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PEDO Midterm (Fall) > 7. Pulp Therapy > Flashcards

7. Pulp Therapy Flashcards

1
Q

Define indirect pulp cap

A
  • Biocompatible material placed in deep carious tooth approximating the pulp
  • No signs of pulpal degeneration or exposure
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2
Q

Define Direct pulp cap

A

Pinpoint mechanical exposure during prep covered with biocompatible material

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3
Q

Define pulpotomy

A

-Removal of pulp in the chamber with the intent to maintain the vitality of the radicular pulp

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4
Q

Define pulpectomy

A

Removal of entire pulp (coronal and radicular)

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5
Q

What is the typical restoration for a primary tooth after indirect pulp cap

A

SSC

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6
Q

What materials can be used for indirect pulp capping

A
  • RMGI (vitrebond)

- CaOH2 followed by vitrebond

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7
Q

Which has a higher success rate indirect pulp capping or pulpotomy for primary teeth

A

indirect pulp cap

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8
Q

Success of indirect pulp capping is dependent on what

A

accurate pulpal diagnosis

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9
Q

Indirect pulp capping will not be successful if

A
  • Furcation RL (or PA RL)

- Pathologic root resorption

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10
Q

What materials are used for direct pulp cap

A

MTA or CaOh2

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11
Q

Direct pulp cap is not recommended for pulp exposures that are _

A

carious (should be a mechanical pulp exposure)

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12
Q

What should you due for a carious pulp exposure

A

pulpotomy

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13
Q

(T/F) After a pulpotomy the tooth should remain in place and exfoliate at the normal time

A

t

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14
Q

After a pulpotomy you may see _ resorption but you should not see

A

internal… pathologic external root resorption

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15
Q

What are the criteria for a primary tooth pulpotomy

A
  • Pulp exposure
  • Dx normal or reversible pulpitis (reversible pulptitis= pain with stimulus no spontaneous pain)
  • Clinical exam (no mobility, fistula, no pain with percusion and must be restorable)
  • Radiographic exam (no furcation involvement or PA RL Want at least 2/3rds of the root remaining)
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16
Q

Contraindications for a pulpotomy

A
  • Pulpal Dx or irreversible pulpitis (spontaneous pain- does your child wake up at night with a toothache)
  • Clinical pathology (Swelling, fistula, pathologic mobility, pain with percussion)
  • Radiographic pathology (Furcation/periapical lucency, external root resorption)
  • Unrestorable tooth
  • Excessive bleeding after coronal pulp amputation
  • No bleeding after coronal pulp amputation (necrosis)
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17
Q

Preparation of a tooth for a SSC should occur (before/after) the pulpectomy

A

before

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18
Q

Coronal pulp removal should be done with what bur

A

Round bur slow speed

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19
Q

Hemorrhagic pulp means what

A

inflammation has spread to radicular pulp

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20
Q

During a pulpotomy the chamber should be treated with any one of these three medicaments

A
  • Foromcresol
  • Ferric sulfate
  • MTA
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21
Q

Coronal filling after a pulpotomy should be done with

A

IRM

22
Q

The ideal pulpotomy medicament has what properteries

A

Bactericisal
Harmless to pulp and surroundign tissues
Promote healing of radicular pulp
Not interfere with physiologic process of root resorption

23
Q

Foromcresol should be placed in the chamber for how long

A

5 mins

24
Q

Foromcresol can be diluted to what ratio

A

5:1

25
Q

What is the gold standard medicament for pulpotomies

A

formocresol

26
Q

What is formocresol made of

A

formaldehyde and cresol

27
Q

Is foromcresol bactericidal

A

yes

28
Q

What are the cons of formocresol

A
  • Can cause inflammarory responses or necrosis in remaining radicular pulp (leads to internal root resorption)
  • Potentially immunogenic, carcinogenic (formaldehyde)
29
Q

Success rate of formocresol is

A

70-90%

30
Q

Directions for ferric sulfate use are

A

apply to pulp chamber for 10-15 sec and rinse

-Seals BVs –> hemostasis

31
Q

Success rate of ferric sulfate is

A

81-97%

32
Q

Is ferric sulfate bactericidal

A

no

33
Q

Which material for pulpotomies has the highest success rate

A

MTA (Close to 100%)

34
Q

MTA sets in the presence of what

A

moisture

35
Q

pH of MTA is _ similar to that of _

A

12.5… CaOH2

36
Q

Is MTA antimicrobial

A

yes

37
Q

does MTA has cytotoxic effects like formocresol

A

no

38
Q

what are the cons of MTA

A

expensive and hard to work with

39
Q

Does MTA promote hard tissue formation

A

yes

40
Q

Pulpectomy is indicated when

A
  • Pulpal Dx is necrosis or irreversible pulpitis

- Hemorrhagic coronal pulp removal

41
Q

Filling material for a pulpectomy must be _ such as….

A

resorbable such as iodoform/CaOH2

42
Q

Why can pulpectomies cause ectopic eruption

A

it is hard to resorb the filling materia

43
Q

Pulpectomy is limited to what teeth

A

2nd primary molars

Maxillary incisors

44
Q

Pulpectomies with _ root systems are difficult

A

Narrow and flared

45
Q

T/F overinstrumentation during a pulpectomy can damage the permenant tooth

A

t

46
Q

Root formation is generally complete _ years after eruption

A

3 years

47
Q

For an immature permanent tooth- bleeding is controlled in pulpotomy by

A

irrigation or chlorhexidine or sodium hypochloritie

48
Q

Cvek pulpotomies can be done for teeth that have undergone

A

traumatic exposures

49
Q

What is apexogenesis

A

continued physiologic development and formation of the root’s apex

50
Q

What is apexification

A
  • Method of introducing end closure of an incompletely formed non-vital permanent teeth
  • Non-vital pulp tissue removed just short of the root end
  • Biocompatible CaOH2 placed in canal space to disinfecrt
  • Apical barrier (MTA) placed
  • Fill with gutta percha

PEDO Midterm (Fall) (8 decks)

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