After Midterm: Lec Dentin Pulp Complex 2

Question 1

Most accepted theory of dentin sensitivity:

Answer 1

Hydrodynamic

Question 2

The other 2, not as accepted theories:

Answer 2

transduction, direct innervation

Question 3

Are nerves present in dentinal tubules?

Answer 3

yes

Question 4

Nerves that are directly activated in the dentinal tubules:

Answer 4

free nerve endings

Question 5

Theory of transduction:

Answer 5

sensation is transduced from odontoblasts to nerves through junctions

Question 6

Are there GAP junctions bw odontoblasts and nerves?

Answer 6

no

Question 7

Hydrodynamic theory:

Answer 7

inward and outward movements of dentinal fluid activates sensory fibers by mechanotransduction

Question 8

Causes of fluid movement:

Answer 8

dehydration, osmotic changes (sugary foods), mechanical probing, thermal probing

Question 9

Stimuli leading to pulpal response:

Answer 9

direct exposure, crack, caries, restorative proc, cold, heat, osmotic differential

Question 10

1’ cause for endo failure:

Answer 10

bacteria

Question 11

TF? Direct exposure of the pulp to the oral environment will always require endo.

Answer 11

T

Question 12

Do caries need to be in pulp to cause pulpal changes?

Answer 12

no

Question 13

These can get to the pulp before caries:

Answer 13

Bacteria and their byproducts

Question 14

Most common cause of pulpal pathosis:

Answer 14

caries

Question 15

When is bacteria able to enter tubules:

Answer 15

once it reaches the DEJ

Question 16

TF? The pulp only get irritated once the bacteria reaches it.

Answer 16

F. before

Question 17

TF? Caries must reach the pulp before necrosis starts.

Answer 17

T

Question 18

Inflammation and necrosis occur via:

Answer 18

toxic action, immune response, or frank invasion of bacteria

Question 19

Ondontolbasts can be damaged due to:

Answer 19

deep preparations, drying of tubules, not enough water during drilling

Question 20

TF? The pulp does not need to be exposed to undergo necrosis.

Answer 20

T, microabscess can lead to this

Question 21

how do dentinal tubules changes as you approach the pulp?

Answer 21

inc in diameter and number

Question 22

How does the dentin change as you approach the pulp?

Answer 22

more permeable

Question 23

Cold stimuli, fast or slow response?

Answer 23

fast

Question 24

Cold stimuli, inward or outward flow?

Answer 24

outward

Question 25

Cold stimuli causes:

Answer 25

fluid contraction

Question 26

Cold stimuli, expansion or constriction?

Answer 26

constriction

Question 27

Is outward flow negative or positive pressure?

Answer 27

negative

Question 28

Heat, inward or outward flow?

Answer 28

inward

Question 29

heat response, slower or faster response?

Answer 29

slower

Question 30

Heat response, negative or positive pressure?

Answer 30

positive

Question 31

Heat stimuli, fluid expansion or contraction?

Answer 31

fluid expansion

Question 32

Heat stimuli, slower or faster expansion?

Answer 32

slower

Question 33

Produces stronger nerve response, outward or inward flow?

Answer 33

outward

Question 34

Produces stronger nerve response, cold or hot stimuli?

Answer 34

cold

Question 35

Most common cause of osmotic differential:

Answer 35

sugars (refined carbs)

Question 36

Direction of fluid flow in dentinal tubules:

Answer 36

deeper tubules to coronal tooth structure

Question 37

Where in the tooth is there a lower osmotic pressure/ less solute?

Answer 37

deeper part of tubule

Question 38

TF? The deeper part of the tubule has a higher osmotic pressure/ more solute.

Answer 38

F, coronal portion

Question 39

TF? Pain after eating, expect carious lesion.

Answer 39

T

Question 40

What does the unyielding walls of dentin lead to:

Answer 40

limited space for pulpal swelling

Question 41

What does the constricted blood source of the pulp lead to:

Answer 41

limited blood supply, subject to "strangulation" by swelling.

Question 42

What does the tooth being surring by PDL/bone lead to?

Answer 42

PDL/ bone infalmmation

Question 43

Major blood source for tooth:

Answer 43

apical foramen

Question 44

3 major factors of pulpal response to irritants:

Answer 44

intensity, duration, host response

Question 45

TF? Innate immunity is specific immunity

Answer 45

F. non-specific

Question 46

Aspects of innate immunity:

Answer 46

histamine, bradykinin, arachidonic acid, neuropeptides

Question 47

What do histamine, bradykinin, arachidonic acid, neuropeptides all result in:

Answer 47

vasodilation, vascular permeability

Question 48

Cells that make histamine:

Answer 48

mast cells

Question 49

Products (?) of arachidonic acid:

Answer 49

prostaglandins, thromboxanes, leukotrienes

Question 50

Neuropeptides:

Answer 50

Calcitonin gene-related peptide (CGRP), Substance P (SP), Neurokinin A (NKA)

Question 51

Innate immunity, specific or non-specific?

Answer 51

non-specific

Question 52

Complement effect on bac:

Answer 52

cell lysis

Question 53

Phagocytes involved in innate immunity:

Answer 53

dendritic cells, PMN, mac

Question 54

PMNs, acute or chronic response?

Answer 54

acute

Question 55

mac, acute, chronic, or response to both?

Answer 55

chronic

Question 56

Goal of phagocytes:

Answer 56

engulf and remove bac and their byproducts

Question 57

TF? All cells involved in innate immunity are involved in antigen presentation.

Answer 57

F

Question 58

1st arrivers in innate immunity:

Answer 58

PMNs

Question 59

What do both B and T cells release?

Answer 59

cytokines --> more inflammation

Question 60

TF? T cells are involved in humoral immunity.

Answer 60

F. cell mediated

Question 61

What does pulp vitality depend upon?

Answer 61

normal cap blood flow and transcapillary fluid exchange

Question 62

Can the pulp become necrotic without being infected?

Answer 62

yes

Question 63

What can result in fluid displacement to be incompatible with pulp vitality?

Answer 63

marked deviations from normal pressure throughout pulp

Question 64

TF? Pulp can bc necrotic wo being infected.

Answer 64

T

Question 65

Pressure cycle:

Answer 65

fluid leaves vasculature, inc interstitial pressure, dentin = pressure can't dissipate, microvasculature shutdown, release of breakdown products, necrosis, inc interstitial osmotic pressure, osmotic attraction draw more fluid from caps, inc interstitial pressure, inc necrosis, inc vessel permeability w fluid outflow and pressure inc, reversal s futile w formation of inflammatory exudate

Question 66

Fluid leaving the vasculature, does this inc interstitial hydrostatic or osmotic pressure?

Answer 66

hydrostatic

Question 67

Do solutes inc or dec interstitial osmotic pressure?

Answer 67

inc

Question 68

What draws more fluid from capillaries after solutes inc the interstitial osmotic pressure?

Answer 68

osmotic attraction

Question 69

As interstitial pressure increases, _this__ inc/dec.

Answer 69

necrosis inc

Question 70

TF? Vessel permeability dec w fluid outflow and increase in pressure.

Answer 70

F. inc

Question 71

Direction of pulpal necrosis:

Answer 71

coronal-apical direction

Question 72

inflammation moves apically as __ moves apically.

Answer 72

antigens

Question 73

Does the pulp die via strangulation at the apex?

Answer 73

no

Question 74

As pulpal necrosis spread through pulp, is the PDL affected or infected?

Answer 74

affected

Question 75

This is req for periapical disease:

Answer 75

bacteria

Question 76

When does inflammatory response in bone begin?

Answer 76

once antigens are beyond apical foramen

Question 77

What happens as bone is resorbed due to antigens leaving apical foramen?

Answer 77

granulation tissue filsl the space --> LEO

Question 78

TF? Pulp must be necrotic and infected to have a LEO.

Answer 78

T

Question 79

How to determine whether there is a LEO:

Answer 79

pulp test