DAM & Endo Flashcards
The cavity in the inner portion of the tooth
Containing the nerves and blood supply to the tooth.
Pulp Cavity
The pulp chamber is devided into what 2 things?
- Pulp Chambe er & horns (coronal)
- Root Canals (in roots)
Anterior teeth have the pulp chamber more?
More incisal
Posterior teeth have the pulp chamber more?
Cervical
How many pulp chambers in each teeth?
1 chamber for all
How many pulp horns in teeth?
1 horn per cusp usually.
Explain the 3 parts of the pulp chamber
- Roof of pulp chamber (top)
- Floor of pulp chamber (bottom, above frucation)
- Orfice from chamber to canals
What can you perforate in a restoration with deep decay?
Perferate the roof of the pulp chamber
What happens if you pass the floor of the pulp chmaber?
Tooth can crack!
Portursion of the pulp chamber extending towards cusps.
Recede over time with trauma & Teritary dentin formation
Pulp Horns
Located below canal orfices, where nerve and vascular supply runs up into the pulp chamber.
Root Canals (pulp canals)
Opening at the end of each root that allows for nerve and vascular supply to enter the tooth, not usally at exact apex more so sideways.
Apical Formaina
What are branches off man root canals called?
Acessory/ lateral canals
Explain a Type 1 Pulp Canal
Type 1
1 canal : 1 Foramen
Mostly anterior teeth
Explain a Type 2 Pulp Canal
2:1
2 canals that merge into 1 foramin
Explain a Type 3 Pulp Canal
2: 2
2 seperate canals 2 foramin
Explain a Type 4 Pulp Canal
1: 2
1 canal, splits into 2 foramin
What type?
type 1; 1 canal 1 foramin
What type?
Type 3
2 canals 2 foramin
What Type?
Type 4
1 canal 2 foramin
What type?
Type 3
2 canals: 2 foramin
What type are these on either root?
Type 3!
2 canals: 2 foramin
Why is this bad?
Curvature is bad! you want a straight endo acess.
What is wrong?
- Apical perforation
- Frucation Abcess
- Broke file left inside
Explain incisor pulp chambes & horns
- 3 pulp horns: mesial, central, and distal correlating with three facial lobes and three mamelons (on incisors)
Explain Peg lateral pulp chambes & horns
1 lobe so they are more likely to only have 1 horn
Explain canine pulp chambes & horns
1 pulp horn, only 1 cusp
Explain anterior root canals
Most likely= 1 root 1 canal (type 1)
*if 2 canals exist one is facial one is lingual
What anterior tooth has high RCT faliure rates because 40% can have 2 canals instead of 1?
Mandibular anteriors
Explain trend of pulp chamber and horns of young anterior teeth
they extend way into the crown, not much seperation of chamber and dentin
In yongue caines, explain size of chamber
Larger and extend well into crown esp mandibular canines
Explain pulp chamber in mandibular 1st PM
Usually 1 root 1 canal, lingual cups is non function; i.e it doenst get its own canal :/
If it has 2 it will be a Type 4; 1 canal, then splitting into 2 foramin
Explain pulp chamber in maxillary 1st PM
2 pulp horns, 2 canals
What does this display?
Pulp Chamber and Horns of Molars young maxillary molar with larger chamber and horns well into crown
What does this display?
Pulp Chamber and Horns of Molar Older Mandibular Molar. Smaller Chamber in Root Trunk, Only Horns Into Crown
What arch and tooth?
most often have three roots and four canals (two in mesiobuccal root), and 4 orifices in the chamber floor.
Maxillary Molars
What arch what tooth?
most often have two roots but three canals (two in mesial) and 3 orifices in the chamber floor.
Mandibular Molars
Not 2 roots, and 3-4 canals
Explain 4 canals on maxillary 1st molar
- 1 DB canal
- 2 MB canals (MB1 MB2
- 1 Paletal Canal
Explain pulp shape in primary molars comparedto secondary molars
Primary have much larger chamber in relation to the size of the crown
Why Pulp Cavities Get Smaller in Older Teeth?
- Depostion of 2nd dentin as we age
- Depostion of reperative dentin in response to trauma and restoations (3)
- Calcium hydroxide base; calcification
Physiological response
What is the Clinical Application of Pulp Morphology Related to Restorative Dentistry
It is important ot know the pulp morphology so that when conducting a resotration you can avoid a pulp exposure, but also know that if decay reaches the pulp then tooth require further tx like RCT
Is a specialty concerned with human dental pulp and periapical tissues
Endodontics
endodontist= specialist
around the root conditions
Periradicular/ Periapical
pulp inflamed and cannot heal. tooth hurts all the time. req RCT
Irreverisble Pulpitis
dark area on x-ray around apex indicating bone loss
Periapical radiolucency
Froms from chronic inflammation
Granuloma
pulp is devital but tooth still function
Pulp Death; necrosis
Tooth is still vital, hurts sometimes but can be repaired via a restoration
Reversible Pulpitis
What is this?
Pericapical radiolucency;
necortic tooth with apical periodontitis
what is diagnosis?
Irreversible pulpitis, pulpal caries lesion.
How can you treat crown discoloration from pulpal damage?
Tooth whitening
4 steps of endo therapy
- Develop accessopening (cut a hole through roof of pulp chamber)
- Locate canal orifices (on floor of chamber)
- Clean out each canal (remove pulpal tissue)
- Fill cleaned canals (with gutta percha)
Where does gutta percha go?
Only in canals NOT chamber
Clean Out Canal with Files
Step 3 Endodontic Therapy
Fill Canals (with Gutta Percha); Temporize
Step 4; endo therapy
What may be required post endo therapy?
Restoration With Post and Core, and Crown
What teeth?
Triagular acess, narrows apically
Max Centrals
What teeth?
Narrower access, more oval shaped (evenly), gets smaller apically
Mandibular central
What teeth?
Narrower access, more oval shaped gets smaller apically, lingual aspect of the acess pinches in towards apical 3rd of root.
Mandibular lateral
What teeth?
Round oval acess, gets smaller apically
Maxillary Canine
What teeth?
Longer oval acess, smaller apically.
Mandibular Canines
What toth?
Oval acess, longer (FL) , may pinch in slightly at the coronal aspect of canal due to mesial concavity.
May have 2 canals
Max 1st PM
- Otutline at cervical is ovoid, wider buccolingually
- Normally one root and one canal
- Root depressions on mesial and distal (distal deeper)
Max 2nd PM
- Cervical outline is ovoid wider buccolingually
- Root depressions mesial and distal; deeper on distal
- One canalmost often
mandibular 1st PM
- Cervical outline is ovoid, wider buccolingually than mesiodistally
- Root Frequent on distal
- One canalmost often
- Crown outline ofthree-cusp type wider in lingual half
Mandibular 2nd PM
Mandibular First and Second Molars
Explain
* How many roots?
* Which root wider
* How many Canals and where?
* Depressions?
* Frucation acess located where?
* Root trunk trends?
Explain
* How many roots= 2 roots
* Which root wider= mesial root wider FL
* How many Canals and where= 3, there are 2 in the mesial root bur there can be 4 if 2 canals in distal root
* Depressions= mesial root has a M & D root depression
* Frucation acess located where= midfacial, midlingual
* Root trunk trends= shorter and more spreaout on 1st, then 2nd, then 3rd
Maxillary 1st and 2nd molars
Explain
* How many roots?
* Which root wider
* How many Canals and where?
* Depressions?
* Frucation acess located where?
* Root trunk trends?
Explain
* How many roots= 3 roots; MB, DB, L
* Which root wider= ** MB root wider FL**
* How many Canals and where= 4, there are 2 in MB root
* Depressions= MB root has a M & D root depression Lingual has sight lingual depression, max 1st have disatal cervical dep.
* Frucation acess located where= midfacial, mesial, and distal
* Root trunk trends= shorter and more spreadout on 1st, then 2nd, then 3rd
What do wider roots on max and mand 1st molars result in?
Larger acesss.
Embryological developmental variation, pulp chamber is single ribon shaped orfice with 180 degreen arc or more.
C-Shaped Canal
Canals dont seperate
Explain trend in C-shaped canal
Most commom among asian population (30%) and in Mandibular 2nd molars.
Why variation in canal shapes and number of roots?
The shape and the number of roots are determined by Hertwig’s epithelial sheath
- All pre-determined during embyrological development of teeth.
Primary objective during operative procedures
PRESERVATION of the HEALTH of the PULP
Reasons why this is bad?
- Short RCT
- Broken instrument in frucation
- Broken floor
- Missed canal
Explain
Type 4, 1 canal split into 2 foramin + lateral canals. Periapical radiolucency. good RCT
