Endo Flashcards
What is the pathway of development for enamel?
Ectoderm to enamel organ, to ameloblasts to enamel
What is the pathway of development for the root?
Enamel organ to HERS to root formation
What is the pathway of development for the pulp cells?
Ectomesenchyme to dental papilla to pulp cells
Pulp cells are mostly:
Fibroblasts, but also odontoblasts
Why not just proceed immediately with root canal?
We want to maintain vitality, delay the restorative cycle, and not significantly weaken the tooth
Why is an irreversible pulpitis tooth potentially able to heal, but not a necrotic pulp?
Necrotic pulps have no capacity to heal as they have no viable cells to create a dentine seal
Describe pulp testing response of asymptomatic irreversible pulpitis
Usually respond normally to thermal testing, but may have had trauma or deep caries that would likely result in a pulp exposure
Pulp Necrosis alone does not cause apical periodontitis, unless the canal is infected with microbes. True or false
True
Why might a pulp not respond to pulp testing, aside from necrosis
Calcification, large restorations, recent history of trauma
What are the advantages of selective etch?
Preserve dentine spear plugs so less irritation and post op sens compared to total etch.
What is the key advantage of composite resin over amalgam
Micromechanical retetion and seal
What is the key ingredeitn in MTA and Endosequence
Calcium Silicate
Calcium silicate based cements such as MTA and Endosequence release what upon setting?
Calcium Hydroxide
What is the advantage of Calcium Hydroxide on the pulp
Antibacterial and promotes bony and dentine tissue formation
What are two disadvantages of Calcium Silicate based cements
Difficult handling, long setting time, stains teeth
Why are news materials like MTA and CaSi cements superior to plain Calcium Hydroxide for vital pulp therapy?
Sealing ability (don’t wash away and permit bacterial re-entry)
What pulp diagnoses allow indirect pulp capping?
Clinically healthy or Reversible pulpitis
What pulp diagnoses would permit direct pulp capping?
Clinically health, reversible pulpitis or irreversible pulpitis (severity dependent)
What is the protocol for direct pulp capping?
Establish haemostasis with NaOCl and pressure, then CaSi cement over pulp (1-2mm thick) then GIC over that (1-2mm thick) then definitive restoration.
In what situation must you do total caries removal
RCT needed, or indirect restoration needed
VPT: If you expose a pulp and can’t achieve haemostatis in under 5 minutes, what do you do?
Remove more tissue, then give it another 5 minutes, then proceed with pulpotomy followed by CaSi and CR. If you still can’t get haemostasis, RCT or Exo
What are the indications for RCT or Exo
- Apical pathology
- Necrotic pulp
- Symptomatic irreversible pulpitis
- Irreversible pulpitis unable to achieve haemostasis for VPT
Why wouldn’t VPT be successful?
- Incorrect initial diagnosis
- Inadequate seal
What is the difference between reactionary dentinogenesis and reparative dentinogenesis
- Reactionary - odontoblasts sense demineratisation of dentine (matrix proteins being released) and descends toward the pulp and lays dentine
- Reparative - primary odontoblasts are damaged and necrose. Ectomesenchymal cells differentiate into odontoblast-like cells and create a different type of dentine. Repair so no tubules.

