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Endo > Pulpal Irritants > Flashcards

Pulpal Irritants Flashcards

1
Q

Irritants can be what three kinds

A

Microbial
Mechanical
Chemical

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2
Q

What is the goal in vital cases

A

Asepsis; to prevent infection, this includes use of a dam to keep bugs out.

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3
Q

What is the goal in non-vital cases

A

Antisepsis; to remove all microorganisms

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4
Q

What organisms are easily eradicated during conventional RCT

A

Obligate anaerobes

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5
Q

What are some examples of facultative bacteria

A

Streptococci
Enterococci
Lactobacilli

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6
Q

What organisms can survive chemo-mechanical RCT

A

Facultative bacteria

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7
Q

What one bacteria is frequently associated with failed RCTs

A

E. faecalis

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8
Q

What are some examples of mechanical irritants:

A 
Deep cavity prep
Lack of cooling
Impact trauma
Occlusal trauma
Deep perio curettage 
Ortho movement (too far or too fast)
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9
Q

What are some example of chemical irritants

A

Dentin: cleaning, sterilizing and desensitizing agents.

Some temp and permanent filling materials

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10
Q

Which fibers are myelinated

A

A-fibers; myelinAted, fAst, fAt

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11
Q

A-delta fibers are for

A

Paint
temperature
Touch

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12
Q

C-fibers are for

A

Pain; dorsal root, deep inside the pulp

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13
Q

Where are A-delta fibers principally located

A

Pulp-dentin junction

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14
Q

What type of pain comes from A-delta fibers

A

Sharp
Pricking
Relative low threshold

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15
Q

Where a C fibers principally located

A

Throughout the pulp

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16
Q

What type of pain comes from C fibers

A

Burning
Aching
Less bearable than A-delta fiber sensation
High threshold usually associated with tissue injury

17
Q

What is another name for the cell free zone

A

Zone of Weil

18
Q

Where is the zone of Weil

A

Immediately adjacent to odontoblastic layer in coronal pulp

19
Q

When is the zone of Weil mostly found

A

During middle age pulps

20
Q

What is the cell rich zone

A

Subodontoblastic area
High proportion of fibroblasts
Immune cells: macros, dendritic cells, undif mesenchymal cells

21
Q

Eventual or rapid necrosis depends on?

A 
The virulence of bacteria
Ability to release inflammatory fluid to prevent increase in intrapulpal pressure.
Host resistance
Amount of circulation
LYMPH DRAINAGE
22
Q

SAP lesions are more likely to have what two viruses

A

Cytomegalovirus

Epstein barr Virus

23
Q

What substance participates in the inflammatory reaction of the dental pulp

A

metabolites of arachidonic acid

24
Q

Metabolism of arachidonic acid results in the formation of what metabolites

A

Prostaglandins
Thromboxanes
Leukotrines

25
Q

What is the clinical sign of advanced internal resorption

A

Pink spots in the crown

but have normal pulpal and periapical tests

26
Q

What is the cause of ischemic necrosis

A

Traumatic injury from disruption of the blood supply

27
Q

What are MMPs

A

Matrix Metalloproteinases

endopeptidases that significantly contribute to the degradation of extracellular matrix components.

28
Q

What is AAA?

A

Localized or diffuse liquefaction lesion of pulpal origin.
Destroys PR tissues
Severe inflammatory response.

29
Q

What are the s/s of AAA

A 
Acute Apical Abscess 
Rapid onset
Spontaneous pain
Moderate to sev discomfort and swelling
Occasional systemic manifestations: temp, malaise, leukocytosis. 
Painful to percussion/palpation
30
Q

What are the s/s of CAA

A

Chronic Apical Abscess:
Long standing lesion.
Abscess that drains through a sinus tract.

31
Q

What are lessons that have similar appearance to PR lesions

A 
Periapical cemental dysplasia
Fibrous dysplasia
Ossifying fibroma
Primordial cyst
lateral periodontal cyst
Dentigerous cyst
Median cyst
Central giant cell granuloma
ameloblastoma
32
Q

What are the four pulpal diagnosis

A

Normal
Reversible pulpitis
Irreversible pulpitis
Necrosis

33
Q

What are the six periapical diagnosis

A 
Normal
SAP
AAP
Acute apical abscess
Chronic apical abscess
Condensing osteitis

Endo (15 decks)

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