Care of the Pulp

Question 1

what cells are in the pulp

Answer 1

odontoblasts

Question 2

what nerves are in the pulp

Answer 2

Alpha fibres
C fibres

Question 3

what happens to dentine tubules as they approach the pulp

Answer 3

increase in number and diameter

Question 4

what fibres cause sharp pains that are stimulated by electric pulp tests

Answer 4

alpha fibres

Question 5

what fibres cause a dull aching pain due to increase pulpal blood flow and pressure

Answer 5

C fibres

Question 6

what is reversible pulpitis

Answer 6

vital tooth
inflamed pulp which has potential to heal

Question 7

what is the treatment for reversible pulpitis

Answer 7

treat the caries causing the irritation

Question 8

what is irreversible pulpitis

Answer 8

vital tooth
inflamed pulp which cannot heal

Question 9

what are the treatment options for irreversible pulpitis

Answer 9

pulpectomy required after RCT
extraction

Question 10

what are features of reversible pulpitis

Answer 10

pain to cold which lasts a short time
no change in pulpal blood flow

Question 11

what are features of irreversible pulpitis

Answer 11

spontaneous pain, sleep disturbance
increase in pulpal blood flow

Question 12

what is a necrotic pulp

Answer 12

non-vital pulp which has partial or total necrosis

Question 13

what is the treatment for a necrotic pulp

Answer 13

RCT or XLA in mature teeth
pulpotomy/ pulpectomy/ XLA in immature teeth

Question 14

what is symptomatic periapical periodontitis

Answer 14

inflammation of apical periodontium with pain on biting and TTP - could have periapical radiolucency

Question 15

what is asymptomatic periapical periodontitis

Answer 15

inflammation and destruction of apical periodontium
no clinical symptoms
appears as apical radiolucency

Question 16

what is an acute apical abscess

Answer 16

inflammatory reaction to pulp infection and necrosis
pus formation
swelling
TTP

Question 17

what is a chronic apical abscess

Answer 17

inflammatory reaction to pulpal infection and necrosis with gradual onset
little or no discomfort due to intermittent discharge of pus through a sinus

Question 18

what is condensing osteitis

Answer 18

usually seen at apex of tooth
diffuse radiopaque lesion presenting as boy localised reaction to inflammation

Question 19

what are five signs of a non-vital tooth

Answer 19

discolouration
sinus
gross caries
large restoration
radiographic evidence

Question 20

give four types of sensibility tests

Answer 20

electric pulp test
cold tests- ethyl chloride
heat tests - hot gutta percha
test drilling

Question 21

what fibres are stimulated in EPT

Answer 21

A delta fibres

Question 22

how is EPT carried out

Answer 22

teeth dried
isolate teeth
medium (toothpaste) used
probe placed on the tooth and patient holds handle of EPT

Question 23

what does a positive response to EPT indicate

Answer 23

vital pulp

Question 24

how are thermal tests for sensibility though to work

Answer 24

by hydrodynamic forces - fluid in the dentinal tubules move

Question 25

what is the caution used with heat tests

Answer 25

too much heat may cause irreversible pulpitis

Question 26

what is the purpose of cavity sealers

Answer 26

protect pulp from bacteria and toxic effects during setting phase of restorative material

Question 27

give four examples of cavity sealers

Answer 27

zinc phosphate zinc oxide eugenol calcium hydroxide RMGI

Question 28

what is the therapeutic effect of CaOH

Answer 28

high pH stimulates fibroblasts to make reparative dentine and stimulates recalcification of demineralised dentine

Question 29

what are the three down sides to CaOH

Answer 29

cytotoxic weak cement very soluble if not protected