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Why are pulpal diseases considered progressive?
Localized insults like caries can develop inflammation by spreading to the pulp and cause apical inflammation
Why are pulpal diseases progressive?
- -pulpal inflammation is non compliant
- -pulp simulates the cranium
Is pulp highly vascularized?
What is the progression pattern of pulpal inflammation
- 1.local irritants cause inflammatory mediator release
- 2. Mediators cause vasodilation and leaky vessels
- 3. fluid leaks into surrounding tissues and increases pressure
- 4. Pressure leads to ischemia and necrosis
What is the causes of pulpal and periradicular inflammation?
- 1. bacterial invasion
- 2. chemical irritation (restorative materials)
- 3. Thermomechanical
What is the primary cause of pulp and periaphical diseases?
Bacteria: dental caries and biofilm
How does bacterial invasion show up on radiographs?
It shows up shallower than it actually is
Is direct pulpal exposure to caries required for pulpan infection and irritation?
No. Caries does not need direct exposure
When does dentin permeability increase?
What causes this?
- Permeability increases from the DEJ to the pulp-dentin complex
- This is caused by an increase in number and diameter of dentinal tubules
Dentin permeability is higher in occlusal walls
What aspects of dentin are directly related to pulpal sensitivity
Dentin thickness and permeability contribute to pulpal effects
What materials can cause pulpal injury?
Restorative materials (resin, eugenol) cause chemical irritation to pulpal tissues
Which materials can cause chronic inflammation
Root canal sealers and gutta percha points cause chronic inflammation
What is the end result of chemical irritation?
Post-operative sensitivity and pulp necrosis
How are pulpal sensitivity and cavitation depth related? Along with what other factor?
Pulpal sensitivity is directly proportional to cavitation depth and types of material used
Which creates more sensitivity, chemical or light curing?
What are the biggest factors for endodontic complications following plastic restorations?
- remaining dentin thickness and composite usage (vs. amalgam)
- preop pain, cavity lining, rubber dam use had no effect
what happens if you clean and fill the canals excessively?
- The material can be pushed into the surrounding tissues, but gutta percha reactions are not common
- however, overfill can cause chronic inflammation
What can cause "blushing" of a preparation?
Pulp hemorrhage associated with crown preparation
What temperature change can cause pulpal necrosis?
Changes of 5.5 degrees celcius can cause necrosis in 15% of teeth
What are the options for treating pulpal disease?
- 1. Conventional RCT
- 2. Root canal retreatment
- 3. Endodontic surgeries (apicoectomy)
- 4. Extraction and Implants