Endodontic Infections

Question 1

What are the 4 causes of pulpal invasion in order of most common to least common?

Answer 1

1. dental caries
2. operative trauma
3. non-operative trauma
4. retrograde periodontitis

Question 2

Bacteria from the mouth, soil, or other exogenous sources can enter the pulp from periodontal ligament through a _____

Answer 2

lateral canal

Question 3

True or False? Systemic antiobiotic and antibodies can not reach the bacteria in the non-vital root.

Answer 3

True

Question 4

The most pathogenic bacteria are ____

Answer 4

black pigmented bacteria

Question 5

What are 4 examples of black pigmented bacteria?

Answer 5

prevotella intermedia (Pi)
prevotella nigresecens (Pn)
porphyromonas endodontalis (Pe)
porphyromonas gingivalis (Pg)

Question 6

Root canal biofilms are less ____ than other oral biolfims.

Answer 6

diverse

Question 7

______ by tubule invades block penetration by disinfectants and attach to collagen.

Answer 7

Polysaccharide

Question 8

Bacterial ____ stimulates nerves

Answer 8

gas pressure

Question 9

_____ stimulates nerves

Answer 9

Inflammation pressure

Question 10

What factors released from defense cells (PMNs, basophils, platelets) stimulate pain receptors?

Answer 10

histamine

serotonin

Question 11

____ levels in endodontically involved teeth correlate positively with pain and size of periapical lesion (usually an abscess).

Answer 11

LPS

Question 12

What black pigmented bacteria causes pain?

Answer 12

Peptosteptococci (mainly Parvimonas micra)

Question 13

True or False? Obturation tends not to eradicate all bacteria in tubules.

Answer 13

True

Question 14

____ dissolves necrotic organic matter and eliminates infectants in only 40-60% of cases.

Answer 14

Sodium Hypochlorite

Question 15

Initial root canal infection contains mainly ____ infectants

Answer 15

Gm- anerobic

Question 16

Failed root canal infection contain mainly _____ infectants

Answer 16

Gm+ facultative

Question 17

___ is the most frequently isolated Gram + facultative coccus in secondary infections and is predominant.

Answer 17

Enterococcus faecalis (EF)

Question 18

The main habitat of Ef is ____

Answer 18

the gut

Question 19

Invasive Ef may reach the tooth via the _____ or be present in the ______

Answer 19

blood; original infection

Question 20

True or False? Ef are sheltered from disinfectants and meds in tubules.

Answer 20

true

Question 21

_____ in Ef protects from pH extremes

Answer 21

efficient proton pump

Question 22

Ef is resistant to high pH of ____

Answer 22

Ca(OH)2

Question 23

_____ conditions cause up-regulation of genes in Ef which allow it to remain for indefinite periods in a barely viable state

Answer 23

Starvation

Question 24

Adverse environments stimulate _____ including ____ which enhance survival as well as pathogenicity

Answer 24

stress protiens; heat-shock proteins

Question 25

____ genes on plasmid also may be acquired by Ef

Answer 25

Cytolysin

Question 26

____ can inhibit other bacteria and may disrupt host tissues

Answer 26

Cytolysins

Question 27

What are the outcomes of chronic/acute abscesses?

Answer 27

bacteremia; spread along tissue plane

Question 28

What are the outcomes of drainage abscesses?

Answer 28

infective; cellulitis

Question 29

What are the outcomes of periodontitis abscesses?

Answer 29

endocarditis; obstruction of airway

Question 30

What are the outcomes of condensing osteitis abscesses?

Answer 30

suppurative osteomyelitis; death

Question 31

____ is a deep neck space infection involving cellulitis in submental, submandibular or sublingual spaces.

Answer 31

Ludwig’s angina

Question 32

When Ludwig’s angina is dentally derived, ___ are suspected

Answer 32

anaerobes

Question 33

When Ludwig’s angina is trauma derived, ___ are suspected

Answer 33

Staph. aureus or Strep. pyogenes