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D117 > 1-1 Disease of the Pulp > Flashcards

1-1 Disease of the Pulp Flashcards

1
Q

Cardinal signs of inflammation

A
  1. rubor (redness)
  2. tumor (swelling)
  3. calor (heat)
  4. dolor(pain)
  5. function laesa (loss of function)
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2
Q

features of the pulp that makes it unusually fragile and sensitive (Regezi)

A
  1. encased by hard tissue that does not allow for the usual swelling associated with the exudate of the acute inflammatory process
  2. pain/dolor is the only symptom that would determine the severity of the inflammation in most cases
  3. no collateral circulation to maintain pulp vitality
  4. biopsies and direct application of chemical would cause organ death
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3
Q

Etiology of pulp diseases

A
  1. caries
  2. operative procedures (mechanical irritants)
  3. trauma
  4. periodontal diseases
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4
Q

most frequent etiology of pulp diseases and how/route

A

CARIES

-MO would go inside the pulp via route of the dentinal tubules

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5
Q

T/F Degree of damage depends on the rapidity and extent of hard tissue destruction

A

true

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6
Q

T/F Entry of bacteria into the pulpal tissue through a carious lesion is necessary for pulpitis to occur

A

false

not necessary

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7
Q

usually the cause of pulpitis of a “virgin tooth”

A

periodontal disease

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8
Q

periodontal disease follows a ___ path

A

RETROGRADE path

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9
Q

Classification of Pulp Disease

A
  1. Focal reversible/Reversible Pulpitis
  2. Irreversible pulpitis
    a. acute irreversible
    b. chronic irreversible
    • Variant: Chronic hyperplastic pulpitis
  3. Pulpal Necrosis
    a. Partial necrosis
    b. total necrosis
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10
Q

test wherein a tooth is subjected to a mild electric current (closed circuit) and response is recorded

A

electric pulp testing

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11
Q

function of electric pulp testing

A

tests the vitality of the pulp

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12
Q

a test wherein a tooth is tapped with the butt end of a mouth mirror

A

percussion test

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13
Q

function of percussion test

A

determine the integrity of the periodontal ligament

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14
Q

other test to determine integrity of pdl aside from percussion test

A

palpation

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15
Q

T/F For pulpitis, palpation and percussion test is positve

A

false

negative since only the pulp is involved

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16
Q

define focal/reversible pulpitis

A

acute, mild inflammatory pulpal reaction that typically follows carious destruction of a tooth or placement of a large metallic filling without an insulating base
“reversible” -only needs some management

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17
Q

Symptoms of Focal/reversible pulpitis

Pain Quality

A

Mild to moderate

intermittent (pain is dependent on the application of stimulus)

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18
Q

Symptoms of Focal/reversible pulpitis

Duration of Pain

A

short (10 sec - 30 sec)

disappears upon removal of stimulus

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19
Q

Symptoms of Focal/reversible pulpitis

Stimulus needed

A

Yes

pain is provoked by cold/sweet (not hot)

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20
Q

Symptoms of Focal/reversible pulpitis

Sensitivity to percussion

A

no response

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21
Q

Symptoms of Focal/reversible pulpitis

sensitivity to palpation

A

no response

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22
Q

Symptoms of Focal/reversible pulpitis

mobility

A

no unless there is concomitant plaque - induced periodontitis

23
Q

Symptoms of Focal/reversible pulpitis

PPD

A

not greater than 3mm unless there is concomitant plaque-induced periodontitis

24
Q

Symptoms of Focal/reversible pulpitis

Pain Quality

A

Mild to moderate

intermittent (pain is dependent on the application of stimulus)

25
Q

Symptoms of Focal/reversible pulpitis

Duration of Pain

A

short (10 sec - 30 sec)

disappears upon removal of stimulus

26
Q

Symptoms of Focal/reversible pulpitis

Stimulus needed

A

Yes

pain is provoked by cold/sweet (not hot)

27
Q

Symptoms of Focal/reversible pulpitis

Sensitivity to percussion

A

no response

28
Q

Symptoms of Focal/reversible pulpitis

sensitivity to palpation

A

no response

29
Q

Symptoms of Focal/reversible pulpitis

mobility

A

no unless there is concomitant plaque - induced periodontitis

30
Q

Symptoms of Focal/reversible pulpitis

PPD

A

not greater than 3mm unless there is concomitant plaque-induced periodontitis

31
Q

Other observations of Focal/reversible pulpitis

EPT

A

responds to lower levels of current than normal teeth

32
Q

Teeth condition that are possible portals of entry for the bacteria from the saliva to cause inflammation

A
  1. deep caries
  2. large metallic resto
  3. defective margins
33
Q

Histological features of focal/reversible pulpitis

A

hyperemia (predominant feature of reversible pulpitis)

34
Q

what’s hyperemia

A

dilation and engorgement of blood vessels, characteristic of any inflammation

35
Q

Pulp testing responses of reversible pulpitis

Stimuli: thermal

A

hypersensitive-short-mild

36
Q

Pulp testing responses of reversible pulpitis

Stimuli:sweets

A

sensitive-short-mild

37
Q

Pulp testing responses of reversible pulpitis

Stimuli: Biting pressure

A

none-none-none

38
Q

Thermal testing

Heat test vs cold test

A

Heat test: uses heated gutta percha cone and apply it to the tooth and see how fat the tooth reacts and how long pain will linger

Cold test: ice

39
Q

Clinical findings in reversible pulpitis

Visual inspection

A

check for decay, fracture lines, orientation of tooth and hyper occlusion

40
Q

Clinical findings in reversible pulpitis

palpation

A

no response

41
Q

Clinical findings in reversible pulpitis

percussion

A

no response

42
Q

Clinical findings in reversible pulpitis

mobility

A

none unless perio condition existed

43
Q

Clinical findings in reversible pulpitis

periodontal probing

A

within normal limits

44
Q

Clinical findings in reversible pulpitis

thermal testing

A

hypersensitive response to cold

heat is for irreversible?

45
Q

Clinical findings in reversible pulpitis

EPT

A

positive response

46
Q

Clinical findings in reversible pulpitis

transillumination

A

little use unless a fracture is the cause

47
Q

test used to detect tooth fracture

A

transillumination

48
Q

Clinical findings in reversible pulpitis

radiographic exam

A

normal periapical area

49
Q

Clinical findings in reversible pulpitis

selective anesthesia

A

usually not necessary

50
Q

Clinical findings in reversible pulpitis

test cavity

A

usually not necessary bec tooth is vital

51
Q

why is selective anesthesia not used that much?

A

teeth are in close proximity to one another and there’s a common nerve supply so it’s hard to determine where the pain was felt particularly

52
Q

what’s test cavity

A

to know if the tooth is vital, they bur it out and if it does not cause pain even if it’s already deep, then pulp is dead

53
Q

Tx for focal/reversible pulpitis

A

remove irritant if present
if no pulp exposure: use CaOH base, direct/indirect pulp capping, restore
presence of pulp exposure: carious=initiate RCT
mechanical=
>1mm-initiate RCT
<1mm crown planned-initiate RCT
<1mm-direct pulp cap or RCT

if irritant is not present. postpone and monitor

D117 (2 decks)

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