Endoperio 1 Flashcards
a type of periapical diagnosis wherein its sign and symptom is that there is painful response to biting and percussion
Acute Apical Periodontitis (AAP)
(9) Ovoid root canal opening
maxillary: LI, Canine, 1PM and 2PM
mandibular: CI, LI, Canine, 1PM and 2PM
aka non vital or internal bleaching
intracoronal bleaching
removal of the entire root, leaving the crown intact
root resection
separation of a multirooted tooth through the furcation in such a way that a root and the associated portion of the crown may be removed
hemisection
a vital pulp therapy procedure performed to allow continued physiologic development and formation of the root
apexogenesis
when the apical protion of the root with periradicular pathosis cannot be cleaned, shaped and obturated
root-end resection
the most apical end of the root
anatomical apex
locate about 0.5mm from the apical foramen in the area of DCJ
apical constriction
termed as the “natural stop”
apical constriction
instrument usd to remove pulp tissue from wide root canals
broach
his tightly spiraled cutting edges that cut either in reaming or a push-and-pull filing motion
K-files
manufactured by cutting the spiral flutes into the shaft of a tapered wire to produce elevated cutting edges that appear to form a series of intersecting cones
hedstrom file
file that is used in pulling strokes only (withdrawal stroke)
hedstrom file
manufactured by cutting the spiral flutes into a round wire of superelastic nickel titanium alloy
NiTi file
a bisbiguanide antiseptic agent is used to kill or inhibit microorganism
Chlorhexidine (CHX)
this aqueous solution removes inorganic ions such as calcium to demineralize and soften the dentin
EDTA
EDTA is short for?
ethylenediaminetetraacetic acid
half turn twist and pull (clockwise) file
reamer
manufactured by twisting a tapered, triangular or square wire to for, an instrument with sharp cutting edges
used to enlarge the root canal
reamer
distance between apical foramen and apical apex = 0.5mm
apical foramen
what root is usually the most difficult to locate?
MB root of Max 1st molar
is the displacement of the tooth from its original position in the alveolus, without total avulsion, resulting from acute trauma
luxation
used to fill the discrepancies between the canal walls and core materials
sealers
used to obturate root canals in conjunction with sealers
gutta percha
odorless, basic, white powder
calcium hydroxide
for calcification and inhibit resorption
calcium hydroxide
complete dislodgement of a tooth out of its socket by traumatic injury
avulsion
partial axial displacement out of its socket
extrusive luxation
fractured alveolar socket
lateral luxation
partial axial displacement into the socket and can be accompanied by fractured alveolar socket
intrusive luxation
sensitivity to percussion but little or no mobility and no displacement
subluxation
treatment for concussion
no treatment 😝
treatment for subluxation
flexible splint can be placed for the px’s comfort 7-10 days
RCT if the tooth becomes symptomatic or it shows necrosis, periodontitis or resorption
treatment for extrusion
reposition the tooth
treatment for lateral luxation
stabilize the tooth with a flexible splint for 3 weeks
RCT if the tooth becomes symptomatic or it shows necrosis, periodontitis, ankylosis or resorption
treatment for intrusive luxation
slightly luxate the tooth with forceps
spontaneous reposition if incomplete root formation or orthodontic repositioning if complete root formation or surgical repositioning
perform prophylactic RCT = 1-3 weeks after injury
part of the masticatory mucosa which cover the attachment apparatus
gingiva
color of gingiva
coral pink
consistency of gingiva
resilient and fibrotic in nature
texture of gingiva
stippling of the attached gingiva (least favorable factor) should be present
contour of the gingiva
gingival margins should be scalloped in form and firmly attached (healthy gingiva)
keratinized stratified squamous epithelium in the gingiva
oral epithelium
nonkeratinized thin squamous epithelium without presence of rete pegs
sulcular epithelium
nonkeratinized stratified squamous epithelium
collar like band of stratified squamous epithelium
junctional epithelium
how many cells are present in the junctional epithelium near the sulcus?
10-29 cells
how many cells are present in the junctional epithelium at the apical end?
2-3 cells
junctional epithelium are attached via?
hemidesmosomes
transudate that emerges from the gingival sulcus
GCF
GCF stands for?
gingivocrevicular fluid
it will become exudate if there is an inflammation
GCF
gingival fibers are composed of what type of collagen?
type I collagen
refers to the irregular surface texture of the attached gingiva similar to the surface of an orange peel
stipplings
stipplings are not usually visible at the age of?
6 years old
result from the absence of stipplings
- edema pf the underlying connective tissue
- inflammatory degradation of gingival collagen fibers
- normal variation in gingival topography
collar tissue that is not attached to the tooth or alveolar bone
free gingiva
most coronal portion of the gingiva
gingival margin
demarcation of the free gingiva to attached gingiva
free gingival groove
shallow groove between the marginal gingiva and the tooth surface
gingival sulcus
bound by sulcular epithelium lateral and JE (junctional epithelium) apically
gingival sulcus
the gingiva that occupies the interdental space coronal to the alveolar crest
interdental gingiva
present between the free gingiva and alveolar mucosa
attached gingiva
separates attached gingiva from the alveolar mucosa
mucogingival junction
radiographic evident which is most accurate for bone loss assessment
bitewing
measurement in mm from the gingical margin down to the deepest point reached by the probe
periodontal pocket depth
probing force
25g
measurement in mm from the CEJ down to the deepest point reached by the probe
attachment loss
allows slight movement of tooth to accomodate masticatory forces
physiologic tooth mobility
increased mobility as a result of connective tissue attachment loss
pathologic mobility
Miller’s classification wherein there is > or = 1mm mobility
grade II
Miller’s classification wherein there is horizontal mobility
grade I
Miller’s classification wherein there is > 2mm and vertical mobility
grade III
Glickman furcation classification (Naber’s probe) wherein there is incipient bone loss. furcation probe can feel the depression of the furcation opening
grade I
Glickman furcation classification (Naber’s probe) wherein there is partial bone loss. probe enters under the roof ofthe furcation
grade II
Glickman furcation classification (Naber’s probe) wherein there is total bone loss with through-and-through opening of the furcation. not visible clinically
grade III
Glickman furcation classification (Naber’s probe) wherein it is like grade III furcation but it is visible clinically
grade IV
hard bristle toothbrush is capable of causing gingival recession and abrasion
toothbrush trauma
v shaped notches inthe cervical area of the teeth and gingival cleft
toothbrush trauma
most prominent teeth in the dental arch that acquires toothbrush trauma
canines and premolars
drugs that causes gingival overgrowth
(1)phenytion, (2) nifedipine, (3) cyclosporine
others: Ca channel blockers (verpamil, felodipine, diltazem, amlodipine) Mycophenolate (immunosuppressant) Sertraline (antidepressant) Pimozide (antipsychotic)
condition where pocketing occurs without attachment loss
pseudopocketing
there is an expansion of gingival coronally NOT apically
pseudopocketing
vascular phase of inflammation
initially starts with VASOCONSTRICTION
-> complement system activation and mediator release: c3b -> c5a -> histamine -> vasodilation -> hyperemia -> increased vascular permeability
cellular phase of inflammation
adhesion -> margination -> diapedesis -> chemotaxis -> phagocytosis
neutrophils -> macrophages -> lymphocytes/eosinophils
its objective is to provide a smooth, clean, hard polished root surface
scaling and root planing
best criterion for the succes of scaling and root planing is?
no evidence of bleeding on probing (BOP)
narrow, delicate instrument having either one or two cutting edges or working surfaces
end of the edges: rounded
smaller than scalers
provide atraumatic entry to the subgingival space
peridontal curette
peridontal pockets are NOT caused by Occlusal Trauma
walang sagot. additional information lang. hihihihi 😊😁😬💁🏻
excessive force applied applied to the teth with normal structures
primary occlusal trauma
excessive force to the teeth with inadequate support
secondary occlusal trauma
eliminate prematurities first in centric relation -> protrusive movements -> lateral excursive movements
selective grinding
aggressive, repetitive and continuous grinding, gritting or clenching of the teeth
bruxism
treatment for bruxism
nightguard
etiology of gingiva and periodontal diseases
microbial plaque
functions as a protective barrier against dessication and also substrate for bacterial attachment
pellicle
what are the process of plaque formation?
- molecular adsorption
- bacterial adhesion
- sequential adsorption
- growth of extracellular matrix
indicated on permanent teeth with IMMATURE APICES
no particular pathoses
6-8 months
application of calcium hydroxide or MTA
indirect pulp capping
what type of bacteria adheres in the initial colonization in plaque formation?
gram (+) facultative anaerobic cocci
in sequential adsorption in the process of plaque formation, gram (+) bacteria shift to?
gram (-) bacteria obligate anaerobic bacteria
what bacteria are present in the growth of extracellular matrix in the process of plaque formation?
gram (+) rods particularly actinomycetes
how does plaque cause disease?
day 0? day 2-4? day 6-10?
day 0: gram (+) cocci and rods
day 2-4: cocci still present but RODS and FILAMENTS increase
day 6-10: presence of VIBRIOS and SPIROCHETES
mineralized plaque formed by bathing in a highly concentrated solution of calcium and phosphorus
calculus
how much inorganic components are present in calculus?
70-90%
2/3 of inorganic is made up of crystalline in structure
deposits found below the free gingival margin
subgingival calcular deposits
deposits found above the free gingival margin
supragingival calcular deposits
deposits are usually white or pale yellow
supragingival calcular deposits
deposits are usually dark due to pigments
subgingival calcular deposits
58% hydroxyappatite crystals are usually detected in?
in all supragingival calculus
magnesium whitelock (21%) are usually located in?
posterior areas
octocalcium phosphate (12%) are detected in?
supragingival calculus
9% brushite are located in?
mandibular anterior region
associated with plaque
no loss of attachment
no bone loss
gingivitis
stages of developing gingivitis
- transient stage
- developing stage
- chronic stage
- advance stage
stage in gingivitis wherein it occurs within 2-4 days after cessation of oral hygiene
transient stage
stage in gingivitis wherein PMN are predominant cells
transient stage
stage in gingivitis wherein LYMPHOCYTES are the predominant cells
developing stage
stage in gingivitis wherein area of collagen destruction becomes larger and is occupied by fluid that contains proteins (fibrin, IgA)
developing stage
stage in gingivitis wherein the cytologic characteristics of the inflammatory infiltrate in the gingival lamina propria are changed
chronic stage
stage in gingivitis wherein plasma cells are the predominant cells
chronic stage
stage in gingivitis wherein the initial stage of periodontitits starts
advance stage
stage in gingivitis wherein changes within the supportive bone occurs as the inflammatory process continues
advance stage
most common complaint of pregnancy gingivitis
gingival bleeding
etioloy of pregnancy gingivitis
increase circulation levels of estrogen, and progesterone
treatment of pregnancy gingivitis
oral hygiene and scaling
characterized by interproximal necrosis and pseudomembrane formation on marginal tissue
ANUG (acute necrotizing ulcerative gingivitis)
other terms for ANUG? (2)
vincent’s infection/ vincent’s stomatitis
trench mouth
affects only the gingiva
soreness, bleeding gums and FETID ODOR
ANUG
treatment for ANUG
debridement, hydrogen peroxide rinses and antibiotic therapy
most superficial layer consisting of bacteria in the histopathology of gingivitis
bacterial zone
dead cells and a fibrin meshwork predominate in the histopathology of gingivitis
necrotic zone
connective tissue inflammation because of spirochetes in the histopathology of gingivitis
zone of spirochetal infiltration
gingivitis infected with HIV
HIV gingivitis
gingivitis characterized by a defined linear marginal gingival erythema
HIV gingivitis
inflammation of the periodontium
periodontitis
histologically, it is marked by apical migration of the junctional epithelium from the CEJ, loss of CT attachment, loss of periodontal ligament and destruction of bone
periodontitis
type of peridontitis wherein there are
localized periodontitis
type of peridontitis wherein there are >30% of the sites involved
generalized periodontitis
range of clinical attachment loss of slight periodontitis
1 or 2mm
range of clinical attachment loss of moderate periodontitis
3-4mm
range of clinical attachment loss of severe periodontitis
> 5mm
stages of periodontitis
- early
- moderate
- advanced
stage of periodontitis wherein there are areas of localized erosion of the alveolar bone crest
early
stage of periodontitis wherein there is rounding of the junction between the crest and lamina dura in posterior region
early
stage of periodontitis wherein there is destruction of alveolar bone beyond early changes
moderate
stage of periodontitis wherein it may include the buccal or lingual plate, generalized horizontal or vertical defects and possible tooth mobility
moderate
stage of periodontitis wherein bone loss is extensive that the remaining teeth show excessive mobility and drifting
advance
2 bacteria that predominate generalized aggressive periodontitis
prevotella
eikenella corrodens
type of aggressive periodontitis that occurs between ages 12-25 and is characterized by rapid, severe periodontal destruction
generalized AP
type of aggressive periodontitis which has a weak serum response
generalized AP
type of aggressive periodontitis which has a strong serum response
localized AP
2 bacteria that are present in the localized aggressive periodontitis
AA and capnocytophagia
slow progressive disease
formerly known as adult periodontitis
chronic periodontitis
type of chronic periodontitis that occures in 30% or more of the sites
generalized CP
type of chronic periodontitis that occures in less than 30% of the sites
localized CP
eliminate periodontal pockets by changing the existing bony topography
osseous surgery
peridontal surgery that DOES NOT CURE PERIODONTAL DISEASE
osseous surgery
bone taken from patient’s own body
autograft
bone taken from another person, same species
allograft
bone taken from another species like Bovine bone
xenograft
termed as synthetic bone
alloplast
reshape the gingiva and papilla of a tooth for correction of deformities
gingivoplasty
procedure in which pocket depth is eliminated by resecting the tissue coronal to the pocket base
gingivectomy
contraindications of gingivectomy
infrabone pockets and lack of keratinized tissue
Okay?
Okay. 🌠🌠🌠
creates a space via placement of nonresorbable or resorbable barrier over a bony defect
guided tissue regeneration (GTR)
periodontal flap surgery before scaling and root planing (SRP)
modified widman flap
full thickness flap used for debridement
modified widman flap
heals by repair usually via long JE and CT adhesion or attachment
modified widman flap
periodontal surgery used for gaining access in underlying roots
modified widman flap
full thickness flap is elevated and necessary
apical positioned flap
the gingiva is reposition at the crest of the bone
apical positioned flap
it requires vertical incision
to ensure that there will be no pocket remains
apically positioned flap
reduces excess tissue and provides access for underlying bone
distal wedge procedure
performed in maxillary tuberosity, retromolar triangle and distal to the last tooth in the arch
distal wedge procedure
prevents ingrowth of long junctional epithelium and gingival connective tissue
retrieved after 6-10 weeks
GTR
in guided tissue regeneration (GTR), is polyetrafluoroethylene resorbable or nonresorbable?
nonresorbable
in guided tissue regeneration (GTR), is collagen, calcium sulfate and polyacetic acid resorbable or nonresorbable?
resorbable
reshaping or recontouring of the bone
does not provide attachment for the perio fibers
osteoplasty
removal of bone defects or infrabony pockets
ostectomy
root amputation is indicated for what teeth?
max molars usually 1st and 2nd
should root amputation be done with RCT or not?
root amputation MUST BE done with RCT
vertical splitting of the tooth
hemisection
should hemisection be done with RCT or not?
hemisection MUST BE done with RCT
hemisection is indicated for what teeth?
mandibular molar teeth
donor tissue is in edentulous region or palatal area
autogenous free gingival graft
the greatest amount of shrinkage of autogenous free gingival graft occurs within how many weeks?
within the first 6 weeks
complications of autogenous free gingival graft?
disruption of vascular supply and infection
procedure is indicated whenever the clinical crown length is inadequate for the restoration
crown lengthening
in crown lengthening, it should have _____ between the margin of the preparation and the crest of the bone to ensure adequate crown
3mm
in crown lengthening, it should maintain the biological width of how many millimeters?
2.04mm
if there is presence of inflammation in the PDL, what kind of physical examination should you use?
percussion test
what kind of physical examination should you use if inflammation spreads to the overlying periodontium?
palpation
provides information if there is a root fracture or pathosis of pulpal in origin
periodontal probing
long term progression of cracked tooth
split tooth
endodontically treated teeth are more susceptible to this fracture
vertical root fracture
MD in direction
pain in chewing and thermal stimulus is common
cracked tooth
most common teeth to be affected in cracked tooth?
mandibular molars
diagnostic tests to be used in cracked tooth?
tactile examination
“tooth slot” bite test
how would you execute tactile examination in cracked tooth?
scratch the tooth surface with a sharp explorer = elicit painful response
treatment indicated on permanent teeth with IMMATURE APICES
no periradicular pathoses
6-8 months
indirect pulp capping
what will you apply in indirect pulp capping?
calcium hydroxide or MTA
mechanical or traumatic vital exposure as long as hemorrhage is easily controlled
direct pulp capping
both indirect and direct pulp capping will induce the formation of?
reparative dentin
surgical removal of the coronal portion of a vital pulp
pulpotomy
treatment used if there is irreversible pulpitis of primary teeth
if in permanent, it may cause canal obliteration
pulpotomy
procedural complication that arises when there is inadequate use of irrigant and lack of attention to preparation of glide path
ledge
procedural complication wherein there is mechanical or pathologic communication between the root canal system and the external tooth surface
perforation
persistent periradicular pathosis following RCT
root-end resection
most widely used intracoronal bleaching agent
superoxol
procedure of intracoronal bleaching
- rubber dam isolation
- application of cement barrier in the cervical area
- bleaching
- temporary restoration
- monitor for color change in 3-4 days
- if +, remove!
in intracoronal bleaching, you may also use ________ mixed with saline
sodium perborate
removal of tooth discoloration using chemical oxidizing agents
intracoronal bleaching
create an apical barrier in a necrotic tooth with an open apex
apexification
application of what paste will you use in apexification?
CALCIUM HYDROXIDE PASTE
other method: MTA
how many months will apexification usually last?
3-6 months
procedure in apexogenesis
- coronal access
- pulp amputation
- control the hemorrhage
- place CaOH over the radicular pulp stump
- place coronal filling
- recall every 3 months
- there should be dentinal bridge and continued apical development
- then RCT is indicated
(3) triangular root canal anatomy
maxillary: CI, 1st molar, 2nd molar
(2) trapezoidal root canal anatomy
mandibular: 1st molar, 2nd molar
root canal instrumentation and obturation should stop about _____ short of the radiographic apex
1.0 mm
cut aggressively than K-files BUT MORE PRONE TO BREAKAGE
hedstrom file
composed of a slender stainless steel shank with a cutting bulb and pilot-tip
gates-glidden bur
designed so that a fracture occurs near the hub rather than between the shank and the cutting bulb
gates-glidden bur
size of the cutting bulb of the gates-glidden bur
0.5-1.5 mm in diameter
clear, pale, greenish yellow, strongly alkaline liquid with a chlorine order
sodium hypochlorite (NaOCl)
has a solvent action in organic tissue and debris and is a potent ANTIMICROBIAL agent
sodium hypochlorite
concentration of irrigating solution of choice
0.5-5.25%
bleaching effect percentage
> 5.25%
irrigating solution less toxic than NaOCl
chlorhexidine (CHX)
brand name of chlorhexidine
peridex (12%)
also used for removing smear layer before obturation
EDTA
active ingredient in root canal preparation
EDTA
interappointment dressing
calcium hydroxide
an odorless, basic white powder for calcification and inhibiting resorption
calcium hydroxide
used to obturate root canals in conjunction with sealers
gutta percha
gutta percha is pliable at room temp and plastic at ____F
140F
gutta percha is dissolved in solvents such as
chloroform, xylol, eucalyptol
used to fill the discrepancies between the canal walls and core materials
sealers
if extra oral dry time is >60 minutes, what would you do?
DO NOT REPLANT!
what is the function of metallic salts in gutta percha?
to make the gutta percha radiopaque in the radiograph
best medium for avulsed tooth re implantation
hank’s balanced salt solution or milk
other medium used for avulsed tooth to be reimplanted
saline and saliva
normal intrapulpal pressure
5-14mmHg
irreversible pulpitis pressure
35 mmHg
when patient is lying down, there is pain elicited on the tooth. this indicates?
irreversible pulpitis
percussion per cusp
tooth sloth bite test
if cracked tooth is left untreated, it may lead to
split tooth
complication that may arise in lateral compaction
vertical root fracture
also known as apicoectomy
root end resection
tx for direct and indirect pulp capping
CaOH or MTA (mineral trioxide aggregate)
depth to pulpal horn in pulpotomy
1.8mm
removing specific pulp infected
CVEK’S PULPOTOMY
if there is profused bleeding in pulpotomy
- cut small portion of periradicular pulp
- observe if there is still bleeding
- if there is still bleeding, cut again
for pulpotomy
Buckley’s formocresol
under formocresol:
- formaldehyde
- tricresol
- glycerine
pulpotomy for permanent
CaOH
pulpotomy for primary teeth
formocresol
calcium hydroxide may lead to
internal root resorption
other term for internal root resorption
pink tooth of mummary
poorest prognosis in perforation
perforation in bifurcation
apicoectomy procedure
- flap
- bone
- trephination
- MTA
aka hemisection
premolarization
bleaching agent for non viral
sodium perborate
bleaching agent for vital teeth
hydrogen peroxide
most common adverse effect of RCT
discoloration
2 types of bleaching techniques
in-office
walk-in
other term for in-office non vital bleaching
thermocatalytic bleaching
other term for in-office vital bleaching
power bleaching
mechanism of hydrogen peroxide in bleaching
oxidation of organic pigments
rubber dam while bleaching to avoid
cervical resorption or external cervical resorption
