Home / Summaries / Class notes - ABE Board Exam / caoh2-tissue-increases

Board Review

210 important questions on Board Review

CaOH2 ph 12.5 (cell membrane, proteins and DNA)

Sequeira

NaOCl vs CHX (same antimicrobial, no dissolution of tissue with CHX)

Jeansonne and White

Instrumentation alone doesn't remove all bacteria

Dalton

US cleans 3mm beyond tip

Vander Sluis

35% of canals untouched by instrumentation

Peters

Irrigant penetrates tubules

Buck and Eleazer

Retreatment increases the prognosis of Sx by 10%

Zuolo

Bioceramic putty = MTA success rate at 1 year

Shinbori

MTA higher success (89%) than other materials

Tsesis

0 degree bevel = less canal leakage

Gilheany and Figdor

CBCT to differentiate external vs internal resorption

Patel

Bleaching 30% H2O2 causes resorption

Rotstein

Orthodontic movement can delay healing of periapical lesion

De Souza

Apical inflammatory root resorption increases apical foramen size - increase instrument size

Felippe

7 days of CaOH2 eliminated 100% bacteria

Sjogren

CaOH2 dissolved porcine tissue at 12 days

Hasselgren

CaOH2 enters dentinal tubules - advocates removal of smear layer

Foster

30 days of CaOH2 decreases fracture resistance of root

Andreassen

Intracanal medication does not decrease the chance of flare-up

Trope

ISO standardization credit goes to...

Ingle

Instrumenting canals long leads to inflammation in necrotic cases

Seltzer and Bender

Anti curvature filing - away from "danger zones"

Abou Rass

Crown down filing - first to describe

Marshall and Pappin

Balanced force technique - first to describe

Roan

Preflaring increases EAL accuracy

Ibbarola

Preflaring increases tactile detection of apical constriction

Stabholz

Preflaring decreases separation of NiTi instruments

Roland

Patency enhances irrigation penetration

Vera

Patency correlated with increased success rate of NSRCT and NSReTx

Glide path creation decreases chance of separating an instrument

Peters

Characteristics of a suitable sealer

According to Ingle: radiopaque, insoluble, nontoxic, seals well, non carcinogenic, non-immunologic, low staining, low shrinkage

Refractory infections are mostly anaerobes, Gram +

Sunde

1 minute of EDTA to remove smear layer

Saito

Apical resorption does not affect EAL reading

Goldberg

Less apical leakage when smear layer is removed...

Cergneaux

No crown after root canal = 6 x more likely to result in extraction

Aquilino

US effectively reduced bacterial load

Hoshino

Epithelium lines sinus tracts

Baumgartner

18% of necrotic cases have a sinus tract

Gupta

More GP enters lateral canals with warm vertical condensation

Reader

Introduced step back filing

Mulaney

How long does it take for the epithelial seal to form following surgery?

According to Harrison - 1 day

How long until a collagen barrier is formed?

48-72 hours

According to Martin, what bacteria was indicative of irreversible pulpitis?

P. endodontalis

When is new periosteum observed histologically?

14 days

Who says traumatized teeth with lesions have bacteria?

Sundqvist

Meta-analysis of separated files with no periapical lesion does not reduce prognosis

Panetvesai

How accurate are our sensibility tests? According to whom?

Cold 86%
EPT 81%
Heat 71%
Petersson

EDTA better than CO2 snow?

Miller

Digital radiographs reduce radiation how much? according to???

80-90% -- Soh

Use transillumination and methylene blue to identify cracks

Pashley

80% of cracked teeth with reversible pulpitis that are crowned will not require NSRCT

Krell

List 6 differentials for radiolucent lesion

abscess, granuloma, scar, cyst, lingual submandibular gland depression (stafne bone defect), hematopoietic bone marrow defect (trabeculation)

Lateral condensation causing 7.2kg force causes VRF in B-L plane

Pitts

Multiple sinus tracts pathognomonic for VRF

Pitts and Natkin

Calcium sulfate guided tissue regeneration/grafting

Thomas

Avoid ASA in <19 year old patients bc risk of ?

Reyes syndrome

How does Plavix work?

Irreversible inhibition of ADP chemoreceptor on platelet surface

How does Coumadin work?

Inhibits factors II, VII, IX, X (extrinsic pathway)

How does Heparin work?

Activates antithrombin = prothrombin won't be converted to thrombin

How does Pradexa work? (Dabigatran)

Direct thrombin (factor II) inhibitor

How do COX inhibitors work?

Block Arachidonic acid --> prostaglandins

What drug makes Epinephrine absolute contraindication?

Digoxin

What do you do for a patient having an asthma attack?

Albuterol q 20 min
SQ 0.3-0.5 mL 1:1000 epinephrine
O2 and monitor vitals until EMS arrives

Who says don't need antibiotics if I&D completed successfully?

Fouad

Who says using CaOH2 as intracanal medicament increases success of endodontic therapy by 10%?

Trope

Prognosis of treatment around 90% if PARL present

Who says 85% success rate of endo treated cracked teeth that are crowned at 2 year recall?

Tan

Leave 4-5 mm GP apical to post

Goerig

US can overheat bone if used on posts without irrigation

Erikkson

No stat. sig. diff. btw 1 vs 2 visits

Figini

What is in double antibiotic paste?

Metronidazole and Ciprofloxacin

How much epinephrine is in a racellet?

0.55 mg Racemic epi

Who describes up regulation of TTX resistant Na-channels in symptomatic irreversible pulpits, leading to LA failure?

Warren or Hargreaves

Insufficient ferrule will lead to increased chance of root fracture

Sathorn

VRF etiology = posts and lateral condensation

Tamse and Fuss

VRF from occlusal loading of posts

Peters

Cavit seals well for 3 weeks

Beach

Coronal seal more important than quality of endo

Ray and Trope

Bond strength of composites is decreased following internal bleaching

Torneck

Causes of Persistent Apical Periodontitis

According to Nair:
Intraradicular infection
Extraradicular infection
Apical cyst
Foreign body reaction
Apical scar
Cholesterol crystals

How long does Roth's sealer take to set completely?

~8 weeks (in vitro)

Asymmetric obturation means missed canal 89% of the time

Hoen and Pink

Silver cones - leakage, silver sulfates, corrosion, cytotoxic

Seltzer

Cyclic fatigue increases as radius of curvature decreases

Haikel

Developed ratio method used in root ZX - measures impedance of 2 frequencies and calculates quotient expressed as a location of file on EAL

Kobayashi

Found that radiographic working lengths 0-2mm short resulted in over instrumentation 51% in premolars and 22% in molars

Weiger

Advocates EAL to locate perforation

Fuss

Irrigant travels 1.5mm beyond side vented needle

Boutsioukis

Irrigant travels 3mm beyond US tip

Van der Sluis

NaOCl accident protocol

long-acting LA, antibiotics, analgesics, steroid, cold compress, daily recalls

Parachloroanaline formed as precipitate with NaOCl and CHX

Basrani

White salt precipitate formed from mixing EDTA and CHX

Racemic

Parachloroanaline is not formed in significant amount if it is formed at all from NaOCl and CHX

Nowicki

Ultrasonics energize, activate and warm irrigant

Cunningham

Acoustic streaming occurs with ultrasonic irrigation

Pitt Ford

Ultrasonics for 1 minute = cleaner canals and isthmuses

Burleson

No statistically significant difference between bacterial reduction between ultrasonic and sonic irrigation

Walker

Meta-Analysis -- 0-1 mm short of radiographic apex > 1-3mm short >> Long obturation

Schaeffer

Heating bone over 10degrees C = bone necrosis

Erikkson

CT and epithelial attachment occurs with geristore

Dragoo

PDL cells closely attach (0.5mm) to MTA

Baik

Roth's will be resorbed within 6 years

Augsberger

Roth's better antimicrobial effects than 3 comparison CaOH2 sealers

Mickel

Sealer extrusion can increase post op pain

Baumgartner

MTA better than amalgam for perforation repair

Baumgartner

Immediate perforation repair = 86% success

Mente

Perf repair factors:

Time, Size, Location - Fuss and Trope

Maxillary sinus perforation incidence with surgery

50% Rud

~50% of maxillary sinusitis has odontogenic etiology

Mailet and McClanahan

Advocate at least 3mm root resection for sx

Gagliani OR Kim & Kratchman

0.012% CHX pre surgery rinse

Vaughn

MTA sets at 36hrs

Charland

Not necessary to curette all tissue in lesion during surgery

Lin and Langeland

Full thickness flaps result in net 0.5mm crestal bone loss

Wood

Advocates monofilament suture material = decreased bacterial wicking

Kim

Do not discontinue anti platelet meds prior to surgery

Napenas

Endogenous opioid system - can explain why some patients with irreversible pulpitis have NO pain

Hargreaves

Success of IAN alone = 38%, with IO =88%

Nusstein and Reader

Back pressure needed for successful intrapulpal injection

Rosenberg and Walton

C fibers = dull pain, Adelta fibers = sharp pain

Dubner

70% C fiber innervation, 30% A delta

Reader

Pain pathway from sensory fibers to cortex

1st order neuron --> trigeminal ganglion (cell body) --> nucleus caudalis in dorsal horn of medulla (synapse) --> thalamus --> cortex (synapse)

Trigeminal neuralgia diagnosed over age 40 ---> immediate referral for possible diagnosis of multiple sclerosis

Radford

Masseter is primary muscle that will cause referred nonodontogenic pain

Wright

Trigeminal systems of pain --> 70% of dental nociceptors coincide with maxillary posterior teeth due to convergence

Sessile

Positive head dip test =?

Sinusitis

Recall schedule for alveolar fracture?

splint for 4 weeks, remove splint, 6-8 weeks, 4 months, 6 months, yearly for 5 years

Recommend 3 vertically angled radiographs for horizontal root fracture

Degering; Bender; Brynolf

How long do you splint cervical root fracture?

4 months - Andreasen

How long do you splint horizontal root fractures?

2-4 weeks - Andreasen

Incidence of necrosis for different traumas:

Concussion: 3%
Subluxation: 6%
Extrusion ~30%
Lateral luxation ~60%
Intrusion ~90%
Avulsion ~100% (closed apex)

36% of traumatized pulps are aseptic

Bergenholtz

EPT, heat and cold testing unreliable in trauma

Bhaskar

Water causes PDL cell lysis - use milk

Blomlof

HBSS best - Ashkenazi

EAL and EPT safe with pacemaker

Wilson

Ultrasonics safe with pacemakers/defibrillators

Gomes

EAL works equally well with necrotic and vital tissue in canals

Dunlap

EAL works well in presence of any irrigant or blood

Jenkins

Instrumentation decreases bacterial load 100-1000 fold

Bystrom and Sundqvist

NiTi --> more flexible, elastic, increased fracture resistance

Walia

Patency filing associated with higher success

NiTi files stay more centered and better taper than SS

Zemner

Described benefits of NiTi rotaries

Hata and Toda

2 carpules better than 1 for IAN success

Agarwaal

B infiltration with 4% articaine

Nusstein and Reader

Topical anesthetic more of a psychological benefit

Morton and Ramsey

Chloroform safe for dental staff

McDonald

Chloroform safe for patient if kept within canal

Chutich

Thickness of Cavit needs to be at least 3.5mm

Weber

Glass ionomer was only temp material with no leakage at 30 days

Barthel

Dens evaginatus prevalence

2.2% (Asian population) Yip

Dens in Dente prevalence

0.3-10%
Hulsmann

2 carps lido in max molars

Mikesell

Keep instrumentation 0.5-1.0mm short of radiographic apex

Kutler

0-1mm short for necrotic cases, 0-2mm short for vital cases

Wu, Wesselink and Walton

1 year peak incidence of healing, recall at 2 years if incomplete healing at 1 year

Orstavik

Teeth are not significantly more brittle after endo

Sedgley

Sealers are toxic until set

Spangberg

Give Antibiotics if swelling and fever present

Matthews/ Basrani

Leaving a 3mm cervical collar of bone increases success of surgery

Song

Microscope increases sx success

Tsesis

Success of endo microsurgery vs conventional root surgery

94% vs 88%
Setzer

Reasons NSRCT fails

POOR PAST according to CRUMP

Perforation
Obturation
Overfill
Root canal missed

Perio
Another tooth
Split tooth
Trauma

(AM)
anatomy
microleakage

True cysts are resistant to conventional NSRCT

Nair

Cysts can heal after removing source of bacteria

Lin

Presence of lesion decreases success 10-25%

deChevigny/Friedman

Negative culture does not equal increased prognosis

Peters/ Wesselink

Overfill = inflammatory responsse

Seltzer

1 visit = more post op pain

Average bony infill rate

3.2 mm2 / month

10% increase in surgery success if retreated first

Zuolo

No sig diff w/ separated instrument w/o lesion

Spilli

Vital pulp therapy : remove tissue to level of uninflamed pulp

Tronstad

Average time for apexification to occur

18 months - Cvek

4mm apical plug of MTA

Lawley

Direct pulp capping with CaOH2 fails 100% at 10 years

Barthel

Don't cap carious exposure - <50% success

Tronstad

MTA best for direct pulp cap

Mente

MTA reacts with tissue fluid -->releases CaOH2 -->causes release of growth factors --> stimulates hard tissue formation

Holland

Implanted DPSC in mice = dentin-like, pulp-like and odontoblast-like cells

Gronthos

First to describe revascularization procedure

Nygaard and Otsby

17% EDTA best supported SCAP. CHX kills stem cells

Trevino

EDTA promotes exposure of growth factors

Galler

Sickle cell anemia causes aseptic PARL

Kaya

Sickle cell anemia causes occlusion of microvasculature

Ingle

Sickle cell anemia 8.3% increased chance of pulp necrosis

Costa

Radiographic appearance of SCA

"step ladder" widened trabeculation

Thermal testing is safe for pulp

Rickoff

Pulp horn extension into DEJ is pathognomonic for what?

Vitamin D resistent Ricketts - Bender and Maidorf
Frontal bossing
bowed legs
enlarged ankles/wrists
Hypoplastic, hypo calcified enamel
apical abscesses
radiographically, enlarged pulp chambers, short roots

Radiographic appearance of Brown tumor

Ground glass

Diabetes = impaired healing

Bender

Avoid NSAIDs with hx of stroke or MI

Olsen

Epi recommendations in HTN/cardiac patients

limit 2 carps 1:100k epi in controlled HTN
0.04 mg in high risk patients

Apex >1mm for avulsion - recommends revascularization

Kling

5 mins of 2% NaF decreases replacement resorption for avulsed tooth

Coccia

NSRCT at 7-10 days following avulsion of closed apex tooth

Gregorio

All avulsed teeth with 90min dry time had ankylosis

Oswald

0 vital PDL cells with over 60 min dry time

Soder

Trauma denudes PDL cells which is chemotactic for clastic cells, sustained by bacteria

Tronstad

CaOH2 increases alkaline phosphatase, increases pH, decreases collagenases, increases hard tissue repair

Tronstad

2% NaF causes root to be more osteoclast resistant

Coccia

Tetracycline decreases resorption

Sae-Lim

10 days post trauma, ferret study ,EPT viable test

Pileggi

Outcome predictors according to Ng

Level of obturation, quality of obturation, coronal seal, size of PARL, presence of PARL, sinus tract, perforation, patency, CHX use (decr), Flareup (decr)

Calcium hydroxide paste caused the characteristic well-defined zone of necrosis subjacent the past. With Dycal there was no zone of necrosis

Tronstad

In crown-fractured teeth with vital pulp tissue after an exposure period of up to 7 days after injury, not more than 2mm of the pulp beneath the exposure needs to be removed. Partial pulpotomy can be performed for the effect of CaOH2 to be exerted on non-inflamed tissue

Cvek

"Dentinal" bridge formed after pulpotomy with CaOH2 is porous. 20-250 microns in size - dye leakage study

Goldberg

94% of crown-fractured teeth (permanent incisors) treated with partial pulpotomy were successful

Fuks

Proposed MTA pulpotomy over CaOH2 pulpotomy due to a greater ability to maintain the integrity of pulp tissue, a thicker dentinal bridge, less inflammation, less hyperemia and less plural necrosis.

Witherspoon

The question on the page originate from the summary of the following study material:

ABE Board Exam

View summary

A unique study and practice tool
Never study anything twice again
Get the grades you hope for
100% sure, 100% understanding

Remember faster, study better. Scientifically proven.