| dentin: prior to root formation / completion | Primary |
| dentin:produced AFTER tooth formation /completion | Secondary |
| dentin:regular & irregular | Reparative |
| dentin pulp altered by some unique features: does not allow for usual swelling associated with exudate of acute inflammatory response | Encased by a hard tissue |
| dentin pulp altered by some unique features: maintain the vitality when primary circulation is compromised | Lack of collateral circulation |
| dentin pulp altered by some unique features: Respond to any stimuli ONLY as ___ | pain |
| PULP DEGENERATION | calcific,atrophic, fibrous |
| Reversible Pulpal Changes:refers to early pulpal changes | Focal Reversible Pulpitis or Pulp Hyperemia |
| Reversible Pulpal Changes:mild transient pulpitis | Focal Reversible Pulpitis or Pulp Hyperemia |
| Reversible Pulpal Changes:first sign of distress of pulp localized chiefly to pulpal ends of irritated dentinal tubules | Focal Reversible Pulpitis or Pulp Hyperemia |
| Reversible Pulpal Changes:due to excessive accumulation of blood in the dental pulp resulting to vascular congestion and force out of the interstitial fluid to make way for the blood | Focal Reversible Pulpitis or Pulp Hyperemia |
| focal reversible pulpitis due to excessive accumulation of blood in the dental pulp resulting to vascular congestion and force out of the interstitial fluid to make way for the blood which may be due to | active and passive hyperemia |
| Reversible Pulpal Changes:Bacterial invasion of the pulp through carious dentin | Focal Reversible Pulpitis or Pulp Hyperemia |
| Reversible Pulpal Changes:Exposure of dentin to saliva over long period of time | Focal Reversible Pulpitis or Pulp Hyperemia |
| Reversible Pulpal Changes:Thermal shock when inadequately cooled high speed burs or polishing devices are used | Focal Reversible Pulpitis or Pulp Hyperemia |
| Reversible Pulpal Changes:Prolonged contact of burs with dentin during cavity preparation | Focal Reversible Pulpitis or Pulp Hyperemia |
| Reversible Pulpal Changes:Excessive dehydration of dentin with airblast | Focal Reversible Pulpitis or Pulp Hyperemia |
| Reversible Pulpal Changes:Trauma due to premature contacts in high restorations | Focal Reversible Pulpitis or Pulp Hyperemia |
| Reversible Pulpal Changes:Galvanic shock - metal restorations | Focal Reversible Pulpitis or Pulp Hyperemia |
| Reversible Pulpal Changes:Contact with freshly placed amalgam filling | Focal Reversible Pulpitis or Pulp Hyperemia |
| Reversible Pulpal Changes:Irritation of exposed dentin | Focal Reversible Pulpitis or Pulp Hyperemia |
| Reversible Pulpal Changes:Ordinarily painless but if due to cervical caries or abrasion, exposure to sweet and sour foods may cause sharp pain | Focal Reversible Pulpitis or Pulp Hyperemia |
| Reversible Pulpal Changes:Sensitive to thermal changes particularly to cold but pain/sensitivity disappears upon removal of irritant or restoration of normal temperature | Focal Reversible Pulpitis or Pulp Hyperemia |
| Reversible Pulpal Changes:Can be seen in teeth with deep carious lesions, large metallic restoration and with defective margins | Focal Reversible Pulpitis or Pulp Hyperemia |
| Sequelae of Repair: | Less vascular, More fibrous, Less cellular, Less able to withstand subsequent insult |
| Untreated advancing carious lesion | Irreversible Pulpal Changes |
| increased inflammatory response as stimulus intensifies | Irreversible Pulpal Changes |
| irreversibly inflamed pulp may be characterized by pulpal micro abscess formation | Irreversible Pulpal Changes |
| Irreversible Pulpal Changes:hyperactivity of exudative inflammatory forces close to source of injury or infection | Acute Pulpitis |
| Irreversible Pulpal Changes:immediate sequela of focal reversible pulpitis | Acute Pulpitis |
| Irreversible Pulpal Changes:(+) pain when regional intrapulpal pressure increases above pain threshold | Acute Pulpitis |
| Irreversible Pulpal Changes:results to varying degrees of pain | Acute Pulpitis |
| Irreversible Pulpal Changes:if primary irritant intensifies, exudative response also intensifies to neutralize the invader | Acute Pulpitis |
| Irreversible Pulpal Changes:an internal irritant maintains an inflammatory response of producing “Spontaneous Pain” | Acute Pulpitis |
| Irreversible Pulpal Changes:cold and heat causes immediate & prolonged response | Acute Pulpitis |
| Irreversible Pulpal Changes:absence of pain means intrapulpal pressure is below the threshold limits of the pain receptors | Acute Pulpitis |
| Irreversible Pulpal Changes:absence of further pain indicate persistent (residual) chronic inflammatory tissues or necrotic tissues that does not increase intrapulpal pressure | Acute Pulpitis |
| Acute Pulpitis: mild form of acute pulpitis | Acute Serous pulpitis |
| Acute Pulpitis: earliest stage of acute pulpitis | Acute Partial Serous Pulpitis |
| Acute Pulpitis: caused by diffusion of toxic products of bacteria | Acute Partial Serous Pulpitis |
| Acute Pulpitis: results to escape of plasma from distended blood vessel wall forming serous exudates on affected pulp | Acute Partial Serous Pulpitis |
| Acute Pulpitis:Sensitivity to hot & cold stimuli ( distressing pain more on cold) | Acute Partial Serous Pulpitis |
| Acute Pulpitis: Pain persists even after removal of irritant | Acute Partial Serous Pulpitis |
| Acute Pulpitis: Involved tooth usually has extensive caries | Acute Partial Serous Pulpitis |
| Acute Pulpitis: almost entire pulp is involved | Acute Total Serous Pulpitis |
| Acute Pulpitis: Severe, persistent throbbing pain | Acute Total Serous Pulpitis |
| Acute Pulpitis: Pain worsens in recumbent position | Acute Total Serous Pulpitis |
| Acute Pulpitis: Heat initiates lancinating pain | Acute Total Serous Pulpitis |
| anatomical features where bacteria can reach the pulp | dentinal tubules, lateral canals, apical foramen |
| Acute Pulpitis: Sensitive to percussion | Acute Total Serous Pulpitis |
| Acute Pulpitis: progressive type of pulpitis | Acute Suppurative Pulpitis |
| Acute Pulpitis: acute inflammation of unexposed pulp with | Acute Suppurative Pulpitis |
| Acute Pulpitis: PULPAL MICRO ABSCESS FORMATION | Acute Suppurative Pulpitis |
| Acute Pulpitis: pus | Acute Suppurative Pulpitis |
| Acute Pulpitis: Intense, pulsating pain which later becomes intermittent, throbbing pain | Acute Suppurative Pulpitis |
| Acute Pulpitis: Continuous pain | Acute Suppurative Pulpitis |
| Acute Pulpitis: Worsens with heat but temporarily relieved with cold stimulus | Acute Suppurative Pulpitis |
| Acute Pulpitis: Referred pain to opposite jaw or ear or anterior to an offending one. | Acute Suppurative Pulpitis |
| Acute Pulpitis: Radiographically reveals periapical changes if inflammation progresses to the apex. | Acute Suppurative Pulpitis |
| Acute Pulpitis: Tooth sensitive to percussion | Acute Suppurative Pulpitis |
| formed due to breakdown of infected pulp tissue by bacteria | pus |
| pus is contained in small cavities known as ____ | abscess |
| Acute Pulpitis: extensive coronal necrosis | Advanced Acute Pulpitis |
| recognized clinically by presence of small beads of PUS extruding from pulp usually followed by exudates but may have insufficient drainage | PULPAL MICRO ABSCESS FORMATION |
| not detected through radiograph | PULPAL MICRO ABSCESS FORMATION |
| Acute Pulpitis:will not increase pain if peripheral coronal receptors are necrotic | Advanced Acute Pulpitis |
| Acute Pulpitis:vasoconstriction of blood vessels reduces blood volume which decreases intrapulpal pressure to sub- threshold level | Advanced Acute Pulpitis |
| Irreversible Pulpal Changes:proliferating phase of the inflammatory process | Chronic Pulpitis |
| Irreversible Pulpal Changes:low grade irritation to the pulp is neutralized by effective tissue resistance | Chronic Pulpitis |
| Irreversible Pulpal Changes:formation of granulation or granulomatous tissue in the areas peripheral to the exudative zones | Chronic Pulpitis |
| Components of the granulomatous tissue:new collagen fibers and capillaries | Granulation tissue |
| Components of the granulomatous tissue:lymphocytes, plasma cells and macrophages | Chronic inflammatory cells |
| Chronic Pulpitis:usually involves Deciduous molars, 1st permanent molars | Chronic Hyperplastic Pulpitis |
| Chronic Pulpitis:excellent blood supply | Chronic Hyperplastic Pulpitis |
| Chronic Pulpitis: with large root opening | Chronic Hyperplastic Pulpitis |
| Chronic Pulpitis:Also called "Pulp polyp" | Chronic Hyperplastic Pulpitis |
| Chronic Pulpitis:Over growth of pulp tissue outside the boundary of pulp chamber | Chronic Hyperplastic Pulpitis |
| Chronic Pulpitis:Most common in deciduous molar and permanent molar | Chronic Hyperplastic Pulpitis |
| Chronic Pulpitis:Asymptomatic irreversible pulpitis | Chronic Hyperplastic Pulpitis |
| Chronic Pulpitis:It is essentially an excessive, exuberant proliferation of chronically inflamed pulp tissue | Chronic Hyperplastic Pulpitis |
| Chronic Pulpitis:Appears as a pinkish red globule of tissue protruding from the pulp chamber and often filling the entire cavity | Chronic Hyperplastic Pulpitis |
| Chronic Pulpitis:Insensitive to manipulation because it has few nerves | Chronic Hyperplastic Pulpitis |
| Chronic Pulpitis:The lesion may or may not bleed readily depending on the vascularity of the tissue | Chronic Hyperplastic Pulpitis |
| Chronic Pulpitis:deposition of collagen fibers on the inflamed area | Chronic Open Ulcerative Pulpitis |
| Chronic Pulpitis:present in teeth with wide open carious lesion | Chronic Open Ulcerative Pulpitis |
| Chronic Pulpitis:most common type of pulpitis | Chronic Closed Ulcerative Pulpitis |
| Chronic Pulpitis:inflamed pulp does not permit release of exudative pressure and this constitutes an increased hazard to the integrity of the pulpal circulation | Chronic Closed Ulcerative Pulpitis |
| death of the pulp without bacterial infection | Necrosis |
| pulp assumes a white, soft, cheese like consistency brought about by coagulation of proteins and fatty substances | Caseation/ Caseous necrosis |
| brought about by protein splitting enzymes liberated by leukocytes at the site of inflammation and dead pulp cells | Liquefaction necrosis |
| Tooth may appear discolored | Necrosis |
| organic decomposition of pulp from bacterial infection | Gangrene |
| Mortification of Pulp | Gangrene |
| types of gangrene: with abundance of serous exudation | Moist gangrene |
| types of gangrene: due to insufficient blood supply | Dry gangrene |
| Tooth may be asymptomatic for a long time | Gangrene |
| If infection spreads into the periapical tissues, acute dentoalveolar abscess or a periodontitis may develop | Gangrene |
| Negative to vitality test. If pulp canal contains liquid, positive response may be noted because liquid is a conductor of electricity | Gangrene |
| Heat produces pain especially if carious exposure is blocked | Gangrene |
| only blood supply of pulp comes from | apical foramen |
| anaerobic process of splitting proteins (organic decomposition) by bacteria and fungi with formation of foul smelling incompletely oxidized products | Putrefaction |
| The only basis is knowing that the pulp is inflamed with the presence of _________ | pain or discomfort |
| CAUSES OF PULP DISEASES:The most common because of bacterial involvement | CARIES |
| CAUSES OF PULP DISEASES:Most commonly when we do restoration on the tooth and we do not use water in our handpiece | HEAT |
| CAUSES OF PULP DISEASES:Dental materials which will generate heat like polycarboxylate cements | HEAT |
| CAUSES OF PULP DISEASES: We use dull burs when we do restoration which will cause friction instead of it cutting off tooth structures | FRICTION |
| CAUSES OF PULP DISEASES:potential irritants to the pulp | FILLING MATERIALS |
| CAUSES OF PULP DISEASES:it may be an entry point of bacteria to enter the pulp causing pulp disease | PERIODONTITIS REACHING THE LATERAL AND APICAL FORAMEN |
| Reversible Pulpal Changes:this happens in incipient caries or caries that has not cause extensive destruction to the pulp | Focal Reversible Pulpitis or Pulp Hyperemia |
| Reversible Pulpal Changes:Prominent feature is dilation and engorgement of blood vessels | Focal Reversible Pulpitis or Pulp Hyperemia |
| Reversible Pulpal Changes:Presence of exudation of proteins | Focal Reversible Pulpitis or Pulp Hyperemia |
| this may cause slight pain whenever the cavity/ carious lesion exposed to acids or sweets | Presence of exudation of proteins |
| What teeth most commonly have reversible pulpitis? | tooth with marginal leakage |
| the ff occurs after restoring tooth with RP | Changes in Repaired Pulpal Tissues |
| the ff happens to the tooth after doing restoration | Sequelae of Repair |
| Sequelae of Repair:because of the formation of new CT especially if you place Calcium Hydroxide | More fibrous |
| Sequelae of Repair:if the same tooth becomes exposed to caries AGAIN in the future may NOT BE ABLE TO RECOVER | Less able to withstand subsequent insult |
| Sequelae of Repair:MOST PROMINENT FACTOR | Less able to withstand subsequent insult |
| TYPES OF REVERSIBLE PULPITIS:Characterized by sharp pain lasting but for a moment | SYMPTOMATIC REVERSIBLE PULPITIS |
| TYPES OF REVERSIBLE PULPITIS:The pain is characterized by the presence of the stimulus and the pain is sharp or lancinating | SYMPTOMATIC REVERSIBLE PULPITIS |
| TYPES OF REVERSIBLE PULPITIS:It does not occur spontaneously and does not continue when the cause has been removed. | SYMPTOMATIC REVERSIBLE PULPITIS |
| TYPES OF REVERSIBLE PULPITIS:May result from incipient caries and is resolved on the removal of caries and proper restoration of the tooth. | ASYMPTOMATIC REVERSIBLE PULPITIS |
| Irreversible Pulpal Changes:Paroxysm of pain | SYMPTOMATIC IRREVERSIBLE PULPITIS |
| Irreversible Pulpal Changes:Pain is often continuous when the cause has been removed and it may come and go spontaneously without apparent cause | SYMPTOMATIC IRREVERSIBLE PULPITIS |
| Irreversible Pulpal Changes:Patients may describe the pain as sharp, piercing, or shooting and it is generally severe, it may be intermittent or continuous, depending on the degree of pulpal involvement and depending on whether it is related to an external stimulus. | SYMPTOMATIC IRREVERSIBLE PULPITIS |
| Irreversible Pulpal Changes: the exposed pulp exhibits little or no pain, except when food is packed into the cavity. | ASYMPTOMATIC IRREVERSIBLE PULPITIS |
| Irreversible Pulpal Changes:Other symptoms may develop, such as diffuse, dull, constant pain, characterized by throbbing and gnawing, and the tooth may respond abnormally and severely to heat. | ASYMPTOMATIC IRREVERSIBLE PULPITIS |
| Irreversible Pulpal Changes:It is the initial reaction of the pulp when an irritation occurs | acute pulpitis |
| Irreversible Pulpal Changes:Close proximity of the pulp to the source of injury or infection (2.5mm) | Acute pulpitis |
| Components of the granulomatous tissue: come from the cells in the pulp which produces new fibers | granulation tissue |
| Chronic Pulpitis:Characterized by an overgrowth of granulomatous tissue into the carious cavity | Chronic Hyperplastic Pulpitis |
| Chronic Pulpitis:Occurs in young teeth where the pulp has been exposed to caries or trauma | Chronic Hyperplastic Pulpitis |
| Chronic Pulpitis:Clinically, pink tissue on the occlusal surface of the tooth | Chronic Hyperplastic Pulpitis |
| Chronic Pulpitis:Mechanical irritation and bacterial invasion result in a level of chronic inflammation that produces hyperplastic granulation tissue extruded from the chamber and often fills the associated dentinal defect. | Chronic Hyperplastic Pulpitis |
| Chronic Pulpitis:An idiopathic slow or fast progressive resorptive process occurring in the dentin of the pulp chamber or root canals of the teeth | INTERNAL RESORPTION |
| INTERNAL RESORPTION: SYMPTOMATOLOGY | asymptomatic. |
| Chronic Pulpitis:generally present in the teeth of older people | PULP DEGENERATION |
| Chronic Pulpitis:result of persistent mild irritation in teeth of younger people, however, as in calcific | PULP DEGENERATION |
| Chronic Pulpitis:Is not necessarily related to infection or caries, although a cavity or filling may be present in the affected tooth. | PULP DEGENERATION |
| Chronic Pulpitis:result of the exposure of the tooth to chemicals from dental materials that are being used. | PULP DEGENERATION |
| In calcific degeneration, part of the pulp tissue is replaced by _________ (pulp stones or dentricles) that appears radiopaque. | calcific material |
| form of degeneration of the pulp is characterized by replacement of the cellular elements by fibrous connective tissue. | FIBROUS DEGENERATION |
| FIBROUS DEGENERATION: On removal from the root canal, such a pulp has the characteristic appearance of a _____ | leathery fiber |
| Vacuolization of the odontoblasts was once thought to be a type of pulp degeneration characterized by empty spaces formerly occupied by odontoblasts. | PULP ARTIFACTS |
| caused by poor fixation of the tissue specimen | PULP ARTIFACTS |
| Fatty degeneration of the pulp, along with reticular atrophy and vacuolization, are all probably artifacts with same cause, that is, unsatisfactory fixation | PULP ARTIFACTS |
| Presence of fatty substances or degeneration in the pulp | PULP ARTIFACTS |
| rare, except possibly in terminal stages | TUMOR METASTASIS |
| types of necrosis: The soluble portion of tissue is precipitated or is converted into a solid material | COAGULATION NECROSIS |
| types of necrosis: Formation of white cheesy substance in the cavity | COAGULATION NECROSIS |
| types of necrosis: Common among younger patients | COAGULATION NECROSIS |
| types of necrosis: You can remove it readily with spoon excavator | COAGULATION NECROSIS |
| types of necrosis: Results when proteolytic enzymes convert the tissue into a softened mass, a liquid, or amorphous debris | LIQUEFACTION NECROSIS |
| types of necrosis: The intermediate products, such as indole, skatole, putrecine, and cadaverine, contribute to the unpleasant odor sometimes emanating from a root canal | LIQUEFACTION NECROSIS |
| types of necrosis: Softened mass are more liquid in consistency such that, when we do endodontic treatment and you bur out the tooth until the pulp of the tooth – the necrotic material starts to ooze out of the cavity | LIQUEFACTION NECROSIS |
| types of necrosis: More liquified in appearance | LIQUEFACTION NECROSIS |
| types of necrosis: Like a condensed milk that is thinned out a little | LIQUEFACTION NECROSIS |
| types of necrosis: More pus in appearance | LIQUEFACTION NECROSIS |
| necrosis: symptomatology | Asymptomatic |
| When does partial necrosis occur? | multirooted teeth |
| It causes the release of gasses that infiltrates the body’s tissue and leads to the deterioration of tissues of the pulp | Putrefaction |
