Pathogenesis and Periapical Diseases Flashcards
Endo
within
dontics
tooth
What resides within the tooth chamber with rigid walls?
unique connective tissue with vascular, lymphatic and nervous elements
What does the connective tissue contain?
odontoblasts
What does the pulp contain?
fibroblasts, undifferentiated mesenchymal cells, collagen type I and II, proteoglycans, glycoproteins, and water
What two dental tissues function as a unit?
pulp and dentin
where are odontoblasts located?
in the periphery of the pulp tissue, with extensions into the inner part of the dentin.
Dentin is the result of what process
odontoblast
How long does it take for a root to fully develop?
2-3 years (mainly 2)
How long does inflammation take to be felt by the patient?
48 hours
antibiotics take how long to kick in?
48 hours
Aδ fibers innervate what area
periphery
C fibers innervate what area
the central pulp
Aδ fibers characteristics
Sharp response to thermal change
extend between the odontoblasts
lose their myelin sheath (slows down the nerve transmission as they die)
extend to a distance of 100 to 200 μm into the dentinal tubules
C fibers characteristics
unmyelinated
dull ache that affects patients with symptomatic irreversible pulpitis
When a tooth first erupts, the root apex is _____ with _____ blood supply.
immature; ample
the older a tooth gets, the ____ the pulp is able to withstand irritation.
less
As a tooth matures what happens to the apices
it closes
What dictates the type and duration of a stimulus?
dental pulp and irritants
How can you classify irritants?
non-living = mechanical, thermal, or
chemical
living = microbial
what increases pulp irritation
more dentin is removed during deep cavity preparations
where is dentinal permeability is greater ?
closer to the pulp
removal of tooth structure without proper cooling
deep scaling a curettage
Periapical tissues can be mechanically irritated by
impact injuries
hyper-occlusion
over-instrumentation of root canals
perforation of the root, and over-extension of root canal fillings materials
under normal conditions, what isolates the the pulp and dentin from microorganisms?
enamel and cementum
what is the most common cause of pulp exposure
caries
What are a few antimicrobial agents?
silver nitrate, phenol with and without
camphor, and eugenol
What can ca inflammatory changes in the underlying dental pulp?
cytotoxicity
What are some irritants that will cause an inflammatory change?
cavity cleansers, such as
alcohol, chloroform, hydrogen peroxide, and various acids; chemicals
present in desensitizers, cavity liners and bases; and temporary and
permanent restorative materials.
What is the initial reaction of a pulp?
immune response
What is the most significant cause of inflammation?
microbial
early response to caries results in focal accumulation of what?
chronic inflammatory
cells, such as macrophages, lymphocytes, and plasma cells
Pulpal inflammation may remain inflamed for a long time or undergo rapid necrosis based on what factors?
virulence of the microorganisms
ability to circulate inflammatory fluids to avoid a marked increase in intrapulpal pressure
host resistance, including genetic variations
amount of circulation
lymphatic drainage
What is the path of travel for micro-organisms and their byproducts?
canal to periapical region
Pulpal and periapical pathoses do not develop without the presence of ?
bacterial contamination
What is the goal of root canal treatment?
to remove microorganism from the root canal system
What is biofilm?
Microcolonies of bacteria that irreversibly attach to a substratum, to an interface like dentin, and to each other
(T/F) Can all areas of the infected root canal system harbor microbial cells
organized as highly variable biofilm structures
true
What is the main microbial agent that causes endodontic infection?
lactobacilli, gramnegative
bacteria,
(T/F) primary root canal infects cannot harbor a multispecies population of facultative and strict anaerobic gram-positive and gram-negative bacteria, spirochetes, yeasts, etc.
false
What major virus is associated with irreversible pulpitis?
Epstein-Barr virus
How can microorganism enter the canal between appointments?
Cracked tooth
Tooth left open
Other reasons:
Not using a rubber dam
Caries left in tooth
Delay in getting a permanent restoration
