11. CDS Endodontics

Question 1

Describe the clinical and pathological sequence of leaving caries untreated in an adult molar tooth

Answer 1

Enamel - caries spread will start in enamel of pit and fissure system
Chronic reversible pulpitis - once caries has spread through enamel to reach ADJ, it will progress rapidly along ADJ and spread through dentinal tubules where they are widest. At this stage there is bacterial infection and pulp irritation
Chronic irreversible pulpitis - caries reaches pulp chamber and patient experiences pain caused by hydrostatic pressure of dentinal fluid and inflammation of blood vessels within pulp
Pulp necrosis - infection has spread to pulp chamber and down root and irreversible damage is done. At this stage an abscess may be seen as inflammation spreads to gingiva
Treatment options are RCT or extraction

Question 2

What fibres contribute to pain sensation and are therefore anaesthetised by LA

Answer 2

A-delta and C fibres