Contacts
Info
These are lectures of The Gulfie Dentist Coaching
Episodes & Posts
Episodes
Posts
18 AUG 2020 · MICROBIOLOGY IN ENDODONTICS
STREPTOCOCCUS SALIVARIS
 Aerobic
 Most abundant
 At birth
 Mainly in saliva
 1st organism to invade the oral cavity
 Seen in aeroter
STREPTOCOCCUS MUTANTS
 Aerobic
 Seen 1st at 6 months age
 Appears after tooth eruption only
 Associated with teeth mostly
 Caries initiator – because enamel contains 95% inorganic content – mutants demineralize inorganic substances
 Examples – nursing bottle caries, smooth surface caries, incipient caries
LACTOBACILLUS
 Aerobic
 Caries progression
 Attacks dentine – because dentine contains 65% inorganic & 35% organic – lactobacillus demineralize organic component easily
ACTINOMYCES
 Strictly anaerobic
 Gram +ve
 Root / senile caries
 Also seen in root canal as part of mixed flora in it
E-FECALIS
 Re-infection in RC treated teeth
 Most persistent organism in root canals
 Can be killed by MTAD / CHX / 5.25% NaOCl
OTHER BACTERIAL SPECIES SEEN IN INFECTED ROOT CANALS
 Porphyromonas gingivalis
 Bacteroids melaninogenicus
 Eubacteria species
 Fusobacterium species
 Prevotella special
(Strict and obligate anaerobes are predominant) ( Collagenase & toxins from bacteria &
spirochetes are seen in canals )
18 AUG 2020 · PULPAL PAIN
Nerve Trunk – 5th cranial nerve i.e. TRIGEMINAL NERVE
A-delta fibres:
1. Dentinal pain
2. Fast conducting, well localised pain
3. Quick, sharp, momentary pain, which disappears quickly on removal of the stimulus
4. Large myelinated nerves
5. Joins with the odontoblastic cell layer and dentin to form the pulpodentinal complex—dentinal hypersensitivity reason- reversible pulpitis
6. Reason for acute pain
7. Found only in mature / permanent / closed apex tooth
8. EPT detects this type fibre only
C nerve fibers:
1. Pulpal pain
2. Slow conducting, poorly localised pain
3. Dull, throbbing ache
4. Small, unmyelinated nerves that course centrally in the pulp
5. In irreversible cases
6. Chronic pulpitis
7. Diffuse pain, may be referred to other tooth also
8. Provoked by hot liquids or food
NOTE: VIEW PICTURE BELOW
18 AUG 2020 · VIEW PICTURE BELOW
18 AUG 2020 · PULPAL DISEASES
Normal Pulp
Thermal test- Mild to moderate transient pain that subsides almost immediately when stimulus is removed.
REVERSIBLE PULPITIS
1. Another name- Hyperemia / Focal reversible pulpitis
2. Quick sharp hypersensitive response that subsides as soon as stimulus is removed.
3. Causes: caries, scaling, deep restorations w/o base, after crown preparation.
4. Aggravating factor- cold
5. Relieving factor- heat
6. Vital tooth
7. A delta fibers involved
8. Thermal response- painful response that disappears after stimulus.
9. Something has invaded our dentine !!
18 AUG 2020 · Reversible pulpitis 1 : DENTINAL HYPERSENSITIVITY
 Symptom: spontaneous sharp lancinating pain
 Tooth is Vital
 Theory – Hydrodynamic Theory
Treatment options:
- Unfilled acrylic soln.- dentine bonding agents
- Fluoride gels / varnishes
- Desensitizing pastes – Potassium Nitrate salts, Strontium salts, 33% NaF salts
- ( use twice daily for 6 months > review > once in a week > once in 2 weeks )
- Crown placement
18 AUG 2020 · Example 2: CRACKED TOOTH SYNDROME (CTS)
 Continuous pain
 Pain on releasing the bite.
 *Best diagnosed by subjective symptoms & horizontal percussion*
 DIAGNOSIS:
1. Bite test- best test
2. Transillumination test - DFOTI
3. Die test- Please correct what I said Propyl glycol to Methylene Blue**
NB : CTS is reversible if pulp crack doesn’t involve the pulp. Treatment- crown. CTS is
irreversible pulpitis if crack involves the pulp. Treatment - RCT + crown
18 AUG 2020 · SYMPTOMATIC IRREVERSIBLE PULPITIS
1. Pulp damaged beyond repair. Cannot reverse or save the tooth.
2. Symptom- Unprovoked continuous or intermittent pain without any stimuli.
3. Symptom -Pain at night, sleeplessness
4. Aggravates more on hot drinks or food
5. So Aggravating factor –both heat & cold
6. Flight, high altitude pain. Pain on postural changes
7. Vital / non-vital
PULP NECROSIS
1. Pulp becomes non-vital
2. Cause- traumatic injury, progression of irreversible pulpitis
3. EPT test –ve
4. Discolouration - if it happens in anterior teeth
18 AUG 2020 · HYPERPLASTIC PULP
1. Pulp polyp
2. Reddish cauliflower-like growth
3. Cause: Low grade, chronic irritation to pulp
4. A type of irreversible pulpitis
5. Young pulp - due to generous vascular supply
18 AUG 2020 · INTERNAL RESORPTION
1. Identified accidentally during routine examination
2. Cause : chronic pulpitis, idiopathic,
3. Histologic appearance- Multinucleated giant cells adjacent to granulation tissue*
4. Necrotic pulp seen coronal to resorbtive defect
5. Partial pulp vitality is necessary for active resorption. (So EPT might show +ve)
6. The only treatment : Immediate single sitting RCT.
18 AUG 2020 · APICAL DISEASES
PULP NECROSIS >> APICAL PERIODONTITIS >> PERAPICAL ABSCESS >> PERIAPICAL GRANULOMA >> PERIAPICAL CYST
SYMPTOMATIC / ACUTE APICAL PERIODONTITIS
a. Intense pain, slight sensitivity-like feel on chewing.
b. TOP +ve
c. No radiographic changes seen
d. Vital AAP & non-vital AAP is differentiated only by pulp tests.
I. Vital AAP
o Post-restoration high point for 2 days
o TFO, bruxism, Pericoronitis
o Ortho PDL tear
o Abutment tooth in prostho FPD, RPD clasps, etc
o Treatment: simple occlusal adjustments only needed.
II. Non-Vital AAP
o Fully infected / necrosed pulp progression
o Over instrumentation in BMP ( piercing the PDL membranes beyond the apex >>> inflammation >>> post BMP pain
o GP extrusion post OBT pain
Nb: pulp vitality test…to know if endo treatment is req
These are lectures of The Gulfie Dentist Coaching
Information
| Author | DrMayakha Mariam |
| Organization | DrMayakha Mariam |
| Categories | Courses |
| Website | - |
| thegulfiedentist@gmail.com |
Copyright 2026 - Spreaker Inc. an iHeartMedia Company
