vital pulp?
A
Asepsis
3
Q
What is the term used for non-vital cases where you remove necrotic tissue and all microorganisms?
A
Antisepsis
4
Q
What is the major type of bacteria present in endo?
A
Obligate anaerobic bacteria
5
Q
What bacteria is frequently found in failed RCTs?
A
E. faecalis
6
Q
What type of nerve fiber is found in the dentin?
A
Myelinated, A-fibers
7
Q
What type of nerve fiber is found in the pulp?
A
Unmyelinated, C-fibers
8
Q
What area is found interior to the odontoblast layer?
A
Cell free zone of weil
9
Q
What is interior to the cell free zone?
A
Cell rich zone
10
Q
What is the order of obtaining a diagnosis (five steps)?
A
- CC, 2. HH, 3. Oral exam + tests, 4. Correlate findings to differential diagnosis and 5. Formulate definitive diagnosis and treatment plan
11
Q
What are localization, commencement, intensity, provocation/relief and duration in the diagnosis process?
A
Subjective tests
12
Q
What are palpation, percussion/bite, mobility, periodontal exam and pulp testing in the diagnosis process?
A
Objective tests
13
Q
Name the five pulp vitality tests.
A
- Cold testing, 2. Heat, 3. Electric, 4. Test Cavity and 5. Selective Anesthesia
14
Q
What is the key to cold testing?
A
Duration
15
Q
What is the downside to electric testing?
A
Only vital tissue can be detected - false negatives common
16
Q
What’s the downside to a radiographic exam for diagnosis?
A
They are very subjective
17
Q
What type of bone must be dissolved by an endo lesion to show up radiographically?
A
Cortical bone - cancellous bone loss cannot be detected by radiographs
18
Q
What is it called when a pulpal lesion has an inflamed pulp and causes dentinoclastic activity?
A
Internal resorption
19
Q
What is it called when pulpal irritation causes the buildup of dentin in the canal?
A
Calcific Metamorphosis
20
Q
What is it called when calcified bodies appear in the pulpal space, but no pathology is present?
A
Pulp stones
21
Q
In order for internal resorption to occur, what must be true of the tooth?
A
It must be vital
22
Q
What is the major cause of endo pathophysiology?
A
Host response to irritation
23
Q
What three things do inflammatory mediators do?
A
- Vasodilation, 2. Increase vascular permeability and 3. Recruit inflammatory cells from blood to site of injury
24
Q
What are the five classifications of periapical Pathosis?
A
- SAP (sym. apical periodontitis), 2. AAP (Asym. apical perio.), 3. AAA (Acute apical abscess), 4. CAA (Chronic Apical Abscess) and 5. Condensing Osteitis
25
First extension of pulpal inflammation into periradicular tissues that is caused by an irreversible pulpitis describes:
Symptomatic Apical Periodontitis
26
What are the six possible irritants in SAP?
1. Irreversible Pulplitis, 2. Bacterial toxins, 3. Chemicals, 4. Hyperocclusion, 5. Overinstrumentation and 6. Overextension of obturation materials
27
Spontaneous pain, acute pain to biting or percussion, hot, cold, electric sensitivity, widened PDL and possible liquefaction necrosis refer to what?
Symptomatic Apical Periodontitis
28
What is the treatment for SAP?
RCT - vital teeth should be taken from occlusion too
29
Little or no pain, no response to pulp vitality test, slight sensitivity to palpation, widened PDL to Extensive lesion, Granuloma and apical cysts are symptoms of what?
Asymptomatic acute periodontitis
30
What condition is a variant of AAP?
Condensing Osteitis
31
What is it called when there is no irritation and an unknown cause makes the bone condense around the roots?
Osteosclerosis
32
Localized or diffuse liquefaction lesion of pulpal origin, destruction of periapical tissues, disintegrating PMNs, Necrotic pulp and abscesses within a granuloma describes?
Acute Apical Abscess (AAA)
33
Rapid onset of acute spontaneous pain to percussion, biting and palpation, moderate to severe discomfort and swelling, purulence, Lymphadenophy, Periapical radiolucency, no response from pulp vitality tests and varying degree of mobility are symptoms of which condition?
Acute Apical Abscess
34
What is the treatment for AAA?
Eventual RCT and possibly an I & D
35
An inflammatory lesion of pulpal origin, long standing lesion with the same histology as AAA describes?
Chronic Apical Abscess
36
Generally asymptomatic, not sensitive to biting, no response from pulp vitality tests, apical radiolucency and a mucosal or facial sinus tract describe:?
Chronic Apical Abscess
37
What is the treatment for a CAA?
Remove the irritant - RCT
38
How should a hyperplastic pulpitis, pulp polyp, irreversible pulpitis and necrotic pulp be treated?
RCT
39
What is the one periapical pathosis that is not treated with RCT?
Hyperocclusion
40
Stimulation uncomfortable, but reverses quickly, caries expose dentin, recent dental treatment, defective restorations and trauma are signs of what?
Reversible Pulpitis
41
What is the treatment for Reversible Pulpitis?
Eliminate cause - RCT NOT generally needed
42
Intermittent or spontaneous pain, stimulation resulting in heightened and prolonged response, minimal or no radiographic changes and pulp eventual necrosis describe:?
Symptomatic Irreversible pulpitis
43
What is caused by deep caries into the pulp space?
Asymptomatic Irreversible pulpitis
44
What term signifies the transportation of microbes to areas of tissue damage?
Anachoresis
45
What three ways does the pulp utilize to attempt to protect itself?
1. Decrease dentin tubule permeability, 2. tertiary dentin formation and 3. inflammatory/immune response
46
What is the scientific name for a pulp polyp?
Hyperplastic pulpitis
47
Extreme temperature exposure results in intense and prolonged pain - what is the diagnosis?
Irreversible Pulpitis
48
What three things should be done in an initial appointment to treat irreversible pulpitis?
1. Clean and shape, 2. Cotton pellet and 3. Relieve occlusion
49
Extreme percussion sensitivity describes what?
AAP
50
What is the treatment for irreversible pulpitis with AAP?
Complete pulpectomy/clean and shape, cotton/cavit and relieve occlusion
51
What should be done to treat a necrotic pulp with AAP?
Clean/shape, drainage (if possible), copious irrigation, cotton/cavit, relieve occlusion and antibiotics
52
What should be done to treat a necrotic pulp with drainage?
Clean/shape, copious irrigation, CaOH after drying, Cotton/cavit, relieve occlusion and antibiotics
53
What should be done to treat a necrotic pulp with no drainage?
Clean/shape, copious irrigation, CaOH after drying, Mucosal I&D, Cotton/cavit and antibiotics
54
What should be done to treat a necrotic pulp with drainage and diffuse swelling?
Clean/shape, copious irrigation, CaOH after drying, Cotton/cavit and antibiotics
55
What should be done to treat a necrotic pulp with no drainage and diffuse swelling?
Clean/shape, copious irrigation, Cotton/cavit, extra oral/intra oral drainage and antibiotics
56
What is the preferred method of draining a parulous lesion?
Through the tooth - next is with a blade
57
What are the four types of drains?
1. I, 2. T, 3. Christmas tree and 4. Penrose
58
What percentage of Enamel fractures cause pulpal necrosis?
1-2%
59
What is an uncomplicated crown fracture?
A fracture only involving enamel and dentin
60
What percentage of uncomplicated crown fractures lead to pulpal exposures?
1-7%
61
What two medicaments were listed as providing aid in an uncomplicated crown fracture?
1. CaOH and 2. VitraBond
62
What is a complicated crown fracture?
Involves Enamel, dentin and pulp
63
What percentage of complicated crown fractures will undergo necrosis without treatment?
100%
64
What medicament is primarily used for pulp capping?
CaOH
65
When would you use a Cvek pulpotomy?
On the day of injury - 80% success
66
What is the primary indicator for the needed depth of treatment in an exposed pulp case?
Time elapsed since exposure
67
What is the key problem with inflammation?
It decreases the success for vital pulp therapy
68
What procedure offers the most predictable success rate in mature teeth?
Pulpectomy
69
For immature teeth, what procedure should always first be attempted?
Vital pulp therapy
70
After pulpal therapy, what is the most important indicator of success?
Bacteria-tight seal
71
What are some of the benefits to using MTA (4)?
1. High pH, 2. Bacteria-tight seal, 3. Acts as a base for permanent restorations and 4. hardens
72
What are the three downsides to MTA?
1. Requires two appointments, 2. Grey - can't be used in anterior teeth and 3. Expensive
73
What two substances can be mixed with CaOH to thicken it?
1. Saline and 2. Anesthesia
74
Name two alternative substances to use as sealers.
1. ZOE and 2. glass ionomere
75
What three structures must be fractured to constitute a crown-root fracture?
Enamel, Dentin and Cementum
76
Occasionally a fractured tooth can be pulled out of the socket further and reshaped to fit a crown. What is this process called?
Extrusion
77
What treatment should be given to a horizontal root fracture that penetrates Dentin, Cementum and Pulp?
A splint should be applied (cervical/middle 1/3)
78
Trauma causing no displacement, no mobility, percussion sensitivity and requiring no treatment is known as:?
Concussion
79
Trauma causing no displacement, mobility, percussion sensitivity, possible sulcular bleeding and requiring no treatment is known as:?
Subluxation
80
Trauma causing displacment coronally, mobility, displacement and non-vital pulp testing is known as:?
Extrusive
81
Trauma resulting in displacement (mdbl) is known as?
Lateral displacement
82
Displacement apically is known as?
Intrussive
83
Why is apical displacement so bad?
High incidence of ankylosis
84
What is it called when the tooth completely leaves the socket?
Avulsion luxation
85
If the patient has a tooth knocked out with a closed apex and is able to reach the dental office in less than 60 minutes, what is your treatment plan?
Xray, irrigate socket, reimplant and splint two weeks with antibiotics. RCT should be done in one week's time with CaOH in 2 weeks
86
If the patient has a tooth knocked out with an open apex and is able to reach the dental office in less than 60 minutes, what is your treatment plan?
Doxycycline 5 minutes, minocycline, reimplant, splint, antibiotics and follow vitality at 2, 6 and 12 months
87
What should a tooth be stored in if it can be taken to the dentist in less that 60 minutes and has a closed apex?
Saline, milk or saliva
88
What should a tooth be stored in if it can be taken to the dentist in less that 60 minutes and has an open apex?
Saline
89
Should a tooth be out of the mouth more than 60 minutes, what is the biggest concern in survivability?
High ankylosis rate
90
If the patient has a tooth knocked out with an open apex and is able to reach the dental office in more than 60 minutes, what is your treatment plan?
RCT out of mouth, attempt reimplantation if at all possible
91
If the patient has a tooth knocked out with a closed apex and is able to reach the dental office in less than 60 minutes, what is your treatment plan?
Soak in 2% NaF 5-20 min., RCT in NaF soaked gauze, reimplant and splint 4 weeks
92
What is apexogenesis?
Vital pulp therapy to encourage continued physiologic development and formation of the root end
93
What procedure is performed on vital, reversible pulpitis teeth to keep them vital?
Cvek Pulpotomy
94
What are the five steps of Apexogenesis?
1. Pulpotomy (depth depends on exposure), 2. Control bleeding, 3. Rinse, 4. MTA or CaOH and 5. Temporize
95
What is apexification?
Knowing that a pulp cannot be kept vital, you place a calcific barrier across the open apex with pulpal necrosis with no lesion
96
What is used as the calcific barrier in apexification procedures?
MTA
97
How long does it take for a barrier to form in apexification?
9-24 months
98
A patient that has pulp necrosis, has an immature root apex, does not need pulp space for restorative purposes and has a coronal seal is likely a good candidate for what procedure?
Regendo
99
What is the first visit's objectives in regendo?
Access and remove necrotic tissue and dry with medicaments
100
What is the second visit's objectives in regendo?
Access, remove all antimicrobials, dry and file out apex to encourage bleeding, place a collagen matrix and permanent restoration and recall in 12-18 months
101
What is the problem with pulp testing in young individuals?
It may not work - nerves may not have developed in the tooth
102
What test is probably best for young individuals to test pulp health?
Cold test
103
What is the Hall Technique?
To place a stainless steel crown atop a deciduous tooth without removing any of the caries
104
When can direct pulp capping be used?
When small mechanical or traumatic exposure occured - not carious!
105
What medicament is frequently used with vital pulps?
Formacresol
106
How does the working length (WL) change when working with deciduous, non-vital teeth?
WL is 2-3 mm short of radiographic length
107
What must NOT be done when performing RCT on non-vital deciduous teeth?
No perforations - thin walls
108
When should you use a small round bur in RCT?
Never! It causes perforations
109
J-shaped lesions tend to be what?
Fractured roots
110
How does bone loss differ from perio to endo?
Bone loss heavier coronially for perio, and apically for endo
