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Endotontics > Pulpal Pathophysiology > Flashcards

Pulpal Pathophysiology Flashcards

1
Q

susceptibility of the pulp to irreversible injury

A

yes

  1. low compliance system
  2. poor collateral circulation
  3. pulpal degeneration
  4. abundant oral bacteria
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2
Q

pulpal response to a carious lesion why?

A

direct communicaton between dentin and the pulp

pulp reacts to carie before it is infected with bacteria

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3
Q

pulp reacts to carie before it is infected with bacteria?

A

yes because of

  • bacterial products
  • endotoxins
  • immune complexes
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4
Q

slcerotic dentin?

A

a response to a carious lesion

  • peri-tubular dentin
  • highly mieralized
  • initial defense against a low grade lesion
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5
Q

initial defense against a low grade lesion?

A

scleortic dentin

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6
Q

describe dead tracts

A

Acute carious lesion

death of odontoblasts

loss of odontoblastic processes

open pathway for infection of pulp by oral bacteria

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7
Q

describe reparative dentin

A

Tertiary form of dentin

less tubular / more permeable than primary dentin

produced by replacement odontoblasts

‘calciotraumatic line’

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8
Q

‘calciotraumatic line’ represented by?

A

reparative dentin

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9
Q

initial response is what type in pulpal inflammation?

desscribe what happens

A

intital response is a chronic one
- lymphocytes / plasma cells/ macrophages

  • deposition of collagen
  • proliferation of blood vessels
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10
Q

formation of microabscesses?

A

yes - a pulpal response to inflammation

it is AN ATTEMPT TO WALL OFF INFECTION

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11
Q

Circumferential spread of inflammation?

A

continued tissue destruction
- continued increase in intra-pulpal pressure

VENULAR COLLAPSE
ISCHEMIC NECORIS

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12
Q

c- fibers may still be vital in necrosis?

A

Yes

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13
Q

Classificaiotn of Pulpal Pathosis

3

A
  1. reversible pulpitis
  2. ireversible pulpitis
  3. pulp necrosis
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14
Q

reversible pulpitis

A

Localized inflammation

localized increase in intra-pulpal pressure

threshold for stimulation of A-delta nerve fibers is lowered
- Hyperalgesia
EXAGGERATED but non-lingering response to stimuli (thermal)

no permanent pulpal damage

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15
Q

hyperalgesia definition

associated with

A

reversible pulpitis–

EXAGGERATED but non-lingering response to stimuli (thermal)

no permanent pulpal damage

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16
Q

describe irreversible pulpitis

A

deep throbbing pain, unstimulated pain

circumferential spread of inflammation

threshold for both A-delta and C fibers is lowered

-lingering pain after thermal stimulation

spontaneous, dull, aching pain

IRREVERSIBLE

17
Q

describe pulp necorsis

A

COMPELTE NECROSIS OF A-DELTA FIBERS
- no response to vitality tests

C-fibers may still be viable

may or may not be symptomatic

18
Q

Periradicular tissue

describe

A

Direct communication with pulp tissue

inflammation ersponse precedes infection

collateral ciculation presnt

cancellous bone allows for drainage of edematous fluids

proprioceptive fibers present

19
Q

calciotraumatic line from?

A

reparative dentin

20
Q

intitial defense against low grade carious lesion

A

sclerotic dentin

- highly mineralized

21
Q

what is the major way bacteria can go through after an acute carious lesion?

A

dead tract – loss of odontoblastic processes and death of odontoblast

22
Q

describe tertiary dentin in terms of permeability and tubules?

A

Less tubular and more permeable than primary dentin

23
Q

describe the pulp in an acute inflammatory reaction

A

vascular changes – vasodilation and increased permeability

  • PMNs and leukocytes
  • increased intrapulpal fluid (edea)
  • increased intrapulpal pressure
  • stimulation of C fibers
24
Q

hyperalgesia represents?

A

reversible pulpitis

when threshold for stimualtion of A delta nerve fibers is lowered
- hyperalgesia

25
Q

circumferential spread of inflammation is represented by?

A

irreversible pulpitits

26
Q

collateral circulation present where?

A

in the peri-radicular areas – NOT PULPAL

27
Q

Implication of cancellous bone in peri-radicualr tissues

A

allows for drainage of edematous fluids

28
Q

main two reasons we see symptomatic apical perio and main feature

A
  1. pulpal pathosis
  2. occlusal trauma

PERCUSSION / PALPATION SENSITIVE

29
Q

radiographic ferature in apical perio

A

widened PDL - break in lamina dura

30
Q

Feature of acute apical abscess

A

SWELLING

31
Q

Radiolucency associated with Asympotmatic apical perio? describe

A

yes – peri-radicular granuloma or cyst

32
Q

describe periradicualr granuloma

A

granulomatous tissue

  • macriphage, lymphocytes, plasma cells
  • fibrous tissue capsule
  • increased vascularity
33
Q

bay cyst vs true cyst

A

bay cyst –> opening in the lining - opening in the canal to the apex

true cyst – completely lined with epithelium

lumen may / may not communicate with apical foramen
- if it does – bay cyst – of if does not – true cyst

34
Q

describe peri-radicular cyst

A

associated with AAP
- stimulation of epithelial rests of Malassez within in the granuloma

3D epithelial lined cavity filled with fluid

lumen may/ may not communicate with apical foramen

35
Q

radiographic feature of focal scelorosing osteomyeltits

histologically?

A

increased bone density/ trabeculation

histologically
- mild inflammatory response with increased bone deposition

it is a response to low grade pulpal inflammation

Endotontics (21 decks)

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