Dental Pulp and Pain Quiz
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Questions and Answers

What type of dentin is secreted in response to minor damage by the original odontoblasts?

  • Sclerotic dentin
  • Reactionary dentin (correct)
  • Tertiary dentin
  • Reparative dentin

What is the characteristic of dull, throbbing pain referred to in pulpitis?

  • Acute pain
  • First pain
  • Referred pain
  • Second pain (correct)

Which type of pain indicates a decreased pain threshold, causing pain from normally non-painful stimuli?

  • Allodynia (correct)
  • Pulpitis pain
  • Sclerotic pain
  • Hyperalgesia

What does the lack of collateral circulation in dental pulp affect?

<p>The ability to fight infection (A)</p> Signup and view all the answers

Which fibers are primarily responsible for transmitting pulpitis pain?

<p>C fibers (C)</p> Signup and view all the answers

What is the treatment for reversible pulpitis?

<p>Remove irritant and provide analgesics (D)</p> Signup and view all the answers

Which clinical presentation suggests symptomatic irreversible pulpitis?

<p>Pain is spontaneous and may be referred (C)</p> Signup and view all the answers

What type of pulp testing results would you expect for normal pulp?

<p>EPT: +, Cold test: +, non-lingering (C)</p> Signup and view all the answers

What radiographic presentation is associated with symptomatic irreversible pulpitis?

<p>Thickening of the PDL space may be evident (C)</p> Signup and view all the answers

What indicates the presence of asymptomatic irreversible pulpitis?

<p>No pain but deep caries approximating the pulp (C)</p> Signup and view all the answers

How is the pain from reversible pulpitis typically described?

<p>Short, sharp pain that subsides (D)</p> Signup and view all the answers

Which of the following symptoms is NOT associated with normal pulp?

<p>Lingering pain during cold testing (B)</p> Signup and view all the answers

What might be observed in a radiograph for asymptomatic irreversible pulpitis?

<p>Thickening of the PDL space (C)</p> Signup and view all the answers

What kind of fibers are primarily responsible for the pain in symptomatic irreversible pulpitis?

<p>C fibers (D)</p> Signup and view all the answers

Which treatment is indicated for symptomatic irreversible pulpitis?

<p>Root canal treatment (A)</p> Signup and view all the answers

What is the primary goal of instrumentation in root canal treatment?

<p>To file, shape, and clean each canal to the working length (B)</p> Signup and view all the answers

When using the crown down technique during instrumentation, what is the order of file sizes applied?

<p>Larger file for coronal ⅓, smaller for middle, and even smaller for apical ⅓ (A)</p> Signup and view all the answers

Which file technique is used for creating coronal flaring in the root canal?

<p>Step back technique (B)</p> Signup and view all the answers

What is the typical number of canals found in a maxillary central incisor?

<p>1 (C)</p> Signup and view all the answers

What is the function of sodium hypochlorite in root canal treatment?

<p>To dissolve organic material and bacteria (D)</p> Signup and view all the answers

Which material is primarily used for obturation in root canal treatment?

<p>Gutta-percha (A)</p> Signup and view all the answers

What is the purpose of using EDTA during root canal treatment?

<p>To dissolve inorganic material and create a clean canal (C)</p> Signup and view all the answers

Which of the following techniques is no longer recommended for dissolving gutta-percha?

<p>Chloroform (C)</p> Signup and view all the answers

What does the warm vertical condensation technique involve?

<p>Seating gutta-percha to working length with a warmed plugger (C)</p> Signup and view all the answers

Which type of restoration is placed temporarily over the gutta-percha after obturation?

<p>Temporary restoration such as Cavit (D)</p> Signup and view all the answers

What is the appropriate treatment for pulpal necrosis?

<p>Root canal treatment (B)</p> Signup and view all the answers

In a previously treated tooth that shows no symptoms but has a persisting apical lesion, what is the recommended treatment?

<p>Retreatment or endodontic microsurgery (D)</p> Signup and view all the answers

Which of the following is a clinical presentation of symptomatic apical periodontitis?

<p>Inflammation around the apex with pain to palpation (A)</p> Signup and view all the answers

How is chronic apical abscess identified radiographically?

<p>Presence of a periapical radiolucency (PARL) (C)</p> Signup and view all the answers

What is the key difference in the response to pulp testing between symptomatic and asymptomatic apical periodontitis?

<p>Symptomatic may respond while asymptomatic does not (A)</p> Signup and view all the answers

What would indicate a diagnosis of acute apical abscess?

<p>Rapid swelling and fluctuance with pain (D)</p> Signup and view all the answers

Which type of dentin forms in response to a stimulus?

<p>Tertiary dentin (A)</p> Signup and view all the answers

In the case of a normal apex with no treatment needed, what is the required next step?

<p>Determine pulpal status and treat (B)</p> Signup and view all the answers

What is a common clinical presentation of condensing osteitis?

<p>Localized bony reaction with asymptomatic apices (D)</p> Signup and view all the answers

What can be a result of prolonged pulpal necrosis if left untreated?

<p>Formation of chronic apical abscess (B)</p> Signup and view all the answers

Which treatment option is typically indicated for symptomatic apical periodontitis with a negative response to pulp testing?

<p>Root canal treatment (B)</p> Signup and view all the answers

What is indicated by a draining sinus tract in a tooth?

<p>Chronic apical abscess (C)</p> Signup and view all the answers

Which response to cold testing indicates pulp necrosis?

<p>No response (D)</p> Signup and view all the answers

What is typically treated with antibiotics and analgesics in the context of acute apical abscess?

<p>Condition with systemic symptoms (C)</p> Signup and view all the answers

What is the primary goal of pulp access during root canal treatment?

<p>Expose pulp horns and orifices (A)</p> Signup and view all the answers

Which taper is commonly associated with rotary files used in root canal treatment?

<p>0.04 or 0.06 mm taper (D)</p> Signup and view all the answers

In the context of hand files, what does a diameter increase of 0.02 mm signify every 1 mm distance from the file tip?

<p>It indicates the file taper. (D)</p> Signup and view all the answers

What is the percentage of canals for the maxillary first molar that is 4 canals?

<p>35% (B)</p> Signup and view all the answers

What is the file size for a hand file that measures 30 in the universal color scheme?

<p>0.35 mm (A)</p> Signup and view all the answers

Which of the following is NOT a goal of pulp access?

<p>Facilitate oral hygiene (D)</p> Signup and view all the answers

In mandibular molars, what is the percentage of teeth with 2 canals?

<p>75% (B)</p> Signup and view all the answers

For the maxillary second molar, what is the percentage of teeth with a single canal in the distobuccal root?

<p>100% (A)</p> Signup and view all the answers

Which hand file taper is specified for hand files?

<p>0.02 mm taper (B)</p> Signup and view all the answers

Which of the following statements is true regarding the file diameter calculation?

<p>Dx increases as taper and X distance increase. (D)</p> Signup and view all the answers

What percentage of mandibular first molars typically contain 3 canals?

<p>55% (B)</p> Signup and view all the answers

Which color corresponds to a hand file size of 40 in the universal color scheme?

<p>Black (C)</p> Signup and view all the answers

What common physiological issue may indicate referred pain to the preauricular area?

<p>Mandibular molar pain (A)</p> Signup and view all the answers

What is the common percentage of canals for a mandibular second molar with three canals?

<p>75% (A)</p> Signup and view all the answers

What is the primary indication for root canal treatment?

<p>Irreversible pulpitis and pulp necrosis (D)</p> Signup and view all the answers

Which procedure involves the removal of the diseased root tip?

<p>Apicoectomy (C)</p> Signup and view all the answers

What is the primary purpose of calcium hydroxide in endodontics?

<p>To stimulate the formation of secondary odontoblasts (D)</p> Signup and view all the answers

What is indicated when a root canal treatment has failed?

<p>Retreatment (A)</p> Signup and view all the answers

Which type of pulp therapy is indicated for traumatic pulp exposure longer than 24 hours?

<p>Partial pulpotomy (D)</p> Signup and view all the answers

In which situation would an incision and drainage be performed?

<p>Fluctuant and localized infection (A)</p> Signup and view all the answers

What complication can arise from the use of excessively large files in a root canal?

<p>Instrument separation (A)</p> Signup and view all the answers

What happens during apexogenesis?

<p>Maintenance of pulp vitality in immature teeth (C)</p> Signup and view all the answers

What is a common sign of vertical root fracture?

<p>Teardrop radiolucency (B)</p> Signup and view all the answers

When is MTA used in endodontics?

<p>For retrofilling during surgical endodontics (A)</p> Signup and view all the answers

Which of the following indicates an uncomplicated fracture?

<p>No pulp involvement (B)</p> Signup and view all the answers

What is the best treatment option for a necrotic tooth with a horizontal root fracture?

<p>Splinting and endodontic therapy (A)</p> Signup and view all the answers

What is a key feature of internal root resorption?

<p>Sharp, well-defined margins on radiograph (D)</p> Signup and view all the answers

What is the recommended action for a tooth exhibiting calcific metamorphosis after trauma?

<p>Observation without treatment (C)</p> Signup and view all the answers

Flashcards

Normal pulp

A state where the pulp is healthy and responds normally to stimuli.

Reversible pulpitis

A condition where the pulp is inflamed due to an irritant, but the inflammation is reversible.

Symptomatic irreversible pulpitis

A condition where the pulp is irreversibly damaged and experiencing pain from a stimulus.

Asymptomatic irreversible pulpitis

A condition where the pulp is irreversibly damaged but the individual does not experience pain.

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Electrical Pulp Testing (EPT)

A test to assess the pulp vitality by using a low-level electrical current.

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Cold Test

A type of pulp testing where a cold stimulus is applied to the tooth to assess the pulp vitality.

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Thermal Test

A test to assess the pulp vitality that involves observing the pulp's reaction to a thermal stimulus.

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Periodontium

The periodontium refers to the tissues that hold the tooth in place, including the gingiva, cementum, periodontal ligament, and alveolar bone.

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Widening PDL Space

A radiographic indication of inflammation in the periodontium, manifesting as a widening of the space between the tooth root and the alveolar bone.

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Root Canal Treatment

The process of removing the pulp from the tooth and replacing it with a filling material and a crown to restore the tooth's functionality.

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Sclerotic Dentin

Dentin that is calcified in response to tooth decay or aging. It forms in response to the irritation caused by the decay, strengthening the dentin and protecting the pulp.

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Reactionary Dentin

A type of tertiary dentin that is produced by the original odontoblasts in response to minor damage to the tooth. It helps to protect the pulp from further injury.

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Reparative Dentin

A type of tertiary dentin that forms when major damage occurs to the tooth. It is produced by odontoblast-like cells in the pulp, forming a new layer of dentin as a protective barrier.

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C fibers

Nerve fibers that transmit pain signals from the pulp to the brain. They are responsible for the sharp, stinging pain that you experience when you have a toothache.

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Referred Pain

Pain that is felt in a different area of the body than where the actual injury or stimulation is occurring. This happens because nerve signals from the injured area also travel through nerve pathways that serve other areas of the body.

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Pulp Necrosis

Death of pulp tissue (partial or total) due to interruption of the pulpal blood supply. Pulp may be asymptomatic.

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Previously Initiated Therapy

This occurs when a tooth has undergone previous endodontic treatment, such as pulpotomy or pulpectomy. Treatment may be incomplete or partially completed.

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Previously Treated

The canals were previously obturated, indicating a past root canal treatment. Treatment outcome depends on apical diagnosis.

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Normal Apical Tissues

Healthy apical tissues are free of inflammation. The lamina dura, a bone lining, is intact.

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Symptomatic Apical Periodontitis

Inflammation surrounds the tooth apex, causing pain to palpation and percussion. The lamina dura may be widened, and a PARL (periapical radiolucency, a dark area on X-ray) may be present.

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Asymptomatic Apical Periodontitis

Inflammation around the tooth apex due to pulp necrosis. The tooth may be asymptomatic, but it will not respond to pulp testing. PARL may be present.

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Acute Apical Abscess

A rapid swelling and/or fluctuance around the tooth that may be painful to bite on, percussion and/or palpation. Pus formation and swelling of associated tissues may be seen, with no time for PARL to develop.

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Chronic Apical Abscess

Asymptomatic apices with no swelling, but a draining sinus tract is present. PARL is present, usually traceable with gutta-percha (a material used in root canal filling).

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Condensing Osteitis

A localized bony reaction to low-grade inflammation, which can be caused by caries, trauma, or other sources of inflammation. Apices are asymptomatic.

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Primary Dentin

The outer layer of dentin formed before root formation.

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Secondary Dentin

The inner layer of dentin formed after root formation. It is formed throughout life.

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Tertiary Dentin

Dentin formed in response to a stimulus (i.e., caries, trauma). It is formed to protect the pulp.

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A Delta Fibers

A type of nerve fiber that transmits a sharp, transient, “first pain” sensation from dentin. It is responsible for dentinal hypersensitivity.

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File taper

The tapering of a file, measured in millimeters per millimeter of length.

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File diameter at 'X' distance

The diameter of a file at a specific distance from its tip.

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Hand File

Instrument used in endodontics for shaping and cleaning the root canal.

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Rotary File

A rotary file with a higher taper (0.04 or 0.06 mm) providing more flexibility.

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Pulp Access

The area where the pulp chamber roofs are removed to gain access to the pulp.

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Inferior Alveolar Nerve (V3)

A major branch of the trigeminal nerve (V3) which innervates the mandibular teeth.

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Percentage of Canals

The percentage of teeth with a certain number of root canals.

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Working length

The ideal working length is 1 mm from the apex of the tooth, but it can be considered 0-2 mm from the apex.

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Instrumentation

The process of cleaning and shaping the root canal system before filling it.

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Crown down technique

This technique uses rotary files to achieve the desired shape and size of the canal. It involves shaping the coronal ⅓ of the canal with the largest file, then using smaller files for the middle ⅓ and apical ⅓.

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Step back technique

This technique uses hand files to achieve the desired shape and size of the canal. It involves shaping the coronal ⅓ with a larger file to create coronal flaring, followed by using smaller files to working length.

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NaOCl

Sodium hypochlorite (NaOCl) is the most common irrigant used in endodontics. It is a powerful disinfectant that dissolves organic material, including bacteria.

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EDTA

EDTA is a chelating agent commonly used as an irrigant in endodontics. It dissolves inorganic material, such as the dentin smear layer, and helps to lubricate the canal.

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Obturation

The process of sealing the root canal system to prevent bacteria from entering and to promote healing.

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Gutta-percha

Gutta-percha is a natural rubber-like material that is commonly used as a filling material in root canal therapy.

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Sealer

Sealer is a material that is used to seal the gaps between the gutta-percha and the canal walls, preventing leakage and bacteria from entering.

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Warm vertical condensation

A technique used to condense gutta-percha into the root canal system. It involves using a heated plugger instrument to create a dense and sealable fill.

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Root Canal Treatment (RCT)

A procedure that removes the infected pulp tissue from a tooth, cleans, shapes, and fills the root canals, and often involves placing a crown for protection.

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Retreatment

A treatment option for teeth with irreversible pulpitis or pulp necrosis that has failed and a persistent infection in the root canals.

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Surgical Endodontics (Apicoectomy)

A surgical procedure performed when root canal treatment has failed and the infection is localized to the apex of the tooth. The infected root tip is removed, the canal is cleaned, and the apex is filled.

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Pulpectomy

A type of endodontic treatment that involves removing infected pulp tissue from the tooth's coronal chamber without removing the entire pulp tissue.

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Pulpotomy

A type of endodontic treatment that involves removing the inflamed coronal pulp tissue and leaving the radicular pulp intact, usually performed in immature teeth.

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Apexification

A treatment for immature teeth with dead or dying pulp, aiming to allow the roots to finish forming and create an apical barrier after a root canal or pulpectomy.

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Apexogenesis

A technique used in immature teeth with exposed or diseased pulp to maintain pulp vitality and allow for root development. It involves placing calcium hydroxide or MTA on the pulp.

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Instrument Separation

A condition where a file breaks inside the root canal during treatment, which can be caused by excessive force, improper technique, or using old or weakened files.

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Perforation

A common endodontic complication that occurs when a hole is made in the tooth's structure, either during access preparation, searching for the pulpal orifices, or due to excessive coronal flaring.

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Coronal Perforation

A type of perforation that occurs when the crown of the tooth is accidentally perforated during access preparation.

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Root Perforation

A type of perforation that occurs at the root of the tooth, creating an artificial apical foramen or a lateral perforation.

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Class II Crack

A condition where a fracture extends through the enamel and involves dentin, but not the pulp.

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Horizontal Root Fracture

A fracture of the root where the apical segment remains in place, but the coronal segment is displaced. It can be managed by splinting or root canal treatment depending on the condition of the pulp.

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Vertical Root Fracture

A fracture that starts at the apex of the tooth and travels coronally, often caused by posts or over-condensation during root canal therapy.

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Calcific Metamorphosis

A response to trauma where the pulp chamber fills with reparative dentin and the tooth may appear yellow or orange.

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External Root Resorption

An inflammatory response to trauma or damage to cementoblasts, resulting in resorption of the root surface. It can be caused by infections or trauma.

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Study Notes

Endodontic Diagnosis

  • Endodontic diagnosis involves separate pulpal and periapical diagnoses.
  • Pulpal diagnosis assesses the health of the pulp. Periapical diagnosis assesses the area surrounding the tooth's root apex.

Pulpal Diagnosis

  • Responsive to cold? If yes, continue. If no, suspect pulp necrosis.
  • Pain? If yes, suspect pulpal inflammation. Consider if the pain is lingering or sharp.
  • Inflammation present? (Caries into pulp) If yes, determine if pain is lingering (>30 seconds).
  • Was RCT previously completed? If yes, determine if previously initiated.
  • How do control teeth respond? (+) or (-).
  • Normal pulp: Asymptomatic, responsive to thermal stimuli.
  • Reversible pulpitis: Symptomatic, responsive to stimuli, short-sharp pain subsiding.
  • Symptomatic irreversible pulpitis: Spontaneous, lingering or referred pain.
  • Asymptomatic irreversible pulpitis: Irreversible damage to pulp, no pain.

Apical Diagnosis

  • Percussion and palpation test: Pain indicates periapical inflammation. No pain indicates no significant periapical lesion.
  • Sinus tract? If yes, determine presence of radiographic changes.
  • Normal apical tissues: Asymptomatic apices, normal anatomy.
  • Symptomatic apical periodontitis: Inflammation around apex, possibly responding to pulp testing, possible referral to a referred, lingering pain.
  • Asymptomatic apical periodontitis: Inflammation, negative response to pulp testing, asymptomatic apices.
  • Acute apical abscess: Swelling, pain on biting, palpation, pus formation, acute.

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Description

Test your knowledge on dental pulp characteristics and the types of pain associated with pulpitis. This quiz covers key aspects such as dentin secretion, pain transmission, and the effects of circulation on dental health. Challenge yourself and enhance your understanding of dental physiology.

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