endodontics introduction Flashcards
how are bacteria presented in a root canal? how is this disadvantageous to the body?
as a biofilm of bacteria and fungi housed by a complex extracellular matrix, first attachment occurs, then colonisation of further bacteria and fungi followed by development of a full biofilm.
prevents antimicrobials entering, or if they do they can be trapped and removed by enzymes.
what are some basic features of apical periodontitis?
poly-microbial infection apically
connective tissue destruction around apices of tooth
Maybe radiographic changes
what are the main clinical objectives of RCT?
remove canal contents
eliminate infection
maintain tooth as a functional unit.
prevent future bacterial ingress
how are cold or hot sensations felt in the tooth?
hydrodynamic mechanism. cold drives fluid away from odontoblasts and warmth drives fluid toward them, causing activation of alpha delta fibres and hence nociception.
what are the main functions of the pulp?
produce dentine
sensitivity of the tooth, and also tooth proprioception
immunocompetent, inducing sclerotic (in tubule to reduce stimuli) or tertiary dentine (pulpal border) or apical bone resorption
what types of nerves innervate the pulp?
80% unmyelinated C fibres for dull aching pain
20% alpha delta fibres for sharp nociception
what is a tooth’s initial defence to a strong stimulus e.g fracture? why?
odontoblasts die due to strong stimulus, hence mesenchymal stem cells produce tertiary reparative dentine below the site
what is a tooth’s reaction to minor damage ?
odontoblasts secrete reactionary dentine in response to the mild stimulus.
how does pulpitis proceed to pulpal necrosis?
pulpal infection travels apically
becomes irreversible when dentine tubule and pulpal irritation persists
cell apoptosis and bacterial by-products form micro abscesses
What is a tooth’s response to ageing or mild caries
Sclerotic dentine is deposited within dentinal tubules to counter mild caries or ageing process.
