1. Why are pulpal diseases considered progressive?
    Localized insults like caries can develop inflammation by spreading to the pulp and cause apical inflammation
  2. Why are pulpal diseases progressive?
    • -pulpal inflammation is non compliant
    • -pulp simulates the cranium
  3. Is pulp highly vascularized? 
  4. What is the progression pattern of pulpal inflammation
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    • 1.local irritants cause inflammatory mediator release
    • 2. Mediators cause vasodilation and leaky vessels
    • 3. fluid leaks into surrounding tissues and increases pressure
    • 4. Pressure leads to ischemia and necrosis
  5. What is the causes of pulpal and periradicular inflammation?
    • 1. bacterial invasion
    • 2. chemical irritation (restorative materials)
    • 3. Thermomechanical
  6. What is the primary cause of pulp and periaphical diseases?
    Bacteria: dental caries and biofilm
  7. How does bacterial invasion show up on radiographs?
    It shows up shallower than it actually is
  8. Is direct pulpal exposure to caries required for pulpan infection and irritation?
    No. Caries does not need direct exposure
  9. When does dentin permeability increase?
    What causes this?
    • Permeability increases from the DEJ to the pulp-dentin complex
    • This is caused by an increase in number and diameter of dentinal tubules

    Dentin permeability is higher in occlusal walls (not axial)
  10. What aspects of dentin are directly related to pulpal sensitivity
    Dentin thickness and permeability contribute to pulpal effects
  11. What materials can cause pulpal injury?
    Restorative materials (resin, eugenol) cause chemical irritation to pulpal tissues
  12. Which materials can cause chronic inflammation
    Root canal sealers and gutta percha points cause chronic inflammation
  13. What is the end result of chemical irritation?
    Post-operative sensitivity and pulp necrosis
  14. How are pulpal sensitivity and cavitation depth related? Along with what other factor?
    Pulpal sensitivity is directly proportional to cavitation depth and types of material used
  15. Which creates more sensitivity, chemical or light curing?
    Chemical curing
  16. What are the biggest factors for endodontic complications following plastic restorations?
    • remaining dentin thickness and composite usage (vs. amalgam)
    • preop pain, cavity lining, rubber dam use had no effect
  17. what happens if you clean and fill the canals excessively?
    • The material can be pushed into the surrounding tissues, but gutta percha reactions are not common
    • however, overfill can cause chronic inflammation
  18. What can cause "blushing" of a preparation?
    Pulp hemorrhage associated with crown preparation
  19. What temperature change can cause pulpal necrosis?
    Changes of 5.5 degrees celcius can cause necrosis in 15% of teeth
  20. What are the options for treating pulpal disease?
    • 1. Conventional RCT
    • 2. Root canal retreatment
    • 3. Endodontic surgeries (apicoectomy)
    • 4. Extraction and Implants
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intro to endodontics