ENDO Adjunctive Endodontic Treatment Flashcards
what are the 5 components of the pulp?
odontoblasts, fibroblasts, nerves, blood vessels, and lymphatics
after injury or irritation, what cells may die?
primary odontoblasts
after injury/irritation and primary odontoblasts die, ___ can form and produce ___ as a defense
secondary odontoblasts, reparative dentin
the pulp can defend itself against most ___ irritatnts
nonmicrobial
when the irritant is too great and deposition of reparative dentin is insufficient, pulp defenses become overwhelmed, what can happen?
when bacteria enter the pulp with sufficient quantity or virulence, complete pulpal necrosis is imminent and irreversible
___ are the main cause of serious pulpal injury and the main cause of pulpitis
- bacteria from dental caries
- this can be initial caries or caries developing under defective restorations (recurrent caries)
- bacteria can penetrate beyond the more obvious carious lesion through dentinal tubules
materials for vital pulp therapy dressing can stimulate ___ formation
dentinal bridge
what are materials used in vital pulp therapy?
calcium hydroxide and MTA
___ has been used as a pulp capping material since the 1930s and has a solid history of clinical documentation
calcium hydroxide
calcium hydroxide has an inherent pH of ___, which causes ___
12.5 which cauterizes tissue and causes superficial necrosis
which vital pulp therapy material develops a sterile necrotic zone that encourages the pulp to induce hard tissue repair with secondary odontoblasts?
calcium hydroxide
MTA is a ___ derivative made of primarily fine ___ particles
portland, hydrophilic
MTA consists of ___ and ___
calcium phosphate and calcium oxide
how does MTA set?
in the presence of moisture
what is the setting time of MTA?
2 hours 45 minutes
when MTA is used as a filling material, it appears to be able to induce ___ to produce ___
cementoblastic cells to produce hard tissue
what are the 5 procedures that fall under vital pulp therapy?
indireact pulp capping, direct pulp capping, partial pulpotomy, pulpotomy, and apexogenesis
___ is a procedure in which material is placed on a thin partition of remaining carious dentin that, if removed, might expose the pulp in permanent immature teeth
indirect pulp cap
what are the indications for an indirect pulp cap?
when teeth have deep carious lesions approximating the pulp but no signs or symptoms of pulpal degeneration or apical disease
what is the clinical objective of indirect pulp capping?
to arrest the carious process and allow remineralization
what should the treatment plan include for a tooth requiring an indirect pulp cap?
- after placement of the indirect pulp cap, wait 6-8 weeks to allow deposition of reparative dentin (at the rate of 1.4 um/day)
- remove the remaining caries leaving healthy dentin and permanently restore the tooth
___ is a procedure where dental material is placed directly on a mechanical or traumatic vital pulp exposure
direct pulp cap
what are the indications for a direct pulp cap?
- pulp has been exposed less than 24 hours
- healthy pulp exposures during an operative procedure
- asymptomatic
- small exposure site
what should be completed during follow up visits for a direct pulp cap?
- test for palpation, percussion, thermal pulp testing, and periapical radiograph
- a hard tissue barrier may be visualized 6 weeks postoperatively