L5: pulpal reactions to caries and dental procedures

Question 1

whats the effect of pulp having a rich neurovascular supply?

Answer 1

regulates effects of inflammation that may lead to rapid degeneration and necrosis

Question 2

important growth factors:

Answer 2

-TGF beta 1 and 3
-insulin like growth factors 1 and 2
-platelet derived growth factor
-BMP2
-vascular endothelial growth factor

Question 3

what characterizes early inflammation response to caries ?

Answer 3

focal accumulation of chronic inflammatory cells (they are directly proportional to depth of lesion)

Question 4

inflammation response is initially mediated by:

Answer 4

odontoblasts (pathogen detection by PRR)

–> ODONTOBLASTS ACTIVELY TRANSPORT ANTIBODIES TO INFCETION FRONT

Question 5

LATER , INflammation response is mediated by:

Answer 5

dendritic cells . which are APCs , and play a major role in odontoblast differentiation . they can also migrate to regional lymph nodes

Question 6

pulpal reaction to LA:

Answer 6

vasoconstrictors are added to make effect of anesthesia last longer. however , this decreases oxygen levels and reduces clearance of large molecular weight toxins or waste

Question 7

what is pulps response to the following :
-pressure
-heat
-desication
-little RDT (<0.5)

Answer 7

-Aspiration of odontoblast
-irreversible pathogenic changes to vital tissue at anything above 10 degrees above body temp
-aspiration of odontoblasts
-coagulation necrosis

Question 8

ideal hemostatic agent :

Answer 8

also has the ability to kill bacteria

Question 9

absorption of water from dentin during setting is one of the

Answer 9

factors that affect how pulp reacts to material

Question 10

how does calcium hydroxide affect pulp when used for pulp capping ?

Answer 10

in direct pulp capping , it may cause low grade irritation, superficial necrosis followed by low grade inflammation . within 30 days itll be back to normal tho

in indirect pulp capping : induces sclerosis by prompting crystal precipitation within tubules

Question 11

how do you disinfect mechanical exposure of healthy pulp created during cavity preparation ?

Answer 11

2% chlorohexidine or 5.25% sodium hypochlorite

Question 12

what are the properties of zinc oxide eugenol ?

Answer 12

anesthetic property:blocks transmission of action potentials in neurofibers and supress neural excitability

antiseptic: arrest caries progression

sealing ability

Question 13

gic is not used on direct pulp exposure

Question 14

lasers effect on pulp

Answer 14

reduce sensitivity and disinfection

disadvantages:
-pulp damage by coagulation necrosis , edema , inflammatory cell infiltration

Question 15

vital bleaching techniques use___

Answer 15

strong oxidizing agents carbamine peroxide and hydrogen peroxide

may cause 2 week minor inflammation (reversible pulpitis treated with flouride )

or severe inflammation

Question 16

treatment for sensitivity :

Answer 16

potassium nirtate (neural modulating agent )

stronium chloride, oxalates (tubule blocking agent s)

Question 17

ortho movement

Answer 17

dental tissue respiration rate is depressed after short term application of ortho force