Endodontic Therapy

Question 1

What is the definition of Indirect Pulp Cap?

Answer 1

• Single stage caries removal to hard dentine
• Biomaterial placement over thin layer of remaining dentine

Question 2

What is the definition of Selective Carious Tissue Removal

Answer 2

• Selective caries removal to soft or firm dentine on pulpal wall
• Biomaterial placement on pulpal wall of cavity

Question 3

What is the definition of Stepwise Excavation

Answer 3

• First stage removal of caries to soft dentine on pulpal wall and
  temporisation
• 6-12mths later caries removal to firm dentine, biomaterial & permanent
  restoration

Question 4

What is the definition of Direct Pulp Cap

Answer 4

• Class I: no pre-operative deep caries i.e. pulpal exposure due to trauma or
  iatrogenic damage
• Class II: Carious exposure, disinfectant and calcium silicate cement used

Question 5

What is the definition of Partial Pulpotomy

Answer 5

• Removal of a small portion of coronal pulp
• Placement of biomaterial and restoration

Question 6

What is the definition of Full pulpotomy

Answer 6

• Removal of all coronal pulp
• Placement of biomaterial and restoration

Question 7

Name the 3 essential aspects for all vital pulp therapy?

Answer 7

• Magnification
• Aseptic technique
• Peripheral seal caries free to enable
  peripheral seal

Question 8

Describe the recommended treatment for pulpitis?

Answer 8

Vital pulp treatment or Root canal treatment
Restoration to function
Supportive postoperative care

Question 9

Describe the recommended treatment for non-traumatic pulpitis with no pain or non-spontaneous pain

Answer 9

Selective/stepwise caries removal without pulp exposure.
If pulpal exposure direct pulp capping or pulpotomy (partial
or full)

Question 10

Describe the recommneded treatment for apical periodontitis?

Answer 10

Root canal treatment
Restoration to function
Supportive postoperative care

Question 11

Describe the recommneded treatment for emergency management of pulpitis or apical periodontitis

Answer 11

Vital Pulp Treatment or Root Canal Treatment

Question 12

Describe the recommneded treatment for pulp necrosis +/- AP with immature permanent tooth?

Answer 12

Apical plug technique or revitalisation

Question 13

How does CaOH, MTA and biodentine differe over post-treatment survival?

Answer 13

MTA performed significantly better than CaOH at all time points
No significant difference between MTA and biodentine however no
darkening with biodentine

Question 14

How does pulpal bleeding infleunce the outcome of pulp therapy success?

Answer 14

Therefore, ensure haemostasis prior to pulp caping and ensure no
space for bleeding below cap
If not possible to cease bleeding progress from pulp capping →
partial pulpotomy → full pulpotomy → pulpectomy (i.e. RCT)

Question 15

What aspect of RCT technique have the strongest evudebce for improving outcome for AP?

Answer 15

NiTi rotary > hand SS (weak)
NaOCl then EDTA, then NaOCl (open)
No need for intracanal medication if single visit is possible (strong)
Obturation with GP, cold lateral, with ZOE sealer (open)
No need for adjuncative therapy (weak)