care of the pulp Flashcards
what are some signs of non vital teeth
discolouration
no response to sensibility testing
gross caries
large restorations
radiographic evidence
-radiolucency
what sensibility tests are there?
hot gutta percha
cold ethyl chloride
electrical pulp test
test drilling
what issues can there be with sensibility testing?
nerve fibres not always correlate to vitality, related to blood flow
periradicular inflammation occur before proper pulpal necrosis
difficulty with multi-rooted teeth
what are positive and negative results for electrical pulp tests?
positive is tingling feeling in tooth and means vital coronal pulp but no indication of reversibility
negative is no feeling, reliable indicator for pulpectomy required
what are positive and negative results for thermal testing? any issues?
sharp pain then dull radiating pain for heat, or very cold for cold testing
not too reliable
too much heat can cause irreversible pulpitis
negative test indicative of necrotic pulp
what is test drilling and when used?
on very large and full restorations
no local given, pain or no pain when cutting tooth is test indicator of vitality
what clinical factors increase risk of irreversible pulpal issues?
carious pulpal exposures
age as tertiary dentine deposition decreases pulpal size and ability to fight infection
periodontal disease leads to prematurely aged pulp
pulpal trauma
how is calcium hydroxide used in pulpal treatment?
any issues?
bactericidal and reparative effect on dentine and promotes recalcification
cytotoxic so can kill pulpal cells
