NEW MD ENDO CARDS Flashcards by Hisham Abughoush

what 3 types of cells are found in pulp?

Fibroblasts

Odontoblasts : primary (before root formation complete) and secondary dentin (after)

mesenchymal cells: tertiary dentin (secondary odontoblasts protect pulp from injury)

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how does dentin affect pulp?

limits ability to expand

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calcifcation of tubules in response to slowly advancing caries is what type of dentin ?

sclerotic dentin ( hard)

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histologic zone of pulp

Inside -> out

predentin , odontoblastic layer, cell-free zone of weil, cell-rich zone, pulp core

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this pulp fiber resonds to cold

A-delta fiber

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structre of C vs alha-delta diber

alpha: marge myelated afference nerve

c-fiber: small unmyelinated afferent

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which way do alpha and C fibers travel

alpha: coronally through pulp

C fiber: centrally om [ulp stroma

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C fiber vs alpha fiber, which one is dull throbbing pain?

C fiber ( alpha is sharp transient)

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a patient feels pain at a stimulus lower than they usually feel. what is this called

allodynia ( sun burn hurts when you touch skin, doesnt normally hurt)

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an example of referred pain would be ?

preauricular pain from mandibular molars ( share V3 innervation)

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EPT test is contraindicated in patients that have what>

cardiac pacemaker

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a patient comes in no complaints of spontaneous pain. turns out symptom is coming from an irritant. what does he have?

reversible pulpitis

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patient is asymtpmatic and no clinical signs. what do they have

asymtpomatic irreversible pulpitis

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patient has a long term interruption of blood supply to the pulp. diagnosis ?

pulp necrosis

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patient has no response to cold. what is it?

pulpal necrosis !!

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patient has heightened and lingering response to pulp. what is it?

symptomatic irreversible pulpitis ( necrosis means no response)

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patient has no sympts but PARL developing on radiograph. what do they have?

asymtpomatic apical periodontitis

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straight line access should be to >

orifice and apex

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what tooth has the highest rate of root occurrence?

maxillary canine 96% chance of 1 root

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what tooth most likely to have 2 roots

max 1st pm

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access shape of maxillary molars

blunted triangle/ rhomboidal

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access prep shape of mandibular molars

trapezoid

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file colors

why you run blu ? go Back

15 20 25 30 35 40

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the SS hand files have what size taper?

.02

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the niTi rotary instruments have what size

.04 | .06

size 15 file is what at the tip? and what at 16 mm?

.15 mm at tip and .47 mm from tip to 16 mm from tip .15 + .02(16mm) .47 mm

what is the irrigant that dissolves ORGANIC materials?

NaOCl sodium hypochlorite

what is the lubricant that dissolves INORGANIC material

EDTA

what dissolves GP in retreatment of RC

chloroform

primary endodontic infection bacteria?

bacteroides

failed endo treatment bacteria?

enterococcus faecalis | EF

main ingredient for GP and sealer? **

zoe !!

when condensing GP which one is warm and which is cold vertical and lateral condensing?

Vertical: warm | Lateral : cold

what is surgical RCT?

cutting off apex tip and re instrumentation

best method for localized and fluctuant swelling?

incision and drainage

periapical microsurgery is what/

resectioning of 3 mm of diseased root tip

ways to avoid ledging in root canals

NiTI files use smaller instruments to bypass ledge instrument canal to full length pre bend file

what type of perforation is through pulpal floor?

furcal perforation

what is considered danger zone in a molar in endo?

D side of M root !!!

what is better. perforating more apical or more coronal?

more apical

what is sign of perforation?

immediate hemmorrhage | sudden pain

what material do you internally repair when perforating a tooth

MTA

trauma protocol for tooth

TRAVMA ``` tetanus booster ( avulsion only) radiograph antibiotic ( avulsion only) vitality test more appointments ```

when would you need tetanus booster for tooth trauma? what about antibiotics?

avulsion only | avulsions only

what are ellis classifcation

``` 1- enamel 2- enamel and dentin 3- e,d,p 4- traumatized tooth becomes non vital 5- luxation ( displacement of tooth) 6- avulsion ( completely out) ```

what is an uncomplicated fracture ?

fracture without pulp involvement

how to fix an euncomplicated fracture affected enamel only?

smooth edges

how to fix uncomplicated fracture that affects enamel and dentin?

restore

a patient fractures his tooth with pulp involvement. it has been less than 24 hrs. what should we do?

direct pulp cap

a patient fractures his tooth to the pulp and it has been 24 hours. what should clinician do?

CVEK ( partial pulpotomy

patient fractures his tooth with pulp involved and it has been 72 hours. what to do?

pulpotomy

patient has a horizontal root fracture on the coronal portion. what should treatment be>

RIGID splint 6-12 weeks ( WORST KIND)

patient has a horizontal root fracture on the midroot portion. what should treatment be>

FLEXIBLE splint for 3 weeks

patient has a horizontal root fracture on the APICAL portion. what should treatment be>

flexible splint for 2 weeks max to avoid ankylosis

if a tooth is concussed, what is the tx option?

let tooth rest

this is when a tooth does not displace, but mobilits is increased. PDL rips and bleeds what is tx? avulsion lateral luxation sub luxation extrusion

subluxation (tooth loose in socket) flexible spling 1-2 weeks

tooth is partially extruded from the socket tx? avulsion lateral luxation luxation extrusion

extrusion ( tooth out coronally) open apex: reposition, flexible splint, monitor closed: resp. flexible splint,RCT

``` displacement of tooth in any direction except axially. usually crown displaced palatally and root displaced labially tx? avulsion lateral luxation luxation extrusion ```

lateral luxation open: reposition, flexible splint, monitor closed: rep. flex sp. RCT if needed 80% necrosis closed apex

complete seperation of tooth from its alveolus tx? closed / open apex >60 and <60 ``` avulsion lateral luxation luxation intrusion extrusion ```

depends on EDT ( extra dry time) closed: <60 : reimplant, splint >60: reimplant, splint, RCT Open: <60: reimplant, splint , specification first sign of pulp infection >60: may or maynot implant, spling, rct, plan for implant

apical displacement of tooth tx? ``` avulsion lateral luxation luxation intrusion extrusion ```

intrusion: tooth gets pushed in to socket OPEN: ALLOW TO REERUP !!!! (BOARD ?_ closed: reposition, flex splint, RCT 96% necrosis closed apices

which one has 96% chance necrosis with closed apex? ``` avulsion lateral luxation intrusion luxation extrusion ```

intrusion

patient falls and tooth comes out. it has been only 45 minutes. what should tx be?

closed: <60 : reimplant, splint Open: <60: reimplant, splint , specification first sign of pulp infection

patient falls and tooth comes out. it has been 2 hours. what should tx be?

closed >60: reimplant, splint, RCT open >60: may or maynot implant, spling, rct, plan for implant

what is the best and worst store media for a tooth that comes out?

Hanks balanced salt solution -> milk _> saline -> water (hypotonic no balnce of ions)

external resorption initiates where and is due to damage of what?

periodonteium | cementoblastic layer

ankylosis is type of what ? cervical resorption replacement resorption inflammatory root resporption

replacement: repalces PDL with bone

a patient that had nonvital bleeching complains about sensitivity. radiograph shows r/l on cervix of tooth. what might this patient have?

cervical resorption

bacteria and byproducts from nectoric pulp travel through dentinal tubules to affect peridontiem called what?

inflammatory root resoprtion ( external resoprtion)

internal resoprtion initates where and damages what layer

root canal system | odontoblastic layer

true or false. external resoption easier to treat than internal

false | internal is easier

tmnt for internal resorption ?

RCT

calcific metamorphosis ( discolation of anterior teeth) is caused by what?

trauma that induces odontoblasts to rapidly crease a lot of dentin in pulp space

what is radiographic finding of calcific metamorphosis

canal obliteration b/c pulp canal shrink to point you cant see it

what does caoh do? | pH?

stimulates secondary odontoblasts (repair dentinal bridge formation) 12.5 ( kills bacteria)

what does MTA do? | what is it used for?

stimulates cementoblasts fxn: root repair, apex filler nonresorbable ( great sealer)

indirect pulp cap uses what materials

CAOH , RMGI

drilling and expose pulp that is 1 mm. what do you do? | material you add?

direct pulp cap, caoh

portion of pulp is diseases. what do you do?

remove small portion coronal diseased pulp

theres a traumatic exposure of pulp more than 24 hours. what do you do?

cvek pulpotomy (partial)

a traumatic exposure lasts more than 72 hours. what do you do? materials add?

pulpotomy zoe in crown formocresol in orifices

a primary tooth with traumatic exposure more than 72 hours that is VITAL and resotrable, what do you do?

pulpotomy

what are properties of formocresol? what is it made of? when do you use it?

20% formaldehyde bactericidal and fixative ( kills bacteria/ fixes pulp) USE PEDIATRIC PULPOTOMY OF VITAL TOOTH

doing a pulptomy on a kid, what do you use ?

formocresol

a patient has a nonvital, restorable primary tooth with pulp exposure that is ASYMPTOMATIC. what should they do>?

pulpectomy

what materials added for pulpectomy of primary tooth?

zoe in crown caoh in root ( caoh resorbed by underlying permanent teeth) pain relief on teeth with irreversible pulpitis Primary teeth: nonvital and reasonable with asymptomatic pulp exposure

a patient has symptomatic molar that nonrestorable and root resporption, what should we do?

extraction SYMPTOMATIC= extraction

what tooth is most susceptible to extraction

primary first molar= LOTS OF ACCESSORY CANALS

teenager walks in with vital pulp exposure, and is undergone pulp therapy ( CVEK, PPTy) etc. what happens now

apexogenesis ( development of apex in an IMMATURE PERMANENT TOOTH) happens afterpulp cap placed on healthy or diseased pulp ( CaOH and MTA)

difference between apexogenesis and apexification?

apexogenesis: - maintain pulp vitality - caOH or MTA place following IPC, DPC, CVEK, PPTY in IMMATURE permanent tooth specification: - disnfection of root canal - CaOH or MTA placed on base of canal after PCTY performed in IMMATURE PERMANENT TOOTJ

a pulpectomy is done on a teenager, what treatment should follow it?

apexification | caoh or mta placed at base of canal after pulp removed especially in IMMATURE PERMANENT TOOTH