Vital pulp therapy

Question 1

What is endodontics

Answer 1

The prevention and/or elimination of periapical periodontitis

Question 2

2 types of tertiary dentine and their differences

Answer 2

Reactionary: in response to milder stimuli , dentin secreted by surviving postmitotic odontoblast cells, dentin secreted is similar to secondary dentin
Reparative: In response to stronger stimulu, dentin secreted by a new generation of odontoblast-like cells in response to an appropriate stimulus after the death of the original postmitotic odontoblasts, dentin secreted is atubular

Question 3

What are the 4 chemical signals that induces tertiary dentin formation

Answer 3

Angiogenic growth factor
TGF
BMP
IGF

Question 4

3 different treatment of deep carious lesion

Answer 4

indirect pulp capping
2 stage excavation procedure
less invasive setpwise excavation

Question 5

4 indications of indirect pulp capping

Answer 5

deep carious lesion likely to expose pulp
No apical pathosis
pulp test vital
no spontaneous or provoked pulpal pain

Question 6

3 treatment that might be done in a case of exposed pulp and which is the least favaroble

Answer 6

extraction
rct
vital pulp therapy (least fav due to unreliable long term results)

Question 7

4 factors to increase success rate of vital pulp therapy

Answer 7

pulp is not inflammed
haemorrhage is controlled
non toxic capping material is applied
good seal provided by capping material and restoration to prevent bacteria influx

Question 8

5 methods to acheive haemostasis

Answer 8

Haemodent, sterile cotton pellets applying pressure, NaOCl, CHx, LA

Question 9

4 advantages and 2 disadvantages of CaOH2

Answer 9

advantages: antibacterial, disinfect superficial pulp, high pH causing coagulative necrosis(removing some inflammed pulp tissue and forming dentinal bridging), use hard setting
disadvantages: tunnel defect (potential of reinfection), poor seal of exposed pulp against external environment

Question 10

What are the 3 different choice of material for pulp capping

Answer 10

MTA(less tunnel defect, less inflammation,more predictable hard tissue barrier formation), Bio dentin, CaOH2

Question 11

types of vital pulp therapy

Answer 11

partial and full pulpotomy direct pulp capping

Question 12

T/F direct pulp capping is indicated for carious pulp expousure

Answer 12

F

Question 13

6 steps in direct pulp capping

Answer 13

LA, RD, Disinfect tooth, control haemorrhage, Calcium hydroxide/MTA (apply capping material), restore tooth

Question 14

Indication for partial pulpotomy

Answer 14

traumatic exposure, immature permanent tooth or mature permanent tooth with simple restorative needs, patient who cannot afford RCT

Question 15

Technique for partial pulpotomy

Answer 15

LA, 
RD, 
disinfect tooth, 
remove 1-2mm pulpal tissue
if extensive bleeding is observed, extend apically
use NaOCl or MTA to aid with bleeding
apply capping material and restore tooth

Question 16

what is apexogenesis

Answer 16

creating an environment for the pulp and HERS to allow the continue formation of the roots