New Developments in Endodontics: Vital Pulp Therapy and Regeneration

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Questions and Answers

What is a key factor to consider in case of direct pulp capping in deep carious lesions?

Presence of spontaneous pain prior to treatment

Use of Caries Detector Dye

Open apex in permanent teeth

Size of the lesion (correct)

What is the purpose of gently enlarging the pulpal wound during pulp exposure preop diagnosis?

To induce spontaneous pain

To perform a pulpotomy

To control the pulpitis disease

To assess the bleeding from the pulp (correct)

In which case is a pulpectomy indicated?

Failures related to misdiagnosis of the severity of the pulpitis disease

Failures related to restoration quality and sealing ability (correct)

Failures related to secondary infection

Failures related to insufficient pulp tissue removal

What is a possible alternative to using Calcium Silicate for a bonded restoration?

Dycal Signup and view all the answers

When is the age of the patient considered secondary to symptoms in direct pulp capping?

When the patient has asymptomatic and no provoked pain prior to treatment Signup and view all the answers

Which treatment principle should be followed for a tooth with a root fracture?

Avoid attempting to move loose teeth Signup and view all the answers

What is the main objective in treating an immature tooth?

Continue alveolar growth and maturation Signup and view all the answers

What is the success rate of direct pulp capping for inflamed pulp due to caries?

<35% Signup and view all the answers

What is the pooled pulp survival rate after 1.5 years for exposed pulps with deep caries lesions in adults?

33.2% Signup and view all the answers

What are the exclusion criteria for direct pulp capping?

Prolonged pain, night sleep disturbance, no response to cold and electrical pulp testing, attachment loss > 5mm, apical radiolucency Signup and view all the answers

What is the preferred treatment when the apical foramen is not completely formed?

Pulp revascularization Signup and view all the answers

What is the occurrence of pulp revascularization enhanced by in humans?

Large apical foramen Signup and view all the answers

What could be expected to be between 18 and 25% for complete revascularization of the pulp in a tooth with an open apex after avulsion?

Pulp revascularization Signup and view all the answers

What type of fracture involves dentin, cementum, and pulp?

Root fracture Signup and view all the answers

What are possible complications of traumatic injuries according to the text?

Pulpal obliteration Signup and view all the answers

Study Notes

Root fracture: - Do not move loose teeth - X Root fracture: extrusion, luxation, force - Prognosis: 20% permanent pulp necrosis in coronal segment after successful endodontic treatment
Necrotic pulp: - Difficult to treat - Inadequate strength - Believed pulp progenitor cells cannot survive infection
Antibiotic mixture study: - Ciprofloxacin, metronidazole, minocycline - Penetrates through root dentin - Kills bacteria in deep layers of extracted tooth root dentine
Regenerative Endodontics: - Evoked-bleeding step triggers accumulation of undifferentiated stem cells in canal space
Immature tooth: - Main objective: continuation of alveolar growth and maturation - Antibiotic mixture has higher success rate than calcium hydroxide in vital pulp therapy
Direct pulp capping: - Requirements for success: healthy pulp (trauma/iatrogenic) - Success rate: >90%, inflamed pulp (caries): <35%
Deep caries lesions in adults: - Randomized clinical trials: stepwise excavation decreases risk of pulp exposure - Success rate: 74.1% for stepwise, 62.4% for complete excavation - Pooled pulp survival rate: 33.2% after 1.5 years for exposed pulps.

Exclusion criteria: - Prolonged pain, night sleep disturbance, no response to cold and electrical pulp testing, attachment loss > 5mm, apical radiolucency.

Root fracture treatment principles: - Do not attempt to move loose teeth - X Root fracture: extrusion, luxation, force - Prognosis: 20% permanent pulp necrosis in coronal segment after successful endodontic treatment.

Necrotic pulp: - Difficult to treat - Inadequate strength - Believed pulp progenitor cells cannot survive infection.

Antibiotic mixture study: - Ciprofloxacin, metronidazole, minocycline - Penetrates through root dentin - Kills bacteria in deep layers of extracted tooth root dentine.

Regenerative Endodontics: - Evoked-bleeding step triggers accumulation of undifferentiated stem cells in canal space - These cells might contribute to regeneration of pulpal tissues.

Immature tooth: - Main objective: continuation of alveolar growth and maturation - Antibiotic mixture has higher success rate than calcium hydroxide in vital pulp therapy.

Direct pulp capping: - Requirements for success: healthy pulp (trauma/iatrogenic) - Success rate: >90%, inflamed pulp (caries): <35% - Exclusion criteria: prolonged pain, night sleep disturbance, no response to cold and electrical pulp testing, attachment loss > 5mm, apical radiolucency.

Deep caries lesions in adults: - Randomized clinical trials: stepwise excavation decreases risk of pulp exposure - Success rate: 74.1% for stepwise, 62.4% for complete excavation - Pooled pulp survival rate: 33.2% after 1.5 years for exposed pulps.

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Description

Explore the latest advancements in endodontics focusing on vital pulp therapy and regeneration. Learn about challenges in treating immature non-vital teeth and the revascularization approach to address pulpal necrosis. This quiz delves into the evolving techniques in endodontic treatment.