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RCDC study time > Questions 2012 > Flashcards

Questions 2012 Flashcards

1
Q

Give 4 features of of irreversible pulpits.

A
  • Limited to one tooth
  • Pain is sharp and doesn’t last
  • Pain is release by LA
  • Tooth is associated with caries, recent filling, trauma
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2
Q

Give 4 features of migraine.

A
  • Duration between 4-72h
  • Unilateral
  • Pulsative
  • Moderate to severely intense pain
  • Nausea/vomiting
  • Photophobia
  • Phonophobia
  • toothache is perceived as secondary to the headache
  • 3 times more commun in women than men
  • Can be associated with aura- 1/3 of the people suffering from migraines perceive aura, transient visual, sensory, language, or motor disturbances signalling the migraine will soon occur.
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3
Q

Give 4 features of dentin hypersensitivity.

A
  • pain not always restricted to one tooth
  • short lasting pain to cold
  • improved with desensitizing age
  • relieved by diagnostic LA block
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4
Q

Give 4 features of trigeminal neuralgia.

A
  • Trigger point
  • L.A won’t help unless the trigger point is a tooth
  • Unilateral (10% bilat)
  • Severe shouting electric pain that lasts a few seconds
  • Normal thermal teeth test
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5
Q

Give 4 features of temporal arteritis.

A
  • Throbbing headache on one side of the head of the back of the head.
  • Malaise, fever, loss of appetite and wight loss
  • Jaw pain and painful jaw muscles
  • Vision difficulties
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6
Q

Give 4 features of TMD.

A
  • Pain in the TMJ area, shoulder, ear, neck
  • Difficulty to open de mouth
  • Clicking on opening
  • Facial pain around the TMJ, mostly in the morning
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7
Q

Give 4 features of acute sinusitis.

A
  • Recent cold, nasal stuffiness and discharge
  • Pain increases when the head is bellow the knees or when the patient lies down
  • Fever, malaise
  • Recent infection of the upper respiratory tract
  • Facial pain, toothache, pain behind the eyes or constant pressure.
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8
Q

Give 4 features of shingles.

A
  • Rash with listers
  • Painful skin
  • Malaise
  • Headache, fever
  • Unilateral, dermatome patterns
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9
Q

4 cardiac condition that need AB prophylactic.

A
  • Transplant heart with valve problem
  • History of infective endocarditis
  • Artificial valve of mechanic valve
  • Congenital cyaonic heart disease unprepared, repaired with residual defect or 6 first months after repair
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10
Q

Regular prescription for AB prophylactic.

A

Amoxicillin 2 g 1 h pre op

Child: 50mg/kg

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11
Q

Patient allergic to Pen, what do you prescribe for prophylactic AB?

A

Clindamycin 600 mg Child: 20mg/kg 1 h pre-op

Azithromycin ou Clarithromycin 500 mg Child: 15mg/kg 1 h pre-op

Cephalexin 2 g2 g 1 h pre op Child: 50mg/kg

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12
Q

As instrument is rotating in the canal and the tip binds, but the motor continues to rotate. The instrument fracture- what type of fracture called?

A

Torsion stress

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13
Q

An instrument is rotating in a curved canal and the tensile and compressive stresses that occur as a result cause fracture – what is this type of fracture called?

A

Cyclic fatigue: mechanical load represented by altering tensile and compressive stresses.

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14
Q

Does fatigue fracture increase or decrease when the degree of curvature increases?

A

Increases

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15
Q

Does the fracture resistance increase or decrease when the diameter of the file is increased?

A

Decrease

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16
Q

Which part of the triple antibiotic paste results in potential discoloration?

A

Minocycline

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17
Q

3 things to do to decrease the risk of declaration when using Tri AB paste.

A

1) use the bi with metronidazole and cephalexin.
2) GI at the level od the CEJ
3) GI of flowable CR on the wall of the access cavity before the injection of the paste
4) use Ca2OH
5) CEJ should be the max height
6) Advise the patient to tell you if discolouration appears

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18
Q

How does dentine demineralize?

A

Bacteria release acids that dissolve the inorganic minerals, hydroxyapatite crystallites, first from the enamel and then from the dentin.

Bacteria cannot hydrolyze fibrous collagen and the organic matrix of the dentin, therefore it has been suggested that host matrix metalloproteinases MPS degrades the dentine organic matrix during and after the demineralization by the bacteria.

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19
Q

2 L.A for pregnant woman

A

Lidocaine 2%

Prilocaine 4%

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20
Q

60kg woman, what is the maximal number of cart you can use for 2% lido and 4% prilo? SHOW CALCULATION

A 
2% lido 
20mg/ml
20/mlX1.8=36mg/cart
Max dose: 7mg/kg
7mg/kgX60=420mg
420/36=11.7 cart
4% prilo
40mg/ml
40/mlX1.8=72
Max dose: 8mg/kg
8mg/kgX60=480mg
480/72=6.7 cart
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21
Q

Two purposes of electropolishing an endo instrument.

A

1) Reduce micro fracture by reducing irregularities

2) Reduce corrosion

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22
Q

5 ways to reduce coronal leakage.

A

1) Adequate temporary filling
2) Adequate final filling in a reasonable time lapse
3) GI over the orifices
4) Pre-operatively changing the old restoration
5) Adequate occlusion

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23
Q

6 properties of ideal irrigant.

A

1) soluble in water
2) non cytotoxic
3) dissolve inorganic debris (Smear layer)
4) dissolve organic debris (Smear layer)
5) bactericide (antimicrobial)
6) easy to access
7) stable for storage
8) non costly
9) penetrate into the dental tubules
10) Allergy is rare

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24
Q

4 components of a cartridge of 2% lidocaine.

A

Cartridge: glass tube, rubber stopper, metal cap and rubber diaphragm

Sln: Lidocaine, epinephrine, sodium chloride, sodium bisulfite, distilled water.

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25
Q

3 goals of revascularization

A

1) tx or preventing AP
2) to trigger the continuation of the root formation
3) re-establishement of the function and sensitivity of the pulp

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26
Q

How long would you expect it to take to get a positive response after revascularisation

A

6 monts (Torabinejad)

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27
Q

How would you determine if the revascularization procedure was a success

A
  • radiographic and clinical exam
  • vitality
  • asymptomatic
  • growth of the root
28
Q

Which organ produces the fibrinogen (plasma protein)?

A

Liver

29
Q

Described the formation of the initial seal between the oral environment ant the wound edge.

A

The critical step is the conversion of fibrinogen into fibrin. Fibrinogen is a plasma protein produced by the liver. The polymerization of the fibrinogen forms a fibrin clot that strength the platelet plug and form the initial seal.

30
Q

Which coagulation pathway is affected by Coumadin?

A

Extrinsic pathway

31
Q

How the extrinsic pathway of coagulation is activated?

A

Thromboplastin (VII) isn’t a component of the blood. It comes from broken cellular membrane

32
Q

How the intrinsic pathway of coagulation is activated?

A

Contact of the blood with collagen.

33
Q

What is the intrinsic cascade?

A

12-11-9-10-5-(2)Protrombine-trombine-(1)fibrinogen-fibrin-13-crosslinked fibrin (fibrin clot)

34
Q

What is the extrinsic cascade?

A

7-10-5-(2)Protrombine-trombine-(1)fibrinogen-fibrin-13-crosslinked fibrin (fibrin clot)

35
Q

Which cascade affects heparin?

A

Intrinsic cascade

36
Q

What is the percentage of organic component, inorganic component and water

A

70% inorg
- hydroxyapatie

20% org
- collagenous matrix (majority type I, also type V)
- phosphoproteins
- proteoglycans
10% water
37
Q

Name of the precipitate when chlorhexidine is mixed with NaOCl.

A

Parachloroaniline (PCA)

38
Q

EDTA antibacterial?

A

NO Torabinejad 2003

39
Q

3 ways bacteria survive better in biofilm than planktonic form.

A

1) Quorum sensing
2) Failure or product to reach bacteria due to matrix binding and secreted catalase in EPS.
3) Presence of persisters
4) Phenotype chances and share between the bacteria
5) Dormant cells with lower multiplication rate

40
Q

How to increase efficacy of NaOCl?

A 
Volume
Time
Concentration 
Continuous delivery 
Agitation 
Temperature 
Freshly prepared solution 
Storage in a opaque bottle
41
Q

What does buffering do to NaOCl?

A

No effect

Zehnder 2002

42
Q

Carbamide peroxyde break down into ammonia, urea, carbone dioxyde (CO2), water and?

A

Hydrogen peroxyde

43
Q

What are the concerns with use of doxycycline in combination irrigants?

A
  • Staining the tooth

- AB resistance

44
Q

US-what is the energy called when a crystal is used and energy is converted into oscillation?

A

piezoelectricity

45
Q

Uses of US in endo.

A
  • PUI
  • US to do retrograde preparation
  • US during the cleaning and shaping, remove files, find canals, remove calcification
46
Q

Does increase in intensity of PUI lead to improved irrigation dynamic? - give a quote.

A

No

Ahmad 1988

47
Q

Why air when removing post?

A

Heat build up and transmission to PDL

48
Q

Why cavitation is important in endo?

A

Cavitation is the impulsive formation of bubble in a liquid by tensile force and enhance the elimination of bcd and smear layer.

49
Q

Why acoustic streaming is important in endo?

A

Rapid movement of fluid in a circular or vortex-like motion around a vibrating file, enhance bcd and smear layer removal.

50
Q

What is a prion?

A

Prion is an infectiou, transmissible protein that lacks nucleic acid in a misfolded form.

51
Q

What disease is most commonly associated with prions?

A

Transmissible spongiform encephalopathy

The human most common: Creutzfeldt-Jakob Disease

52
Q

Are they studies that show prions are in the pulp?

A

No, 8 patients with CDJ. Presence of prions in the brain but not in the pulp. Maybe because the sensitivity of the test was to low to detect pulp concentration.
Blanquet-Grossard 2000

53
Q

Why would it be logical to believe there is prion in the pulp?

A

Dental pulp origines from the richly innervated tissue of the neural crest, therefore, it is reasonable to assume that dental pulp is infected with prions (vCJD).

54
Q

In which part of the body prions can be found, name 3?

A

Brain
Trigeminal ganglia
Tonsils

Head 2003

55
Q

What are 2 recommendations from AAE regarding single use instruments?

A

1) The extreme low risk of prion’s disease in North America does not justify a single use of the endodontic instrument.
2) Clinician should use their jugement and discard the files when necessary and continue to adopt acceptable method to sterilize endodontic instrument.
3) It is recommended to discard all endodontic instruments after tx a patient with confirmed CJD.

56
Q

Rickert and Dixon 1936 - Tube theory. What was the experience and their conclusion?

A

Hollow needle in rabbits. The authors also concluded that hollow tubes were not tolerated by the body and therfore, a root canal can not be filled short of the apex. = “hollow tube” theory – the idea that the body cannot tolerate an underfilled canal.

57
Q

How responded Torneck 1966-67 to the hollow tube theory?

A

RICKERT%DIXON 1936 DISPROVED BY: Torneck (1967) CLASSIC:
1- Disproved the hollow tube theroy with implanting sterile hollow needles and demonstrating minimal tissue response.
2- Showed that STERILE canal did not need to be completely obturate to prevent tissue irrigation and inflammation.

58
Q

Bhaskar 1967, what is about?

A

Histological analysis of >2000 apical lesion.

59
Q

Bhaskar 1967, percentage granuloma and cyst; which jaw is the most affected?

A

Granuloma - 48%
3 max : 1 mand

Cyst - 42%
10 max : 1 mand

60
Q

Bhaskar 1967, why more of granuloma at the maxilla?

A

Greater frequency of caries at the maxilla.

61
Q

Bhaskar 1967, why more cyst at the maxilla?

A

Greater epithelial debris in the maxilla.

62
Q

Kuttler study 2 findings.

A

1- The coincidence of the center of the major foramen and center of the apex was found in 20% only. The deviation between the major foramen and the root apex increases with age.
2- The diameter of the major foramen increase with age because of cementum apposition.
3- The major foramen cannot be filled hermetically, unless it is overfilled with cement.
4- The cementum-dentino junction can be at different distance from the foramen.
5- The minor diameter of the root canal is found usually in the dentin.
6- The constriction is more marked in older people because of a smaller size of the canal and the larger size of the foramen.
7- The average thickness of the apical cementum was above 0.5mm in the younger age and thicker in the older group. It gives justification for filling the root canal 0.5mm before reaching the foramen.

63
Q

Byrnolf 1967, what percentage of teeth didn’t show inflammation.

A

7%
93% inflammation despite the absence of radiolucency

obturation with chloroform technique and silver points, 43% gross overfill

64
Q

Green 1997, what percentage of teeth didn’t show inflammation?

A

74% of the teeth with normal radiographic findings

65
Q

Explain the differences between the findings of the two cadavers studies Green 1967 Vs Byrnolf 1967.

A

Green:

  • Better treatment and obturation technique
  • Better radiographic technique to evaluate success of treatment

Byrnolf 1967:

  • Wrong root canal filling technique: chloroform technique, silver points and 43% of the specimen has gross overfill.
  • Wrong radiographic technique to show apical abnormalities
66
Q

Bystrom 1981, two conclusions.

A
  • Mechanical instrumentation and saline reduce the bacteria in the RC.
  • Ofter, bacteria are left in the site and antibacterial agent would be necessary.
67
Q

Langeland 1977, what the correlation between inflammatory signs and symptoms.

A

No correlation

RCDC study time (5 decks)

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