Vital Pulp Therapy

Question 1

What is vital pulp therapy?

Answer 1

treatment aimed at preserving and maintaining pulp tissue that has been compromised by trauma, caries, or restorative procedures in a healthy state

Question 2

What is an indirect pulp cap?

Answer 2

a procedure in which a material is placed on a thin partition of remaining carious dentin that, if removed, might expose the pulp in immature permanent teeth

Question 3

___________ __________ __________ is essential to eliminate infected tissues and visualize pulp tissue conditions under magnification when pulpal exposures occur

Answer 3

complete caries removal

Question 4

_________ caries compromises necessary observations of pulpal inflammation levels and areas of potential necrosis.

Answer 4

Residual

Question 5

What is a carious pulp exposure?

Answer 5

a pulp exposure resulting from the progressive destruction of tooth structure by acids and proteolytic enzymes elaborated through microbial activity

Question 6

What is the pulp inflammation like for carious pulp exposure?

Answer 6

underlying pulp is inflamed to a varying and unknown extent, due to the progression of dental caries

Question 7

What is a mechanical pulp exposure?

Answer 7

an accidental exposure of the pulp by hand or engine-driven dental instruments in the absence of dental caries

Question 8

What is the pulp inflammation like for mechanical pulp exposure?

Answer 8

if aseptic conditions are maintained the underlying pulp is usually not inflamed

Question 9

What is a traumatic pulp exposure?

Answer 9

a pulp exposure due to a fracture of the tooth

Question 10

What is a pulp cap?

Answer 10

treatment of an exposed vital pulp by sealing the pulpal wound with a dental material such as calcium hydroxide or mineral trioxide aggregate to facilitate the formation of reparative dentin and maintenance of a vital pulp

Question 11

What is a direct pulp cap?

Answer 11

a dental material placed directly on a mechanical or traumatic vital pulp exposure

Question 12

What are the different kinds of pulp caps?

Answer 12

direct pulp cap
indirect pulp cap

Question 13

If a pulp exposure on a vital pulp occurs at UMKC SOD what protocol do you follow?

Answer 13

1. isolate the tooth in question
2. remove all the remaining caries
3. irrigate with 8.3% NaOCl to achieve homeostasis
4. gently place DYCAL in the pulp exposure and a temporary restoration (IRM, PARACORE)
5. after you have filled out all of the forms and taken the radiographs needed, contact endo faculty at a later time via email and get the patient referred and/or scheduled in the appropraite clinic

Question 14

What is a pulpotomy (pulp amputation)?

Answer 14

the removal of the coronal portion of a vital pulp as a means of preserving the vitality of the remaining radicular portion; may be performed as emergency procedure for temporary relief of symptoms or therapeutic measure

Question 15

What is a partial pulpotomy (shallow pulpotomy)?

Answer 15

the removal of a small portion of the vital coronal pulp as a means of preserving the remaining coronal and radicular pulp tissues

Question 16

If you have a controlled pulp exposure what do you do?

Answer 16

• direct pulp cap
• CSC Cap
• bonding restoration

Question 17

If you have an uncontrolled pulp exposure what do you do?

Answer 17

• bleeding controlled pulpotomy
• bleeding not controlled pulpectomy (RCT)

Question 18

If you have reversible pulpitis with NO pulp exposure what do you do?

Answer 18

cavity restoration with/without base

Question 19

There is a reversible pulpitis with a pulp exposure. The dentin is sound and bleeding is controlled. What do you do?

Answer 19

Direct pulp cap with bioactive materials

Question 20

There is a reversible pulpitis with a pulp exposure. Dentin is NOT sound and the bleeding is uncontrollable. What do you do?

Answer 20

pulpotomy

Question 21

There is irreversible pulpitis with a pulp exposure. Bleeding is controlled what do you do?

Answer 21

pulpotomy

Question 22

There is irreversible pulpitis with a pulp exposure. Bleeding is NOT controlled what do you do?

Answer 22

pulpectomy

Question 23

Teeth with deep carious lesions approaching the pulp and with signs of reversible pulpitis can be treated successfully by indirect capping using either…

Answer 23

Biodentine or Fuji IX

Question 24

Pulp capping should only be performed if the surrounding dentine and pulp is….

Answer 24

dentine is sound and exposed pulp does not show signs of infection

Question 25

What is the method for direct pulp cap with MTA?

Answer 25

▪ Deliver MTA with amalgam carrier or MTA carrier instrument (Dentsply); do not use plugger!
▪ Blot excess moisture from MTA with dry cotton ball/forcepts; carve MTA 1.0mm past exposure site
▪ Restore

Question 26

What does the human pulp histology look like at 3 months using calcium hydroxide?

Answer 26

• no dentin bridge
• pulpal inflammation
• zone of necrosis under CaOH

Question 27

What does the human pulp histology look like at 3 months using mineral trioxide aggregate?

Answer 27

• dentin bridge formation
• minimal pulpal inflammation

Question 28

What cell types create tertiary dentin?

Answer 28

fibroblasts

Question 29

What is the success rate of partial pulpotomy in cariously exposed posterior permanent teeth?

Answer 29

98%