Care of the Pulp Flashcards
what cells are in the pulp
odontoblasts
what nerves are in the pulp
Alpha fibres
C fibres
what happens to dentine tubules as they approach the pulp
increase in number and diameter
what fibres cause sharp pains that are stimulated by electric pulp tests
alpha fibres
what fibres cause a dull aching pain due to increase pulpal blood flow and pressure
C fibres
what is reversible pulpitis
vital tooth
inflamed pulp which has potential to heal
what is the treatment for reversible pulpitis
treat the caries causing the irritation
what is irreversible pulpitis
vital tooth
inflamed pulp which cannot heal
what are the treatment options for irreversible pulpitis
pulpectomy required after RCT
extraction
what are features of reversible pulpitis
pain to cold which lasts a short time
no change in pulpal blood flow
what are features of irreversible pulpitis
spontaneous pain, sleep disturbance
increase in pulpal blood flow
what is a necrotic pulp
non-vital pulp which has partial or total necrosis
what is the treatment for a necrotic pulp
RCT or XLA in mature teeth
pulpotomy/ pulpectomy/ XLA in immature teeth
what is symptomatic periapical periodontitis
inflammation of apical periodontium with pain on biting and TTP - could have periapical radiolucency
what is asymptomatic periapical periodontitis
inflammation and destruction of apical periodontium
no clinical symptoms
appears as apical radiolucency
what is an acute apical abscess
inflammatory reaction to pulp infection and necrosis
pus formation
swelling
TTP
what is a chronic apical abscess
inflammatory reaction to pulpal infection and necrosis with gradual onset
little or no discomfort due to intermittent discharge of pus through a sinus
what is condensing osteitis
usually seen at apex of tooth
diffuse radiopaque lesion presenting as boy localised reaction to inflammation
what are five signs of a non-vital tooth
discolouration
sinus
gross caries
large restoration
radiographic evidence
give four types of sensibility tests
electric pulp test
cold tests- ethyl chloride
heat tests - hot gutta percha
test drilling
what fibres are stimulated in EPT
A delta fibres
how is EPT carried out
teeth dried
isolate teeth
medium (toothpaste) used
probe placed on the tooth and patient holds handle of EPT
what does a positive response to EPT indicate
vital pulp
how are thermal tests for sensibility though to work
by hydrodynamic forces - fluid in the dentinal tubules move
what is the caution used with heat tests
too much heat may cause irreversible pulpitis
what is the purpose of cavity sealers
protect pulp from bacteria and toxic effects during setting phase of restorative material
give four examples of cavity sealers
zinc phosphate
zinc oxide eugenol
calcium hydroxide
RMGI
what is the therapeutic effect of CaOH
high pH stimulates fibroblasts to make reparative dentine and stimulates recalcification of demineralised dentine
what are the three down sides to CaOH
cytotoxic
weak cement
very soluble if not protected
