Pulp Therapy

Question 1

what are there an increased number of in root canals of deciduous teeth?

Answer 1

accessory canals and foramina

Question 2

what is the porosity like of root canals in deciduous teeth?

Answer 2

more porous

Question 3

what are the root canal shapes like of deciduous teeth?

Answer 3

more ribbon like

Question 4

is canal debridement harder in deciduous teeth?

Answer 4

yes

Question 5

why is complete extirpation of deciduous root canals so difficult?

Answer 5

the morphology of the roots

Question 6

where does the root canal lie in the tooth?

Answer 6

several mm coronal to the radiographical apex

Question 7

irriversible pulpitis leads to what treatment?

Answer 7

pulp therapy

Question 8

if 1/3 of the marginal ridge is broken down what is likely to be happening in the tooth?

Answer 8

irriversible pulpitis

Question 9

what is a pulp polyp?

Answer 9

chronic response
inflammatory hyperplastic response to disease associated with a non vital tooth
may be symptom free - as chronic

Question 10

do not do pulp therapy if?

Answer 10

tooth not long term unrestorable
pre co operative pt
medically compromised (e.g bleeding tendancies)
ortho

Question 11

what are the 3 types of VITAL pulp therapy?

Answer 11

pulp capping
pulpotomy
desensitising therapy

Question 12

what is a pulpotomoy?

when would a pulpotomoty not be suitable?

Answer 12

the removal of the diseased portion of pulp only, applying medicaments to remaining pulp = continue function
can only carry out if no diseased radicular pulp

Question 13

cant do a pulpotomy if? (non vital signs or diseased radicular pulp)

Answer 13

abscess - radicular
excessive bleeding - radicular
no bleeding on access = non vital

Question 14

what is formocresol made of?

Answer 14

tricesol - antiseptic
formalin - stops decomposition
works by binding bacterial and pulp proteins

Question 15

what are the properties of formocresol?

Answer 15

bacteriocidal/devitalising
mutagenic/carcinogenic
kidneys/liver fast absorb
tissue fixed - rendered inert and resistant to further bacterial breakdown

Question 16

when can formocresol cause tissue damage?

Answer 16

if passes through apical foramen and damage the underlying tooth germ
causes 80-90% of pulp to become non vital
superficial tissue demineralisation

Question 17

what is ferric sulphate and how is it used?

Answer 17

haemostatic agent
not a fixative
15% applied to pulp stumps for 15seconds
may have bacteriocidal properties

Question 18

what is gluteraldehyde?

Answer 18

aqueous sol 2-4%
powerful fixative
some toxic effects
not as effective

Question 19

what is calcium hydroxide?

Answer 19

causes internal resorption
tertiary dentine stimulated
dentine bridge - causes a barrier against bacterial invasion
pure powder form - as effective as formacresol
not used as medicament bc internal resorption
allows healing in pulp rather than fixing the tissue

Question 20

what do you create a large access cavity for?

Answer 20

to visualise all the pulp horns

Question 21

what part of the pulp chamber do you remove in a pulpotomy and with what kind of bur?

Answer 21

roof of chamber

round head stainless steel bur

Question 22

why is a 3in1 not used in pulp therapy?

Answer 22

air bubble in blood can cause emphysema

Question 23

what do you irrigate the pulp with in a pulpotomy?

Answer 23

saline

Question 24

what do you restore the tooth with during a pulpotomy?

Answer 24

dycal, zinc oxide eugenol, crown

Question 25

what is desensitising therapy?

Answer 25

reduce pulpal inflammation and or symptoms

Question 26

when is a desensitising therapy used?

Answer 26

carious pulp exposure, no signs/symptoms/vitality loss
hyperaemic pulp
hyperalgesic pulp

Question 27

what is the desensitising therapy technique?

Answer 27

pulpotomy up to medicament step
cotton pledget and ledermix
place well sealed temp dressing
rev in 2 weeks

Question 28

what is a pulpectomy?

Answer 28

remove necrotic tissue and obturate the canals
if diseased radicular pulp
diff to RCT bc morphology

Question 29

what is the irrigation solution used in a pulpectomy?

Answer 29

sodium hypochlorite

Question 30

what are the steps of a pulpectomy following irrigation?

Answer 30

canal instrumentation
file canal walls
irrigate
paper points and dry
temp dressing - rev 7 days
irrigate 
root filler

Question 31

what is a tooth filled with during a pulpectomy?

Answer 31

non setting calcium hydroxide/zinc oxide eugenol

zinc oxide and crown

Question 32

if a tooth has pulp therapy, vital or non vital how often should it be reviewed?

Answer 32

6 monthly follow up

yearly review and radiographs