Vital Pulp Therapy – Flashcards
Unlock all answers in this set
Unlock answersquestion
Apexogenesis
answer
1. normal physiological development and formation of the root end 2. a vital pulp therapy procedure performed to encouraged continued physiological development and formation of the root end; frequently used to describe vital pulp therapy performed to encourage the continuation of this process.
question
List 3 main tx options for vital pulp therapy.
answer
1. IPC 2. DPC 3. Pulpotomy
question
T/F: the tx of pulp in extensively decayed, vital and asymptomatic th presents something of a clinical problem. However, there is an agreement as to the most effective tx modality for vital teeth.
answer
FALSE; there is no consensus or agreement as to the most effective tx's.
question
What are the 5 main pulpal dx's? Indicate with a * which ones are associated with vital teeth.
answer
1. Normal* 2. Reversible Pulpitis* 3. Asymptomatic Irreversible Pulpitis* 4. Symptomatic Irreversible Pulpitis 5. Pulpal Necrosis
question
List 2 materials used for vital pulp therapy. *material of choice
answer
1. Ca(OH)2 2. MTA *
question
What are 3 characteristics of Ca(OH)?
answer
1. Bactericidal --> overtime 2. seal/strength --> poor 3. pulpal regeneration --> repair w/ dentin formation
question
ProRoot MTA components
answer
1. Tricalcium Silicate 2. Bismuth oxide 3. dicaclicum silica 4. tricalcium aluminate 5. tetracalcium aluminoferrite 6. calcium sulfate dihydrate
question
What are the main crystals of calcium oxide amorphous structure of MTA?
answer
1. Calcium (33%) 2. Phosphate (49%)
question
List 7 of the physical/chemical properties of MTA
answer
1. pH of 10.2--> 12.5 (3hrs) 2. hydrophilic 3. radioopaque 4. setting 2hr 45min 5. compressive strength similar to IRM 6. solubility similar to IRM 7. increase production of both pro-inflammatory and anti-inflammatory cytokines from Osteoblasts
question
List the 2 ways that MTA > CaOH for Pulp Capping procedure
answer
1. less pulpal inflammation w/ MTA 2. more complete dentin bridges (6 studies) w/ MTA 3. No significant differences- both worked well (only 1 study)
question
What does MTA stand for?
answer
Mineral Trioxide Aggregate
question
Where was MTA derived from?
answer
Portland Cement --> added Bismuth oxide to make radio-opaque.
question
List 4 characteristics of MTA in Vital Pulp Therapy
answer
1. Bactericidal (Slightly) 2. Seal/Strengthen (Yes) 3. Pulpal Regeneration (Maybe) 4. Dentin formation (Yes)
question
Which is more predictable: Ca(OH)2 or MTA?
answer
MTA
question
Indirect Pulp Cap
answer
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
Direct Pulp Cap
answer
Tx of an exposed vital pulp by sealing the pulpal wound with a dental material such as CaOH2 or MTA to facilitate the formation of reparative dentin and maintenance of a vital pulp
question
Pulpotomy
answer
the removal of the coronal portion of a vital pulp as a means of preserving the vitality of the remaining radicular portion; can be emergency tx or therapeutic tx
question
Partial Pulpotomy
answer
- shallow pulpotomy -Cvek pulpotomy -The removal of a small portion of the vital coronal pulp as a means of preserving the remaining coronal and radicular pulp tissues.
question
List 4 requirements for an IPC
answer
1. RDT (remaining dentin thickness) of 0.5mm 2. Dx of reversible pulpits 3. No hx of pain 4. Sound dentin at the borders of the cavity prep
question
Describe the general change in bacteria after performing an IPC
answer
- despite presence of bacteria in excavated dentin, no carious lesions resulted in pulp perforation, suggesting that the initial removal of the cariogenic biomass appears to be essential for control of caries progression.
question
What were the results of a study done by Bogen G in JADA "Direct pulp capping: MTA"
answer
-53 th with carious exposures -vital pulp tx -caries removal -MTA placed over exposure -9yr follow ups: 97% success rates -15/15 teeth in younger pts showed complete root formation (apexogenesis) when open apices were present initially
question
What were the results of a study comparing MTA to CaOH for Direct Pulp Capping?
answer
Probability for success after 24mo: -MTA: 80.3% -CaOH: 68.5%
question
What are 2 instances that vital pulp therapy should generally be carried out in?
answer
1. open apex teeth 2. alive pulpal tissue
question
T/F: Teeth in older pts typically have better results following vital pulp therapy
answer
FALSE: younger pts with better results
question
T/F: In general, when use with vital pulp therapy, MTA has better results than CaOH2
answer
TRUE
question
T/F: Teeth w/o a hx of pain have better results.
answer
TRUE
question
T/F: Control of pulpal bleeding does not play a significant role on Vital Pulp Therapy.
answer
FALSE - need to be able to control pulpal bleeding. pulpal bleeding indicator of non-vital pulp.
question
List 5 general principles of DPC and Pulpotomies
answer
1. bacteria control 2. dentin debris control 3. hemorrhage control 4. avoid material entering into the pulp 5. immediate
question
T/F: It is best to avoid placing pulp cap/ pulpotomy materials on bleeding tissues
answer
TRUE
