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Endo Final > Pulp Micro > Flashcards

Pulp Micro Flashcards

1
Q

Primary cause of endo disease.

A

Bacteria

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2
Q

Primary source of bacteria.

A

Caries

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3
Q

Dentinal tubule density increases or decreases as you get closer to the pulp?

A

Increases

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4
Q

Size of the dentinal tubules increase or decrease as you get closer to the pulp?

A

Increases

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5
Q

These do not have to penetrate the pulp chamber for bacteria to enter.

A

Caries

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6
Q

Irreversible pulpitis occurred when the bacteria were within how many millimeters of the pulp?

A

0.5 mm

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7
Q

Little pathosis is seen how many mm from the pulp?

A

> 1.2

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8
Q

Dentin formed during development and eruption.

A

Primary

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9
Q

Dentin formed after tooth formation is complete.

A

Secondary

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10
Q

Formed by external influences, like caries or attrition.

A

Tertiary/Irritation

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11
Q

A tertiary dentin secreted by odontoblasts and have more regular tubules.

A

Reactionary

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12
Q

A tertiary dentin secreted by odontoblast-like cells after death of odontoblasts.

Much stronger stimuli than reactionary.

Can be irregular and atubular.

A

Reparative

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13
Q

Removes the smear layer to expose dentinal tubules.

A

Acid etch.

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14
Q

Are always colonized by bacterial biofilms.

A

Cracks

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15
Q

There’s no break in the DEJ yet, but there’s already inflammation occurring in the pulp.

A

Enamel fissures.

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16
Q

Developmental anomalies that can lead to bacteria getting into the pulp.

A

Developmental groove
Dens in dente
Dens evaginatus

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17
Q

Periodontal pathogens pass thru lateral canals or the apical foramen to cause pulpitis.

A

Retrograde pulpitis.

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18
Q

Removal of cementum/dentin, and exposes dentinal tubules and can sever a lateral canal.

A

Root planing.

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19
Q

Microorganisms in the blood or lymph go to areas of inflammation where they can cause an infection.
Will not cause pulpal necrosis.

A

Anachoresis

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20
Q

Need this in order to have a LEO.

A

Pulpal necrosis.

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21
Q 
What are the following:
Pili
Capsules
extracellular vesicles
Enzymes
LPS
LTA
A

Bacterial virulence factors.

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22
Q

Polysaccharide layer outside the cell envelope. Helps avoid phagocytosis.

A

Capsules

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23
Q

Contain enzymes and toxic chemicals involved in:

Hemagglutination
Hemolysis
Bacterial adhesion
proteolytics activities
Neutralizing antibodies.
A

Bacterial extracellular vesicles.

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24
Q

Virulence factors that neutralize immunoglobulins and complement components.

A

Proteases

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25
Q

Made by gram (-) bacteria, agonist of TLR4, causes fever, BP changes, and inflammation.

A

LPS

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26
Q

Components of LPS.

A

Lipid A core
Core polysaccharide
O-antigen

27
Q

Virulence factor made by gram (+) bacteria; agonist of TLR2

A

LTA (Lipotechoic acid)

28
Q

Bacteria with a thin peptidoglycan wall and stain pink (don’t retain the crystal violet).

A

Gram Negative

29
Q

Have more bacteria than secondary endo infections, and are a polymicrobial infection dominated by gram negative, obligate anaerobes

A

Primary endo infections

30
Q

This region of the root canal has lower oxygen tension, nutrients from the periapical area, lower bacterial number, and less accessible to treatment.

A

Apical

31
Q

These bacteria predominate early in the primary endo infection.

A

Gram + facultative anaerobes.

32
Q

What’s the most dominant bacteria in primary infection?

A

Gram negative obligate anaerobes.

33
Q

Bacteria in primary endo infections that remain AFTER chemomechanical preparation (Root Canal).

A

Gram + facultative anaerobes.

34
Q

Reinfection of a RCT tooth is called this.

A

Secondary endo infection

35
Q

Predominant bacteria in secondary endo infections.

A

Gram + facultative anaerobes.

36
Q

Most recovered bacterial species in secondary endo infection.

A

Enterococcus faecalis.

37
Q

Most common fungus in secondary endo infections.

A

Candida

38
Q

Survival methods of this bacterium:

  • Invade dentinal tubules
  • Resists Ca(OH)2 by using a proton pump.
  • Forms biofilms.
  • Can enter VIABLE BUT NON-CULTURABLE STATE, so the doctors can’t grow it in the lab.
A

E. faecalis

39
Q

Components of biofilm.

A

1) 15% bacterial cells in microcolonies.

2) 85% Extracellular Polymeric Substance (polysaccharide)

40
Q

Communication to coordinate gene expression

A

Quorum sensing.

41
Q

These are 100-1,000 times more resistant to antibiotics.

A

Biofilms

42
Q

What do you put the gutta percha in for 1-2 minutes AFTER cutting it with the gauging cutter?

A

NaOCl

43
Q

This antibiotic must be given with another antibiotic.

A

Metronidazole

44
Q

Antibiotic of choice for endo infections bc it’s low-spectrum, efficient, low toxicity, and low cost.

A

Pen VK

45
Q

Augmentin kills 100% of bacteria. So why not use it for endo infections?

A

Colitis- will kill all the normal flora in the gut.

46
Q

Components of the Adaptive/Specific immunity.

A

B and T cells

47
Q

Immune cells of the pulp

A

APC’s
T cells
B cells
Mast cells

48
Q

Pulp immune cells only present during inflammation.

A

B cells and Mast cells

49
Q

APC’s present bacteria that they’ve phagocytosed in the pulp to the T cells via MHC Class I (Killer T cells) and MHC Class II (Helper T cells).

Cytokines are released to cause inflammation and increase vascular permeability

A

Pulpal Response

50
Q

Substances released in a pulpal response that cause vasodilation.

A

CGRP, Substance P, NKA

51
Q

Increase in interstitial pressure during pulpal inflammation would spread down the canal and “strangle” the entering blood vessels, leading to necrosis.

This DOES NOT occur.

A

Pulp Strangulation Theory

52
Q

How is the periapical response different from the pulpal response in an endo infection?

A

Activation of osteoclasts.

53
Q

How are osteoclasts activated?

A

Cytokines are released that cause osteoblasts to make RANKL.

54
Q

These make RANKL.

A

Osteoblasts.

55
Q

Bind RANK to activate osteoclasts.

A

RANKL.

56
Q

Binds RANKL to prevent activation.

A

Osteoprotegrin

57
Q

Inflammatory cells found in the periapical lesion of an endo infection.

A
  • Macrophages Dominate
  • Lymphocytes (T cells > B cells).
  • Plasma cells
  • Neutrophils
58
Q

Predominant inflammatory cell found in the periapical lesion.

A

Macrophages

59
Q

What do the Zones of Fish describe?

A

Areas of bone infection in a periapical lesion.

60
Q

Zones of Fish in order are:

A

1) Zone of infection
2) Contamination
3) Irritation
4) Stimulation (stimulates osteoblasts to make RANKL).

61
Q

No bacteria are found in this zone.

A

Contamination

62
Q

Where healing STARTS when the nidus of infection is removed.

A

Zone of stimulation

63
Q

Most common endo lesion

A

Granuloma

64
Q

A ______ is not an area where bacteria live, but in which they’re destroyed.

A

granuloma

Endo Final (6 decks)

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