Ch 2 Flashcards by Luis Franco

What can be accomplished by apexification

Apical closure, but NOT root elongation.

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What is MTA

Mineral Trioxide Aggregate

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What are two material used for pulp caping

MTA

Calcium Hydroxide

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What is pulpectomy

The complete surgical removal of the vital pulp

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What is apexification

Induction of a calcified or and artificial barrier in a root with an open apex or the continued apical development of an incompletely formed root in teeth with a necrotic pulp

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What is apexogenesis

A vital pulp therapy procedure perfomed to enable continued physiologic development and formation of the root end; the term frequently used to describe vital pulp therapy that encourages the continuation of this process.

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What is the most important property of ZOE

Prevents microleakage of bacterial cells, thereby reducing hypersensitivity and providing antimicrobial properties.

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What is the ultimate goal of endo treatment

Prevent the development of apical periodontitis or

create adequate conditions for periradicular tissue healing.

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What is the most common cause of of pulpal exposure

caries

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What is anachoresis

process by which microorganisms are transported by the blood or lymph to an area of tissue damage, where they leave the vessel, enter the tissue and establish and infection.

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Primary infections have a dominance of what type of bacteria

Obligate anaerobic bacteria

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What gram negative bacteria is most commonly found in endo infections

Dialister
Porphyromonas
Tannerella
prevoterlla
Fusobacterium
Campylobacter
Pyramidobacter
Catonella
Selenomonas
Centipeda

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What gram positive bacteria is most commonly found in endo infections

Actinomyces
Pseudoramibacter
Filifactor
Eubacterium
Mogibacterium
Propionibacterium
Eggerthella
Olsenella
Bifidobacterium
Slackia
Atopobium
Solobacterium
Lactobacillus
Actinomyces
Corynebacterium

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What sources of nutrients are available to bacteria within the root canal system

Necrotic pulp tissue
Proteins and glycoproteins from tissue fluids that seep in
Components of saliva that may coronally penetrate
Products of metabolism of other bacteria

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What does planktonic mean

unattached

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Gram negative bacteria are very sensitive to

strong oxidizing agents such as sodium hypochlorite

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What type of bacteria is most likely found post-instrumentation and post-medication

Gram-pos bacteria

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What are PAMPS

Pathogen Associated Molecular Patterns

What are PRRs

Patterns Recognition Receptors

TLR4

LPS, lipid A; Gram neg bac

TLR5

Flagelin; bacteria flagellum

TLR3

dsRNA; Virus

TLR7,8

SSRNA; Virus

TLR9

CpG DNA; Bacteria DNA

PRR

PAMP; pathogen

What are some factors that may result in pulpal necrosis and the development of periradicular pathosis

Increased tissue pressure Inability of the pulp to expand Lack of collateral circulation.

What are the Sx of reversible pulpitis

Usually asymptomatic | Sharp transient pain with stimuli (hot/cold), removal of stimuli results in immediate relief.

What is irreversible pulpitis

Severe inflammatory process that does not resolve, even if the cause is removed. Pulp is incapable of healing and slowly or rapidly becomes necrotic. symptomatic/asymptomatic

What are the Sx of irreversible pulpitis

Usually asymptomatic but, May be: associated with intermittent or continuos episodes of spontaneous pain (with no external stimuli). Pain might be: sharp, dull, localized or diffused and last from a few minutes to a few hours. Application of stimuli may result in prolonged pain. Application of cold might result in pain relief for patients.

What is hyperplastic pulpitis (pulp polyp)

Form of irreversible pulpitis that originates from overgrowth of a chronically inflamed young pulp onto the occlusal surface. Usually asymptomatic

What is calcific metamorphosis

Extensive formation of hard tissue on dentin walls, often in response to irritation or death and replacement of odontoblasts

Teeth with necrotic pulps are usually sensitive to

palpation and percussion due to spread of inflammatory reactions to periradicual tissues

Lesions associated with significant symptoms such as pain or swelling are referred to as

Acute (symptomatic)

Lesions associated with mild or no symptoms are identified as

Chronic (asymptomatic)

What is SAP

Symptomatic Apical Periodontitis

What is AAP

Asymptomatic Apical Periodontitis | Results from pulp necrosis and is usually a sequel to SAP

What are the Sx of AAP

No respons to electrical or thermal stimuli Percussion produces little or no pain. Possible slight sensitivity to palpation; indicating an alteration of the cortical plate of bone and extension into the soft tissues.

What is a periapical granuloma

``` Granulomatous tissue infiltrated by: Mast cells Macrophages Lymphocytes Plasma cells Leukocytes PMN's ```

What is an apical/radicular cyst

central cavity filled with an eosinophilic fluid or semisolid material and is lined with stratified squamous epithelium.

Where does the epithelium from a cyst come from

remnants of Hertwig's epithelial sheaths, the cell rests of Malassez. These cells proliferate in response to inflammatory stimuli.

What is condensing osteitis

Variant of AAP, represents an increase in trabecular bone in response to persisting irritation.

What is AAA

Acute Apical Abscess. Localized or diffuse liquefaction lesion of pulpal origin that destroys periradicular tissues and a severe inflammatory response to microbial and nonbacterial irritants from a necrotic pulp.

What are the Sx of AAA

Rapid onset and spontaneous pain. Moderate to severe discomform and or swelling. No swelling if abscess is confined to bone. Occasional systemic manifestations: fever, malaise No response to electrical or thermal stimulation. Painful to percussion/palpation

What is CAA

Inflammatory lesion of pulpal origin characterized by the presence of a long standing lesion that has resulted in an abscess that drains to a mucosal (sinus tract) or skin surface.