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Endotontics > Apexogenesis, Apexification, and Regeneration > Flashcards

Apexogenesis, Apexification, and Regeneration Flashcards

1
Q

apexogenesis main concept with it

A

maintain the pulp vitality

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2
Q

goal of apexogenesis

A

preservation of vital pulp tissue so that continued root development with apical closure may occur

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3
Q

when can you do apexogensis

A

addressing the shortcomings involved with capping the inflamed detnal pulp of an INCOMPLETELY DEVELOPES

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4
Q

what are two components you consider with these therapies

A
  1. PULP VITALITY
  2. AGE OF PATIENTS
  • same clinical picture
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5
Q

choice of tx with necrotic 10 years old vs necrotic and 25 years old

A
  1. 10 years – regeneration

2. 25 years – apexification

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6
Q

apexification procedure aims to do what

A

form a plug at the apex

  1. induce a hard tisssue barrier in a tooth with an open apex
  2. or the continued apical developmment of an incomplete root in teeth with apical periodontisis
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7
Q

pulp reaction to caries

A

poor tolerance to injury

large volume of tissue with a small volume of blood supply

terminal circulation (collateral vessels?)

confined in calcified tissue

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8
Q

carries progressiuon what radiograph ? what is the bacterial penetration

A

BITEWING

bacterial penetration that is less than .75 mm away from the pulp

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9
Q

carries progressiuon what radiograph ? what is the bacterial penetration

A

BITEWING

bacterial penetration that is less than .75 mm away from the pulp

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10
Q

vital pulp therapy example

A

apexogenesis

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11
Q

clincial procedure of apexogenesis is basically a

A

a deep pulpotomy

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12
Q

how do you apexogeneis (3)

A
  1. direct pulp capping
  2. indirect pulp capping
  3. pulpotomy
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13
Q

indirect

A

still some dentin between pulp and p

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14
Q

direct

A

right into the pulp

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15
Q

pulpotomy

A

resecting coronal part

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16
Q

indications for vital pulp therapy

A
  1. truamatic injuries
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17
Q

mm for indirect vs direct pulp cap

A

less than 2mm – can do a DIRECT PULP CAP

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18
Q

material of choice for pulpotomoy

A

MTA (or a bioceramic)

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19
Q

follow up after pulp capping and pulpotomy

A

should be seen periodically for the next 2-4 years

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20
Q

evidence that an apexogenesis was successful?

A

continued root formation/ development (length and wall thickness) and calcific batterir formation in response to the dressing

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21
Q

apexification is what?

A

root-ended closure, whereby a NON-VITAL, IMMATURE, PERMANENT tooth has LOST the ability for further root development is induced to form a calcified barrier at the root terminus

22
Q

what will apexification NOT cause

A

will NOT CAUSE further root development in terms of length or wall thickness

23
Q

apexification acts as a?

A

barrier so your root canal filling can be compacted with length control
- considered a last resort treatment

24
Q

why apexificatoin instead of conventional RCT?

A
  1. open apex
  2. blunderbuss canals
  3. thin and fragile canal walls
  4. absolute dryness of canals diffult to achieve
25
Q

Advantages of MTA/ bioceram with apexification

A
  1. reduction in tx time
  2. biocompatible material
  3. osteo-inductive properties
  4. moisture compatibility
  5. No CaOH disadvantages
26
Q

Advantages of MTA/ bioceram with apexification

A
  1. reduction in tx time
  2. biocompatible material
  3. osteo-inductive properties
  4. moisture compatibility
  5. No CaOH disadvantages
27
Q

regeneration advantages

A
  1. root elongation
  2. thickening of roots
  3. formaiton of morphologic apex
28
Q

flow chart that reaches regeneration

A

pulp exposure – non-vital pulp– open apex (immature) –young patient – regeneration

29
Q

rely on what in regeneration

A

apical stem cells

apical dental papilla

30
Q

if successful what does regeneration allow for

A

continued root development, thicker dentin walls, longer root length, and a closed apex, thus reducing the risk of fracture, in immature and structurally vulnerable teeth

31
Q

biological principles of regeneration (3 aspects that are required)

A
  1. scaffold
  2. progenitor or stem cells
  3. growth factors
32
Q

what differentiation do you need

A

stem cells capable of differentiating into an odontblast

33
Q

adult stem cells are what type?

describe

A

multipotent
- divide and create another cell like itself, also a cell more differentitated than itself

ability to divide into other cell types is more limited

34
Q

adult stem cells are what type?

describe

A

multipotent
- divide and create another cell like itself, also a cell more differentitated than itself

ability to divide into other cell types is more limited

35
Q

scaffold describe and give examples

A

provides support for cell organization, proliferation, differentiation and vascularization

mostly utalized scaffolds are dentin or blood clot

others

  • platalet rich plasma
  • biodegradable or permanent or syntehtic scaffolds
36
Q

can you intrsument a regeneration case?

A

NO – you will get rid of the growth factors!

previously instrumented is no good for regeneration

37
Q

can you intrsument a regeneration case?

A

NO – you will get rid of the growth factors!

previously instrumented is no good for regeneration

38
Q

age range for regeneration recommended by ADA

A

6-18 years old

39
Q

step 1 for regeneration

A

everything youd do for access and irrigate with diluted hypochloride

1.2-2.25?

40
Q

what happens if leave calcium hydroxide in tooth for 4 weeks

A

it can weaken the dentin

41
Q

how long doyou leave calcium hydroxide in teh tooth for

A

2-3 weeks

42
Q

do you use epinephrine in regeneratin? why?

A

NO

- rely on scaffolding and need the bleeding so we do not want to lose the scaffolding

43
Q

LA use for regeneration

A

mepivicaine 3%

44
Q

step 2 do you use sodium hypochloride?

A

NO – only EDTA

45
Q

step 2 do you use sodium hypochloride?

A

NO – only EDTA

46
Q

three goals for regenration? set by?

general

A

primary
secondary
tertiary

47
Q

primary goal of regenration

A

elimination of symptoms and evidence of bony healing

48
Q

secondary goal

A

increased root wall thickness and/or increased root length

49
Q

tertiarty goal

A

positive response to vitality testing

50
Q

ultimate goal of regeneration*

A

histologic confirmation of functional dental pulp (with an intact odontoblastic layer)

Endotontics (21 decks)

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