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Tim's Cards > Pee Dos > Flashcards

Pee Dos Flashcards

1
Q

How do we determine vitality of Primary teeth?

  • 4 tests
  • unreliable in Primaries
A

Thermal

Percussion

Palpation

Mobility

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2
Q

How do we determine vitality of Immature Permanent Teeth?

*useful to establish baseline in trauma

A

Electric

Thermal

Percussion

Palpation

Mobility

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3
Q

How do we determine viability of Permanent Teeth?

A

Electric

Thermal

Percussion

Palpation

Mobility

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4
Q

Feel changes in alveolus/furcation/mobility

Infection leads to Resorption leads to Mobility

A

True

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5
Q

T/F

Never base Tx decisions on sensibility tests/feedback

A

True

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6
Q

Tx exposes pulp, how determine Pulp Status?

*2 options

A

Purulent/profuse bleeding - Irreversible Pulpitis

Bright red/arrests 5 min. - Reversible Pulpitis

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7
Q

12/24 month (general) Success Rate: MTA

FS:

FMC:

Laser:

ZOE:

CaOH

A

100 98

86 86

96 85

93 78

92 68

86 53

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8
Q

What is the best filler for Pulpotomy?

A

MTA

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9
Q

4 reasons MTA best filler for Pulpotomy:

A

Bioactive glass/ceramic

biocompatible (non-toxic)

Minimal inflammatory response

HA forms dentin and filling material

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10
Q

What is a dentinal bridge?

A

Reparative Dentin laid down after Pulpotomy

*MTA

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11
Q

3 Protective Liner Meds (Primary and Permanent)

A

GI (Vitrebond/Fuji IX)

CaOH

Dentin Bonding Agent

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12
Q

4 Direct Pulp Cap Meds (Primary/Permanent)

A

MTA (Mineral trioxide aggregate)

BIO

CaOH

RMGI/GI

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13
Q

What 2 products would you NEVER USE for Pulpotomy for Permanent teeth?

What 2 products are ok to use?

A

FMC or FS

MTA or CaOH

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14
Q

6 Pulpotomy meds:

*that can be used on Primary teeth

A

Formocresol (FMC)

Ferric Sulfate

MTA

Electrosurgery/Laser

TempIt (ZOE)

NaOCl (bleach)

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15
Q

Primary Pulpotomy Meds: FMC ___ application, is _____

Ferric Sulfate ____ application, is _______

MTA/Endosequence, ________

Electrosurgery/Laser, careful of…

ZOE, aka…

NaOCl, similar success rate to ______

A

5 minute, bactericidal

15 second, coagulant

leave it in

exces heat/energy

TempIt

FMC

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16
Q

4 Indirect Pulp Tx Meds (Primary/Permanent)

A

GI

RMGI

CaOH

ZOE/IRM

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17
Q

3 Pulpectomy Meds to never use with Primary teeth:

Why?

A

IRM, MTA, Gutta Percha

non resorbing

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18
Q

IRM, MTA, GP never used for Pulpectomy on Primary teeth (non resorbing), what do you use instead?

A

Vitapex

followed by ZOE/GI

*flush canals w/ NaOCl 1%

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19
Q

there is a tendency to ______ Vitapex and ______ ZOE

*primary pulpectomy

A

overfill Vitapex

underfill Zoe

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20
Q

What are the steps for Immature Permanent Apexification?

A

(like pulpectomy) Irrigate NaOCl

CaOH 2 wks for disinfection

Apical collagen as needed

MTA (moist pellet 24 hrs)

check MTA after 24 hrs, Place GP

***MTA/composite fill for reinforcement of immature root (this is apexification)

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21
Q

What is used for Apexification?

A

MTA/composite fill to reinforce immature root

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22
Q

What are the filling (obturating) materials for the chamber?

A

ZOE (IRM)

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23
Q

FMC has similar success to FS and Bleach

A

True

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24
Q

If the Pulp is Vital, what procedures can you do?

A

Direct Pulp Cap

Pulpotomy

Indirect Pulp Cap

Revascularization

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25
Q

If the Pulp is Non-Vital, what procedures can you do?

A

Pulpectomy

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26
Q

Use a Protective Liner in Normal Pulp for what?

A

Dentinal tubules exposed by prep

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27
Q

A Protective Liner is only used when what 2 conditions are met?

A

All decay removed

no pulp exposure

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28
Q

When can you use a Direct Pulp Cap?

2 conditions

A

Vital

Small/pinpoint exposure (less than 1mm)

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29
Q

A Direct Pulp Cap is NOT recommended for a Primary tooth when?

A

if carious exposure

*internal resorption

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30
Q

Pulpotomy on a Primary, do when the Tooth is Vital, or ______ pulpitis

And the tooth is restorable

A

Reversible Pulpitis

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31
Q

3 options if you have a Vital tooth and a Large exposure due to caries on a Permanent tooth:

A

Direct pulp cap

Partial pulpotomy

Pulpotomy

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32
Q

Direct Pulp Cap, Partial Pulpotomy, and Pulpotomy for large carious exposure, vital tooth absence of _______, no radiographic pathology

And what?

A

spontaneous pain

open apex

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33
Q

For an Indirect Pulp Tx on Primary you must remove what?

Re-enter?

Caries should be __ mm from the pulp

A

All caries that would potentially expose pulp

no

1 mm

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34
Q

When would you do a Pulpectomy on a Primary?

A

Non vital

Strategic

Resorable

Adequate root

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35
Q

Immature Permanent Apexification:

A

RCT

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36
Q

Vital Pulp Tissue

Dentin pulp complex free of bacteria

Creation of new pulp for Apexogenesis

A

Revascularization

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37
Q

Procedure that addresses the shortcomings involved with capping the inflamed dental pulp of an incompletely developed (immature) permanent tooth. The goal is the preservation of vital pulp tissue so that continued root development with apical closure may occur on its own naturally

A

Apexogenesis

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38
Q

Achieving artificial closure of the Apex, pulp is non vital in immature permanent teeth, tooth discontinues its natural maturation process and can be weakened

A

Apexification

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39
Q

Primary Pulpectomy, can’t use what 2 products?

Use what instead?

A

MTA/IRM

Vitapex

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40
Q

Which medications/Tx are not used in Permanent Pulpotomies?

*why?

A

FS/FMC

*don’t want existing vital pulp inert/leave clot

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41
Q

In what scenario do we not perform a direct pulp cap?

why?

A

Carious pulp exposure, Primary teeth

mesenchymal cells differentiating into odontoclasts and resorbing the pulp internally

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42
Q

How do we promote apexogenesis in pulpally involved teeth?

A

Vital

no RCT, pulpectomy, apexificatoin

vital pulp therapy options instead

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43
Q

Where would a Primary Pulpectomy be a good Tx option?

Where do we NOT do them?

A

necrotic, strategic, restorable

primary 1st Molars

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44
Q

Apexogenesis is used…

Apexification is used…

A

normal natural closure of root for Immature Permanent

artificial closure (RCT)

***vital vs non-vital

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45
Q

When would you remove a tooth instead of doing a Pulp Therapy?

A

infection uncontrolled

Bony support can’t be regained

inadequate tooth structure

excessive root resorption

not strategically important

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46
Q

Good pain often sharp

Bad pain often throb

A

True

True

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47
Q

What is the most reliable pulp test?

Electric, Thermal, Percusssion/palpation/mobility

A

Percussion/Palpation/Mobility

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48
Q

Never base Tx on sensibility tests alone. They are only one possible indication of pulp vitality

A

True

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49
Q

2 indications, Irreversible Pulpitis:

2 indications, Reversible Pulpitis:

A

Profuse Bleeding, purulent exudate

bright red, 5 min arrested

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50
Q

What isn’t recommended in a Primary Tooth with Carious Exposure?

A

Direct Pulp Cap

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51
Q

Primary tooth w/ Carious Exposure, no Direct Pulp Cap

What instead?

A

Pulpotomy

52
Q

Biocompatibility is a function of…

A

Microleakage

53
Q

IPT (indirect pulp treatment) is better than what?

__% at 3 years

A

Formocresol

94%

54
Q

ITR (Interim Therapeutic Restoration) will successfully diagnose treateable vital pulp therapy teeth ___% of the time

A

98%

55
Q

Early tooth extraction may decrease the length of stay in the hospital

A

True

56
Q

ABCDE: missing E:

Missing D:

Missing E on both sides:

Missing D on both sides

A

distal shoe

banded loop

Nance/Transpalatal Arch

Two banded loops (or Transpalatal Arch)

57
Q

ONMLK: Missing K

Missing L (after 1st molars in)

A

LLHA

Do nothing

58
Q

Most reliable pulp test for Primaries:

A

Percussion

Mobility

Palpation

59
Q

When evaluating Primary for pulp Vitallity, what x-rays are the most helpful:

A

BW

PA

60
Q

8 y/o, tooth 30, deep lesion, vital, all decay removed, moderate sized pulp exposure:

What meds?

A

Pulpotomy

MTA

61
Q

6 y/o, tooth K, deep lesion, all decay removed, no exposure:

Meds:

A

Liner

GI

62
Q

10 y/o, tooth 3, deep lesion, vital, potential for pulp exposure:

Meds:

A

Indirect pulp therapy

RMGI

63
Q

5 y/o, tooth D, deep lesion, non-vital, moderate sized pulp exposure, pulpal necrosis/purulence

A

Extraction

64
Q

T/F

A tooth cannot be fractured without having had an associated displacement injury

A

True

65
Q

Prognosis of crown fracture: depends upon ______ to PDL

A

concomitant injury

66
Q

Age of pulp exposure, extent of dentin exposed, stage of root development at the time of injury secondarily affect the tooth’s prognosis

A

True

67
Q

Crown/root fractures: When the primary tooth can’t be restored, entire tooth removed unless?

A

Retrieval apical fragments might damage Succedaneous Tooth

68
Q

Root fracture involves what?

A

dentin, cementum, pulp

69
Q

Reduce/reposition a root fracture and space in a ______ splint for ______

rinse with what?

Prognosis:

In the event that the pulp becomes necrotic…

If necrotic part removed:

A

non rigid, 4 weeks

CHX, antibiiotics

improves w/ fracture closer to Apex

radiolucency at fracture site

apical segment continues to develop/calcify

70
Q

T/F

It is typical for slight root resorption to occur at the fracture site early in the healing process

A

True

71
Q

Follow up timeline for a fracture: 4 week splint removal

4 month splint:

4 weeks splint removal:

2 week splint removal:

A

apical third and mid root fractures

root fracture near cervical area

lateral luxation, alveolar involvement

intrusion alveolar fracture

72
Q

Splinting should be non-ridig, passive atraumatic, with small diameter ortho wire measuring:

A

.014 - .015

or monofilament fishing line + composite

73
Q

Splinting involves 2 non-affected teeth on either side and must allow movement, otherwise…

A

risk ankyloses

74
Q

4 things requiring 2 week splint:

3 things requiring 4 week splint:

A

subluxation, extrusion, intrusion, avulsion

lateral luxation, delayed avulsion, root fracture

75
Q

ECC, presence of ____ decayed/missing/filled in any primary tooth in a child ____ months or younger

A

1+

71 months

76
Q

Severe ECC any smooth surface lesions in a child younger than…

A

3 y/o

77
Q

From ages 3-5, one or more cavitated/missing/filled smooth surface where?

or…

A

Primary Mx Anterior

decayed/missing/filled score

78
Q

What meds do we Never use on a Permanent tooth?

What do we use instead?

A

FMC/FS

MTA/CaOH

79
Q

4 options for Vital Pulp therapy:

A

Liner

Indirect Pulp Cap

Direct Pulp Cap

Pulpotomy

80
Q

Never do a Direct Pulp cap if there is what?

***Primary tooth

A

Carious lesion

81
Q

3 meds suitable for a Direct Pulp Cap:

A

DiCal, MTA, CaOH

82
Q

FMC, time…

FS, time…

A

5 minutes

15 seconds

83
Q

Depth of a Partial Pulpotomy in a Permanent tooth:

A

1-3 mm

84
Q

Primary Pulpectomy, never use…

Instead use…

A

MTA, IRM

Vitapex, ZOE

85
Q

IRM is reinforced ______

Therefore, you can’t use IRM in a Primary Pulpectomy, but you can use…

A

ZOE

86
Q

Apexification:

A

Collagen plug, GP

87
Q

Revascularization, make the canal ______, then do what?

A

Sterile

puncture alveolus, bleed, creates scaffolding that creates new pulp

88
Q

Pulp vitality in Primary teeth: (3 things)

Also what?

A

percussion, mobility, palpation

Hx

89
Q

4 y/o, tooth T, deep lesion, no exposure:

A

Liner

90
Q

5 y/o S and L extracted, what is space management?

A

LLHA or Band/Loop

  • **in this case, go with 2 Band/Loop
  • **if M also gone, LLHA (but warn about linguals)
91
Q

Primary pulpectomy, don’t use IRM or MTA why?

A

don’t resorb

92
Q

Why would we do a Pulpectomy in a Primary tooth?

A

non vital

root intact

Anterior Teeth

2nd Primary Molars

93
Q

Apexogenesis:

Apexification:

A

natural growth of the root

collagen Plug (non-vital, immature)

94
Q

PERRLA:

A

Pupils equal, Round, Responsive to Light, Accommodation

95
Q

4 types of Displacement Injuries:

A

Concussion

Subluxation

Luxation (3 subtypes)

Avulsion

96
Q

3 types of Luxation:

A

Extrusion

Lateral

Intrusion

97
Q

Injury to tooth-supporting structures without abnormal loosening or displacement of the tooth

A

Concussion

98
Q

Prognosis for Primary Concussion:

A

53% discolor

99
Q

PRIMARY/Permanent Concussion Tx: ____ radiograph

Pulp sensibility tests:

Observation ____ diet

____ week follow up

_____ week follow up w/ radiograph

Follow for ______ and signs of necrosis

A

1 occlusal

don’t do (perm: should be negative)

soft

1 week (perm: 4 weeks)

6-8 week

1 year

100
Q

Radiographic evidence Pulp Necrosis:

Inflammatory resorption:

Replacement resorption:

A

2 weeks

3 weeks

6 weeks

101
Q

Injury to tooth-supporting structures with Loosening but no displacement

A

Subluxation

102
Q

Subluxation will get bleeding from where?

because PDL is _____

Radiographs show no ______ and minimal PDL thickening

A

sulcus

torn

displacement

103
Q

PRIMARY Subluxation Tx: ____ radiograph

sensibility tests?

Observation and ____ diet

____ week follow up

_____ week follow up w/ radiograph

Prognosis:

A

1 occlusal

no

soft

1

6-8 week

possible discoloration, can lead to pulp canal obliteration

104
Q

Permanent Subluxation Tx: 1 occlusal radiograph, Splint for ______ weeks

___week follow up

______ week follow up w/ radiograph

Follow for ___ signs necrosis

Prognosis open apex:

Prognosis Closed apex:

A

2 weeks

4 week

6-8 week

1 year

minimal risk necrosis

slight risk necrosis (15%)

105
Q

While Splinting, _____ is required ____ times/day

A

CHX

2x

106
Q

Displacement of the tooth axially

PDL partially/totally separated

  • tooth appears elongated
  • negative pulp tests
A

Extrusion Luxation

107
Q

Extrusion Luxation, reposition/splint Primary tooth is less than ___ mm extrusion

Extract if….

A

3 mm

greater than 3 mm

108
Q

How long to splint Extrusion Luxation?

A

2 weeks

109
Q

The need to Splint Extrusively luxated Primary Tooth is likely an indication for what?

A

Extraction

110
Q

Permanent Extrusion Luxation Tx: splint:

Follow ups at:

Prognosis for Open Apex

Prognosis for Closed Apex:

A

2 weeks

1, 2, 4, 8 weeks, 6 months, 1 year, follow annually 5 yrs

best

necrosis/obliteration common Ankylosis

111
Q

Lateral Luxation Primary Tx, if Crown displaced labially:

follow ups:

Prognosis:

A

Extract

1 week, 2-3 weeks (splint), 6-8 weeks (radiographs)

if repositioned, pulp necrosis increases

112
Q

Lateral Luxation Permanent Tx: when reposition?

follow ups:

Prognosis Open Apex

Prognosis Closed Apex:

A

immediately

2, 4, 6-8 weeks, 6 months, 1 yr, annually 5 yrs

best

necrosis/obliteration common

113
Q

Lateral Luxation in Permanent tooth has ___% chance of necrosis:

A

75%

114
Q

Primary Apical Luxation Tx: displaced labially:

displaced lingually:

if extract?

A

re-eruption

extraction

radiograph every yr until permanent erupts

115
Q

___% of intruded teeth will re-erupt spontaneously

A

90%

116
Q

Intrusion Luxation Permanent Tx: remove splint when?

If Immature:

If mature:

A

2 weeks

spontaneous eruption (ortho after 3 wks)

reposition ASAP surgically

117
Q

Intrusion: if Apex is Open, when allow spontaneous eruption?

When ortho/surgical

If Apex Closed, when allow spontaneous eruption?

When ortho/surgical?

A

up to 7 mm

more than 7 mm

up to 3 mm

ortho 3-7, surgical more than 7

118
Q

Most complicated luxation injury

A

Ankylosis

119
Q

Avulsion for Primary Teeth:

A

Never Replant

120
Q

Avulsion Tx permanent:

A

put back in right away

121
Q

Avulsion Tx, if less than 60 minutes:

if more:

A

replant

will Ankylose and fail - replant for esthetic, delayed resorption

122
Q

Any immature tooth out for less than 1 hour is worth replanting

A

True

123
Q

Mature Apex (closed) tooth Avulsion, pulpectomy when?

A

within 7-10 days

*before removal of splint

124
Q

Avulsion: Mature apex replant?

don’t replant?

A

less than 1 hr

more than 1 hr

125
Q

Partial pulpotomy removes 1-3 mm and is called what?

What is goal?

A

Cvek

apexogenesis

126
Q

If a fracture is near the cervical area the Splint should be kept in how long?

A

4 months

127
Q

In order, the best transport medium for teeth:

never:

A

put in socket, hanks, milk, saliva

water

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