1. Care of the Pulp Flashcards
Pulp composition (5)
Cells Nerves BVs Vital tissue Parts of dentine-pulp complex
Functions of the pulp (4)
Nutrition
Sensory
Protective
Formative
Pulpal injuries (8)
Caries Cavity prep Restoration Trauma Tooth wear Periodontal pahtology Orthodontic treatment Radiation therapy
Restorative material pulp injury due to (8)
Toxicity pH of water Water absorption Heat of reaction Poor marginal adaptation/seal Cementation of restoration Impression making Agents for treating dentine
Relationship between cavity depth and dentine permeability
Deeper the cavity, greater the dentine permeability
Dentine permeability is affected by (6)
Bacteria substances Polysaccharides Antibodies Immune complexes Complement proteins Tissue destruction products
Cause of dental pain (2)
A-fibres
C-fibres
Pulpal diagnoses (6)
Healthy pulp
Reversible pulpitis
Irreversible pulpitis (symptomatic/asymptomatic)
Necrotic pulp
Previously treated
Previously initiated therapy (RCT not finished)
Periapical diagnoses (5)
Normal Periapical periodontitis (symptomatic/asymptomatic) Acute apical abscess Chronic apical abscess Condensing osteitis
Clinical definition of healthy pulp (2)
Vital
Free of inflammation
When would a healthy tooth be removed
If endo treatment is indicated for elective/prosthetic purposes
Clinical definition of reversible pulpitis (3)
Vital
Pulpal inflammation
Demonstrates a regular response to sensibility tests
Clinical definition of irreversible pulpitis (3)
Symptomatic/asymptomatic
Occurs in vital tooth
Pulpal inflammation
Treatment options for irreversible pulpitis (2)
Pulpectomy, RCT
Extraction
Difference between reversible or irreversible pulpitis (2)
Depends on clinical symptoms
Reversible pulpitis - pain to cold, lasts a short time; hydrodynamic expression (microleakage)
Irreversible pulpitis - spontaneous pain, negative to cold (pain to hot), increase in plural blood flow
Types of necrotic/non-vital pulp (2)
Partial
Total
Treatment options for necrotic pulp (2)
RCT/extraction (mature teeth)
Pulpotomy, RCT/extraction (immature teeth)
Definition of pulpotomy
Partial removal of dead pulp
Definition of pulpectomy
Full removal of pulp
Features of normal periodical tissue (2)
Not sensitive to percussion/palpation
Normal radiograph
Features of symptomatic periodical periodontitis (3)
Inflammation of apical periodontium
Pain caused by biting, percussion, palpation
Periodical radiolucency radiographically
Features of asymptomatic periodical periodontitis (3)
Inflammation and destruction of apical periodontium (of plural origin)
Periodical radiolucency radiographically
No present clinical symptoms
Features of acute apical abscess (4)
Inflammatory reaction to plural infection and necrosis
Rapid inset, results in spontaneous pain
Extremely tender to pressure, results in swelling and pus formation
Malaise, fever, lymphadenopathy
Features of chronic apical abscess (4)
Inflammatory reaction to plural infection and necrosis
Gradual onset, little/no discomfort
Intermittently discharge pus through sinus tract
Results in radiographic periodical/periradicular radiolucency
Features of condensing osteitis (3)
Localised bony reaction to a low-grade inflammatory stimulus
Seen at apex of tooth
Diffuse radiopaque lesion
Signs that a tooth may be non-vital (5)
Discolouration (yellow/grey/pink) Sinus Gross caries Large restorations Radiographic evidence (periapical/periradicular radiolucency)
Primary function of a sensibility test
To differentiate vital from non-vital pulp
Types of sensibility test (3)
EPT
Thermal tests (hot/cold)
Test drilling
Types of thermal test (2)
Cold test - ethyl chloride
Hot test - hot gutta percha stick
Associated clinical factors when considering pulp care and treatment (4)
Carious pulp exposure
Age
Periodontal disease
Previous pulpal insult/trauma
Previous pulpal insult includes (4)
Caries
Caries removal
Restorative procedures
Involves tubular occlusion
Function of CaOH
Encourage tertiary dentine formation. It has bactericidal/bacteriostatic action, but is cytotoxic
Treatment of plural damage (4)
Placing an indirect pulp cap/stepwise excavation
Direct pulp cap
Partial plural removal (pulpotomy)
Full plural removal (pulpectomy and then RCT)
