Chapter 17 Quiz

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  1. One hypothesis for root resorption not occuring is due to hertwig's root sheath, what proteins are expressed to prevent?
    OPN, BMP-2, and Ameloblastin
  2. Formation of sealing zone of osteoclast is mediated by ______.

    need mineralized surface for resorption

    cementum has unmineralized cementoid and circumpulpal dentin has predentin
  3. Cementum externally and predentin internally lack what extracellular proteins containing this sequence of amino acids?
    RGD; arginine-glycine-aspartic acid
  4. Another explanation for resistance of teeth to resorption is that factors found in predentin and cementum such as __________ or __________ act as __________ of resorptive cells.
    osteoprotegerin or amelogenin,

  5. The _________ cementum, the innermost layer of cementum, creates a barrier between the dentinal tubules and the PDL.

    if lost allows inf mediators to progress to PDL initiating resorption
  6. This B-cell transcription factor is the earliest determinant of the osteoclast lineage.
  7. ____ is one of the recognized markers of osteoclast precursors in human
  8. Dissolution of the mineralized component of bone and cementum by osteoclasts is largely dependent on _________ of the extracellular resorption lacuna by _______ wihtin the riffles border membranes.

  9. Cytokines ___ and ____ appear to have the most profound effect on hard tissue resorption.
    IL-6 and IL-11

    IL-6 reduces osteoclasts ability to be inhibited by inc in extracellular Ca, so much of it is formed during resorption
  10. The singular defining feature of the mature osteoclast is _______, namely the ability to _________________.

    resorb calcified tissues
  11. Characterisitic morphologic features of osteoclast:
    ruffled border (cytoplasm undulations)

    sealing zone (ventral surface of the osteoclast membrane in contact with the targeted bone)
  12. What are some RGD peptide containing proteins?
    OPN, BSP, FN, Vitronectin
  13. Initiation of root resorption has two requirements:
    1. removal or protective predentin or precementum

    2. presence of noxious stimulus to start inf response.

    First step in root resorption is binding of the odonto- or osteo-clast
  14. After the clast binds then what?
    Ruffled border formation and release of carbonic anhydrase and V-ATPase into the resorbing compartment to decalcify
  15. Describe one theory for internal resorption etiology?
    Coronal necrotic infected pulp provides the stimulus for inflammation in the more apical parts

    Alternative theory is apoptosis of odontoblasts induce cytokines
  16. Localized injury: healing with cementum
    External resorption caused by an injury restricted to external root

    concussion or subluxation

    mechanical damage to cementum but localized

    vital pulp

    healing within 14 days
  17. Diffuse injury: Healing by osseous replacement
    External resorption caused by an injury restricted to external root

    severe injury (intrusive luxation or avulsion with extended dry time)

    more than 20% of root surface

    precursors of bone not PDL repopulate injury

    dentoalveolar ankylosis (becomes part of bone-remodeling)
  18. Name 5 treatment strategies to avoid or minimize osseous replacement resorption
    • 1. prevent initial injury
    • 2. minimize additional damage
    • 3. pharmacologic interventions
    • 4. stimulation of cementum rather than osseous
    • 5. reduce rate of osseous replacement
  19. Four general types of inflammatory stimulus that cause external root resorption?
    • 1. pressure
    • 2. microbial infection of cana or periodontal sulcus
    • 3. sulcular infection
    • 4. chemical damage secondary to bleaching
  20. What is perapical replacement resorption?
    coined by Bender 1997

    apical resorption when predentin is affected in ortho movement
  21. What treatment factors can be attributed to OIRR (ortho induced infla root resorption)?
    • 1. Duration
    • 2. Magnitude of force (use intermittent)
    • 3. Direction of tooth movement (intrusive and lingual torque > bodily, extrusive, lingual tipping)
    • 4. Method of movement
  22. What patient factors can be attributed to OIRR?
    • 1. Short roots or previous signs of root resorption
    • 2. Endo teeth more resistant
    • 3. Genetic predisposition (homo for IL1B allele 1, 5.6 times greater risk)

    Halt tx for 2-3 months with passive archwires
  23. Pulp space infection can lead to external root resorption in either the ________ or ________ regions of the root.
    apical (apical periodontitis)

    Lateral (damaged cemental covering during severe trauma)
  24. The microbial profile of a traumatized necrotic pulp should resemble that of a primary endo infection with upward of ___ CFUs and more than __ strains.

  25. The two major tx principles are _______ of pulp space infection and _________ of any bacteria in the pulp space.

  26. Success of revascularization of open apex soaked in doxycycline for 5 mins?
  27. At present, the dx tools cannot detect a vital pulp until approx _ months following successful revascularization.

    possible to lose tooth to resorption if not known sooner that tooth was acually not revitalizing

    LDF can detect as soon as 4 weeks
  28. Closed apex and trauma, how soon endo?
    within 7-10 days of trauma

    hard to do so CaOH, 1 month PDL heals, then endo, can be done for up to 6 months
  29. What is coined "pink spot"?
    Subepithelial inflammatory resorption

    long-standing resorption gives rise to granulation tissue which undermines the enamel of the crown
  30. Predisposing factors for cervical resorption?
    • 1. Trauma
    • 2. Orthodontics
    • 3. Intracoronal bleaching
    • 4. dentoalveolar surgery
    • 5. period disease or treatment
  31. It has been postulated that _______ in the sulcus of the tooth stimulate and sustain an inflammatory response leading to subepithelial infl root resorp.
  32. Approx __% of cervical resorption was attributed to bleaching.
  33. In cervical root resorption does the lesion pierce the canal?
    No, not normally, tooth is vital.

    Pulp can be outline through the defect
  34. What did Friedman 1988 find?
    58 teeth with 30% hydrogen peroxide, 7% developed cervical resorption
  35. Holmstrup 1988?
    Follow up study to Friedman, found no cervical resorption when using sodium perborate in water
  36. What can contribute to cervical resorption due to IB?
    • 1. hx of traumatic injury
    • 2. application of heat
    • 3. acidity of external root environment adjacent to the application of bleaching agent
  37. Classification of internal root resorption?
    Apical or Intraradicular
  38. Two hypotheses for internal resorption etiology?
    1. infected coronal pulp leads to adjacent granulation tissue

    2. granulation tissue if nonpulpal origin, from vascular compartment or PDL
  39. Internal root resorption only takes place when?
    Odontoblastic and predentin layer are damaged (lost or altered)
  40. Systemic diseases and root resorption?
    Renal dystrophy: inc oxylate concentration

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Chapter 17 Quiz
2013-11-11 00:13:17

CH 17
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