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Endodontics > Test Two Materials > Flashcards

Test Two Materials Flashcards

1
Q

What are the three pulpal irritants?

A
  1. Microbial, 2. Mechanical and 3. Chemical
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2
Q

What is the term used that means the prevention of infection penetration into vital pulp?

A

Asepsis

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3
Q

What is the term used for non-vital cases where you remove necrotic tissue and all microorganisms?

A

Antisepsis

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4
Q

What is the major type of bacteria present in endo?

A

Obligate anaerobic bacteria

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5
Q

What bacteria is frequently found in failed RCTs?

A

E. faecalis

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6
Q

What type of nerve fiber is found in the dentin?

A

Myelinated, A-fibers

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7
Q

What type of nerve fiber is found in the pulp?

A

Unmyelinated, C-fibers

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8
Q

What area is found interior to the odontoblast layer?

A

Cell free zone of weil

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9
Q

What is interior to the cell free zone?

A

Cell rich zone

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10
Q

What is the order of obtaining a diagnosis (five steps)?

A
  1. CC, 2. HH, 3. Oral exam + tests, 4. Correlate findings to differential diagnosis and 5. Formulate definitive diagnosis and treatment plan
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11
Q

What are localization, commencement, intensity, provocation/relief and duration in the diagnosis process?

A

Subjective tests

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12
Q

What are palpation, percussion/bite, mobility, periodontal exam and pulp testing in the diagnosis process?

A

Objective tests

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13
Q

Name the five pulp vitality tests.

A
  1. Cold testing, 2. Heat, 3. Electric, 4. Test Cavity and 5. Selective Anesthesia
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14
Q

What is the key to cold testing?

A

Duration

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15
Q

What is the downside to electric testing?

A

Only vital tissue can be detected - false negatives common

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16
Q

What’s the downside to a radiographic exam for diagnosis?

A

They are very subjective

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17
Q

What type of bone must be dissolved by an endo lesion to show up radiographically?

A

Cortical bone - cancellous bone loss cannot be detected by radiographs

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18
Q

What is it called when a pulpal lesion has an inflamed pulp and causes dentinoclastic activity?

A

Internal resorption

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19
Q

What is it called when pulpal irritation causes the buildup of dentin in the canal?

A

Calcific Metamorphosis

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20
Q

What is it called when calcified bodies appear in the pulpal space, but no pathology is present?

A

Pulp stones

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21
Q

In order for internal resorption to occur, what must be true of the tooth?

A

It must be vital

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22
Q

What is the major cause of endo pathophysiology?

A

Host response to irritation

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23
Q

What three things do inflammatory mediators do?

A
  1. Vasodilation, 2. Increase vascular permeability and 3. Recruit inflammatory cells from blood to site of injury
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24
Q

What are the five classifications of periapical Pathosis?

A
  1. SAP (sym. apical periodontitis), 2. AAP (Asym. apical perio.), 3. AAA (Acute apical abscess), 4. CAA (Chronic Apical Abscess) and 5. Condensing Osteitis
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25
Q

First extension of pulpal inflammation into periradicular tissues that is caused by an irreversible pulpitis describes:

A

Symptomatic Apical Periodontitis

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26
Q

What are the six possible irritants in SAP?

A
  1. Irreversible Pulplitis, 2. Bacterial toxins, 3. Chemicals, 4. Hyperocclusion, 5. Overinstrumentation and 6. Overextension of obturation materials
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27
Q

Spontaneous pain, acute pain to biting or percussion, hot, cold, electric sensitivity, widened PDL and possible liquefaction necrosis refer to what?

A

Symptomatic Apical Periodontitis

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28
Q

What is the treatment for SAP?

A

RCT - vital teeth should be taken from occlusion too

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29
Q

Little or no pain, no response to pulp vitality test, slight sensitivity to palpation, widened PDL to Extensive lesion, Granuloma and apical cysts are symptoms of what?

A

Asymptomatic acute periodontitis

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30
Q

What condition is a variant of AAP?

A

Condensing Osteitis

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31
Q

What is it called when there is no irritation and an unknown cause makes the bone condense around the roots?

A

Osteosclerosis

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32
Q

Localized or diffuse liquefaction lesion of pulpal origin, destruction of periapical tissues, disintegrating PMNs, Necrotic pulp and abscesses within a granuloma describes?

A

Acute Apical Abscess (AAA)

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33
Q

Rapid onset of acute spontaneous pain to percussion, biting and palpation, moderate to severe discomfort and swelling, purulence, Lymphadenophy, Periapical radiolucency, no response from pulp vitality tests and varying degree of mobility are symptoms of which condition?

A

Acute Apical Abscess

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34
Q

What is the treatment for AAA?

A

Eventual RCT and possibly an I & D

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35
Q

An inflammatory lesion of pulpal origin, long standing lesion with the same histology as AAA describes?

A

Chronic Apical Abscess

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36
Q

Generally asymptomatic, not sensitive to biting, no response from pulp vitality tests, apical radiolucency and a mucosal or facial sinus tract describe:?

A

Chronic Apical Abscess

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37
Q

What is the treatment for a CAA?

A

Remove the irritant - RCT

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38
Q

How should a hyperplastic pulpitis, pulp polyp, irreversible pulpitis and necrotic pulp be treated?

A

RCT

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39
Q

What is the one periapical pathosis that is not treated with RCT?

A

Hyperocclusion

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40
Q

Stimulation uncomfortable, but reverses quickly, caries expose dentin, recent dental treatment, defective restorations and trauma are signs of what?

A

Reversible Pulpitis

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41
Q

What is the treatment for Reversible Pulpitis?

A

Eliminate cause - RCT NOT generally needed

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42
Q

Intermittent or spontaneous pain, stimulation resulting in heightened and prolonged response, minimal or no radiographic changes and pulp eventual necrosis describe:?

A

Symptomatic Irreversible pulpitis

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43
Q

What is caused by deep caries into the pulp space?

A

Asymptomatic Irreversible pulpitis

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44
Q

What term signifies the transportation of microbes to areas of tissue damage?

A

Anachoresis

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45
Q

What three ways does the pulp utilize to attempt to protect itself?

A
  1. Decrease dentin tubule permeability, 2. tertiary dentin formation and 3. inflammatory/immune response
46
Q

What is the scientific name for a pulp polyp?

A

Hyperplastic pulpitis

47
Q

Extreme temperature exposure results in intense and prolonged pain - what is the diagnosis?

A

Irreversible Pulpitis

48
Q

What three things should be done in an initial appointment to treat irreversible pulpitis?

A
  1. Clean and shape, 2. Cotton pellet and 3. Relieve occlusion
49
Q

Extreme percussion sensitivity describes what?

A

AAP

50
Q

What is the treatment for irreversible pulpitis with AAP?

A

Complete pulpectomy/clean and shape, cotton/cavit and relieve occlusion

51
Q

What should be done to treat a necrotic pulp with AAP?

A

Clean/shape, drainage (if possible), copious irrigation, cotton/cavit, relieve occlusion and antibiotics

52
Q

What should be done to treat a necrotic pulp with drainage?

A

Clean/shape, copious irrigation, CaOH after drying, Cotton/cavit, relieve occlusion and antibiotics

53
Q

What should be done to treat a necrotic pulp with no drainage?

A

Clean/shape, copious irrigation, CaOH after drying, Mucosal I&D, Cotton/cavit and antibiotics

54
Q

What should be done to treat a necrotic pulp with drainage and diffuse swelling?

A

Clean/shape, copious irrigation, CaOH after drying, Cotton/cavit and antibiotics

55
Q

What should be done to treat a necrotic pulp with no drainage and diffuse swelling?

A

Clean/shape, copious irrigation, Cotton/cavit, extra oral/intra oral drainage and antibiotics

56
Q

What is the preferred method of draining a parulous lesion?

A

Through the tooth - next is with a blade

57
Q

What are the four types of drains?

A
  1. I, 2. T, 3. Christmas tree and 4. Penrose
58
Q

What percentage of Enamel fractures cause pulpal necrosis?

A

1-2%

59
Q

What is an uncomplicated crown fracture?

A

A fracture only involving enamel and dentin

60
Q

What percentage of uncomplicated crown fractures lead to pulpal exposures?

A

1-7%

61
Q

What two medicaments were listed as providing aid in an uncomplicated crown fracture?

A
  1. CaOH and 2. VitraBond
62
Q

What is a complicated crown fracture?

A

Involves Enamel, dentin and pulp

63
Q

What percentage of complicated crown fractures will undergo necrosis without treatment?

A

100%

64
Q

What medicament is primarily used for pulp capping?

A

CaOH

65
Q

When would you use a Cvek pulpotomy?

A

On the day of injury - 80% success

66
Q

What is the primary indicator for the needed depth of treatment in an exposed pulp case?

A

Time elapsed since exposure

67
Q

What is the key problem with inflammation?

A

It decreases the success for vital pulp therapy

68
Q

What procedure offers the most predictable success rate in mature teeth?

A

Pulpectomy

69
Q

For immature teeth, what procedure should always first be attempted?

A

Vital pulp therapy

70
Q

After pulpal therapy, what is the most important indicator of success?

A

Bacteria-tight seal

71
Q

What are some of the benefits to using MTA (4)?

A
  1. High pH, 2. Bacteria-tight seal, 3. Acts as a base for permanent restorations and 4. hardens
72
Q

What are the three downsides to MTA?

A
  1. Requires two appointments, 2. Grey - can’t be used in anterior teeth and 3. Expensive
73
Q

What two substances can be mixed with CaOH to thicken it?

A
  1. Saline and 2. Anesthesia
74
Q

Name two alternative substances to use as sealers.

A
  1. ZOE and 2. glass ionomere
75
Q

What three structures must be fractured to constitute a crown-root fracture?

A

Enamel, Dentin and Cementum

76
Q

Occasionally a fractured tooth can be pulled out of the socket further and reshaped to fit a crown. What is this process called?

A

Extrusion

77
Q

What treatment should be given to a horizontal root fracture that penetrates Dentin, Cementum and Pulp?

A

A splint should be applied (cervical/middle 1/3)

78
Q

Trauma causing no displacement, no mobility, percussion sensitivity and requiring no treatment is known as:?

A

Concussion

79
Q

Trauma causing no displacement, mobility, percussion sensitivity, possible sulcular bleeding and requiring no treatment is known as:?

A

Subluxation

80
Q

Trauma causing displacment coronally, mobility, displacement and non-vital pulp testing is known as:?

A

Extrusive

81
Q

Trauma resulting in displacement (mdbl) is known as?

A

Lateral displacement

82
Q

Displacement apically is known as?

A

Intrussive

83
Q

Why is apical displacement so bad?

A

High incidence of ankylosis

84
Q

What is it called when the tooth completely leaves the socket?

A

Avulsion luxation

85
Q

If the patient has a tooth knocked out with a closed apex and is able to reach the dental office in less than 60 minutes, what is your treatment plan?

A

Xray, irrigate socket, reimplant and splint two weeks with antibiotics. RCT should be done in one week’s time with CaOH in 2 weeks

86
Q

If the patient has a tooth knocked out with an open apex and is able to reach the dental office in less than 60 minutes, what is your treatment plan?

A

Doxycycline 5 minutes, minocycline, reimplant, splint, antibiotics and follow vitality at 2, 6 and 12 months

87
Q

What should a tooth be stored in if it can be taken to the dentist in less that 60 minutes and has a closed apex?

A

Saline, milk or saliva

88
Q

What should a tooth be stored in if it can be taken to the dentist in less that 60 minutes and has an open apex?

A

Saline

89
Q

Should a tooth be out of the mouth more than 60 minutes, what is the biggest concern in survivability?

A

High ankylosis rate

90
Q

If the patient has a tooth knocked out with an open apex and is able to reach the dental office in more than 60 minutes, what is your treatment plan?

A

RCT out of mouth, attempt reimplantation if at all possible

91
Q

If the patient has a tooth knocked out with a closed apex and is able to reach the dental office in less than 60 minutes, what is your treatment plan?

A

Soak in 2% NaF 5-20 min., RCT in NaF soaked gauze, reimplant and splint 4 weeks

92
Q

What is apexogenesis?

A

Vital pulp therapy to encourage continued physiologic development and formation of the root end

93
Q

What procedure is performed on vital, reversible pulpitis teeth to keep them vital?

A

Cvek Pulpotomy

94
Q

What are the five steps of Apexogenesis?

A
  1. Pulpotomy (depth depends on exposure), 2. Control bleeding, 3. Rinse, 4. MTA or CaOH and 5. Temporize
95
Q

What is apexification?

A

Knowing that a pulp cannot be kept vital, you place a calcific barrier across the open apex with pulpal necrosis with no lesion

96
Q

What is used as the calcific barrier in apexification procedures?

A

MTA

97
Q

How long does it take for a barrier to form in apexification?

A

9-24 months

98
Q

A patient that has pulp necrosis, has an immature root apex, does not need pulp space for restorative purposes and has a coronal seal is likely a good candidate for what procedure?

A

Regendo

99
Q

What is the first visit’s objectives in regendo?

A

Access and remove necrotic tissue and dry with medicaments

100
Q

What is the second visit’s objectives in regendo?

A

Access, remove all antimicrobials, dry and file out apex to encourage bleeding, place a collagen matrix and permanent restoration and recall in 12-18 months

101
Q

What is the problem with pulp testing in young individuals?

A

It may not work - nerves may not have developed in the tooth

102
Q

What test is probably best for young individuals to test pulp health?

A

Cold test

103
Q

What is the Hall Technique?

A

To place a stainless steel crown atop a deciduous tooth without removing any of the caries

104
Q

When can direct pulp capping be used?

A

When small mechanical or traumatic exposure occured - not carious!

105
Q

What medicament is frequently used with vital pulps?

A

Formacresol

106
Q

How does the working length (WL) change when working with deciduous, non-vital teeth?

A

WL is 2-3 mm short of radiographic length

107
Q

What must NOT be done when performing RCT on non-vital deciduous teeth?

A

No perforations - thin walls

108
Q

When should you use a small round bur in RCT?

A

Never! It causes perforations

109
Q

J-shaped lesions tend to be what?

A

Fractured roots

110
Q

How does bone loss differ from perio to endo?

A

Bone loss heavier coronially for perio, and apically for endo

Endodontics (2 decks)

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