Pulp Pathology and Irritants Flashcards
What are the 3 main types of pulpal irritants?
1-Microbial
2-Mechanical
3-Chemical
______ dominate intraradicular infections while ______ are the most common bacteria in endodontic infections
Obligate anaerobes
Gram Negative
What bacteria is frequently isolated from failed RCTs?
E. Faecalis
Which fibers are myelinated, carry sharp or pricking pain and slightly innervate dentin tubules?
A-delta fibers
Which fibers are not myelinated, carry burning or aching sensations and are deeper in the pulp?
C fibers
What layer immediately adjacent to the odontoblastic layer is traversed by blood capillaries?
Cell Free Zone of Weil
What are 5 pathways of pulpal disease?
1-Dentinal tubules 2-Direct pulp exposure 3-Caries 4-Iatrogenic 5-Trauma
Pulpal necrosis can result from periodontal disease if it reaches where
The apical foramen
Traumatized teeth can become infected through what process that transports microbes to tissue damage through blood?
Anachoresis/Chemotaxis
What three reactions protect the pulp against caries?
1-Decrease dentin permeability
2-Tertiary dentin formation
3-Inflammatory and immune responses
What rare condition may occur if an opening of the pulp cavity occurs and the pulp becomes hyper plastic?
Pulp Polyp
*usually younger teeth
What are the 5 classes of periapical pathosis?
1-SAP (Symptomatic Apical Periodontitis) 2-AAP (Asymptomatic Apical Periodontitis) 3-AAA (Acute Apical Abscess) 4-CAA (Chronic Apical Abcess) 5-Condensing Osteitis
What are 6 irritants that can result in SAP?
1-Irreversible pulpitis 2-Bacterial toxins from necrotic pulp 3-Chemical irritants or disinfectants 4-Hyperocclusion 5-Overinstrumentation 6-Overextension of obturation material
Spontaneous, acute pain to biting or precision, hot, cold, and electric sensitivity with a widened PDL is likely what?
Symptomatic Apical Periodontitis
*may or may not respond to pulp vitality tests. May not have radiolucency yet
What condition is caused by pulpal necrosis, is a sequel to SAP, is chronic and asymptomatic with widened PDL and likely cyst?
Asymptomatic Apical Peridontitis
*no response to pulp vitality.
What is the breakdown of the 4 likely kinds of cysts?
1-Granuloma (59%)
2-Cysts (22%)
3-Scars (12%)
4-??? (7%)
Which variant of AAP is an increase in trabecular bone as a response to persistent irritation in the pulp, is mostly found in mandibular posterior teeth and is not a problem on its own?
Condensing Osteitis
What rapid onset liquefactive lesion destroys periapical tissues, may have swelling, varying degree of mobility, pain to percussion, biting and palpation and is frequently accompanied by fever?
Acute Apical Abscess
*may have fistula or sinus tract. may need I & D
What lesion is generally asymptomatic, may feel different to percussion, has an apical radiolucency but does not respond to pulp vitality tests?
Chronic Apical Abscess
*long standing lesion. May have mucosal or facial sinus tract
What 8 conditions merit Root Canal Therapy?
1-Hyperplastic pulpitis 2-Irreversible pulptitis (symptomatic or asymptomatic) 3-Necrotic pulp 4-SAP 5-AAP 6-AAA 7-CAA 8-Condensing Osteitis
