Test questions Flashcards
Reversible Pulpitis
- Pain
- Cold- exaggerated/non-lingering
Symptomatic Irreversible Pulpiitis
- Pain
- Cold- Hyperesponsive/ Lingering
Asymptomatic Irreversible Pulpitis
- No pain
- Responds to cold with no-lingering pain
Necrotic Pulp
- Non responsive to cold
Symptomatic Apical Periodontitis
- Pain
- Painful during
- Bitting
- Percussion
- May or may not have a RL
Asymptomatic Apical Periodontitis
- No response to anything
- RL
Acute Apical Periodontits
- Pain
- Swelling
- Painful to
- Palapation
- Bitting
- Percussion
- Radio
- WNL
- PARL
- Inflammatory reaction to pulpal infection and necrosis
- rapid onset, spontaneous pain, pus formation
Chronic Apical Periodontitis
- Sinus tract
- PARL
A-beta and A-delta fibers
- Myelinated
- Located in pulp and DENTIN
- Sharp pain, stabbing, pricking
- Low threshold
- Stimulated by hot/cold/air/drilling
- Warning sign, not neccesarily associated with tissue damage
C fibers
- Non-myelinated
- Centrally located throughout pulp
- Dull burning, aching prolonged pain
- High threshold
- May not be stimulated by hot/cold
- Usually associated with tissue damage w/i pulp
Prognosis for Vital pulp
95% prognosis
No bacteria
no infection, inflammation could be present
Non vital/necrotic prognosis
85% prognosis
bacteria and infection present
Antibiotics
- Very seldomly used
- Only RX if systemic indications
- Temp, swelling, cellulitis, malaise, trismus
T/F
An acute apical abcess will not respond to pulp vitality tests
An acute apical abcess is only observed in association with a necrotic pulp
T
T
Pt present with swelling, non-vital tooth
- Periapical dx
- Acute apical abcess
- Pulpal dx
- Non-vital tooth pulpal necrosis
- If no PARL does not mean there is not an abcess, could be very new due to rapid onset and just hasnt shown up on radio yet
What is a RL telling us?
Micro of tooth and number of species
- RL indicates presence of an inflammatory response and steoclast activity (bone resorption)
- 10-30 species 90% obligate anaerobes
- Mixed community
- Planktonic (free floating)
- Gram negative predominate
Case: swelling, spontaneous pain
No RL or might be RL
Negative EPT and cold
- Non-vital/Necrotic pulp
Put a cold pellet on tooth
Explain how A fibers are stimulated
- Hydrodynamic theory
- movement of fluid in tubules stimulates fibers
- Fluid within tubules directly act on pulpal nerves
- Fluid movement is result of capillary force
Younger vs older patients
cells and collagen diff
- Younger
- More cells and fewer collagen, less calcified
- Older
- Less cells more collagen more calcified
Pulp development
- Pulp develops from Dental Papilla (along with dentin)
- Dental papilla is ectomesenchymal origin (neural crest cells with local mesenchyme)
- Outer layer of dental papilla will differentiate into odontoblasts (dentin)
CDJ
What 2 soft tissues are present at CDJ
- Pulp to PDL transition
- Where youu want to end your working length
- .5-1mm coronal to radio apex
- Pulp and PDL are present at CDJ
*
EPT
- Provides no diagnostic value with vital pulp pathosis
- Not indicated for teeth which respond to thermal challenge
- Indicates only pulp vitality or necrosis
- yes or no
- Device output numbers are insignificant
- EPT Vitality measures vascular supply
- Cold measures nerve response
- 0-79 vital
- 80+ necrotic
As you get closer to the pulp how do the numbers and size of dentinal tubules change
Increase in size, diameter and number
What dx test reflects the histologic status of pulp
NONE