Microbiology, Endo, Immuno

transverse root fracture prognosis is favorable if located in

apical third

vertical root fractures usually start at

apical third

occlusal trauma causes damage in what area

furcal

traumatic occlusion radiographic appearance

widened PDL space, thickened lamina dura

how long should you use ultrasonic irrigation to remove smear layer?

3 minutes

Most prevalent bacteria in endodontic infections?

Firmicutes, Actinobacteria, Fusobacteria, Proteobacteria, Spirochaetes, Bacteroidetes

Next generation sequencing looks at what component of bacteria

16S rRNA

What pathogen responsible for caries acidity?

Strep mutans

What pathogen prevalent in caries once into dentin?

S. mutans, Lactobacilli, Bifidobnacteria, Prevotella, Propionibacterium, Fusobacterium

endodontic infections favor what bacteria

Gram negative and gram positive ANAEROBES

Endodontic Gram Positive STRICT Anaerobes

Eubacterium, Eggerthella, Filifactor, Parvimonas, Peptostreptococcus, Pseudoramibacter, and Propionibacterium (Arachnia)

Endodontic Gram Positive FACULTATIVE Anaerobes

Actinomyces, Lactobacillus, Streptococcus, Enterococcus, Gemella, and Staphylococcus

Endodontic Gram Negative STRICT Anaerobes

Fusobacterium, Porphyromonas, Prevotella, Olsenella, Tannerella, and Treponema

Endodontic Gram Negative FACULTATIVE Anaerobes

Capnocytophaga, Eikenella, Haemophilus, and Neisseria

According to Riccuci and Siquiera, apical periodontitis is a result of

infectious disease and biofilm

persistent endodontic infections due to

gram positive facultative anaerobes

most abundant bacteria in secondary infections

Proteobacteria Pseudomonas

most prevalent microbes in RCT with AP

Enterococcus @ 69%

CaOH pH level?

12.5

what percentage of extraradicular component is due to an intraradicular infection according to Riccui and Siquiera

83%

what percentage of previously treated cases have extraradicular biofilm according to Riccuci and Siquiera

6%

what bacteria responsible for AAA?

fusobacterium, Prevotella, Porphyromonas, Dialister, Treponema

How does Prevotella and Fusobacterium prevent other microbe growth?

Hydrogen sulfide H₂S production

Listeria uses what protein to create biofilms

internalin A

Author to quote for viral endodontic studies

Sabeti

inflammatory mediators for irreversible pulpitis

IL-8, MMP9, TNF-a

According to Jakovljevic, what percent of RCT teeth develop AP?

41.3%

predominant immunoglobulin in AP

IgG

RANKL activation induces

osteoclast activity for bone resorption

According to Nair, what is the frequency of apical lesions

50% granulomas, 35% abscesses, 15% cysts (61% true cyst, 39% bay cyst)

According to Yu et al, what is the incidence rate of flare-up after RCT

5.8%

Classic lit author who found microbes are required for AP

Kakehashi

Most frequent species in RCT teeth

E. faecalis

growth factors stored in bone essential osteoblasts, bone remodeling, wound healing

IGF, TGF-b, BMP, FGF, PDGF

Remnants of Hertwig’s epithelial root sheath

Epithelial Rests of Malassez (ERM)

what activates mast cells?

IgE, C3a, C5a, Sub P, cytokines, physical stimuli

first immune cells to respond

neutrophils

neutrophil function

phagocytosis, NETs

macrophage function

phagocytosis, APC, production of IL-1, TNF-a, IL-6, kill microbes via IFN-gamma

AA via COX-1 produces

PGI2 (GI protection), TXA2 (platelet formation)

AA via COX-2 produces

PGE2 (pain, fever, bone formation)

Role of PGI2 in inflammation

vasodilation, immune cell response modulator

in the arachidonic acid pathway, LOX produces?

leukotrienes

Leukotrienes responsible for

chemotaxis, increased vascular permeability, airway constriction, increased mucus (think allergic reaction)

What are some agents that block the LOX pathway in AA?

Montelukast (Singulair), Zafirlukast (Accolate), Zileuton (Zyflo)

C3a and C5a of complement cascade function as

anaphlyatoxins

C3b of complement cascade function as

opsonin

C5a of complement cascade function as

anaphylatoxin and chemotaxin

C5b-9 of complement cascade function as

MAC attack

cytokines responsible for bone resorption

IL-1b, TNF-a

cytokine responsible for acute inflammation

IL-6

cytokine responsible for innate immunity changing to adaptive immunity

IL-12

cytokine responsible for macrophage activation

IFN-gamma

acute inflammatory response timing with what cells

PMNs 1-2days, macrophages 4-8 days

Neuropeptide substance P function

pro-inflammatory and increased permeability

Neuropeptide CGRP function

vasodilation

Neuropeptide VIP function

anti-resorption, anti-inflammatory

What cytokines are assocaited with bone resorption

IL-1, IL-6, TNF

On what days is AP noted after pulp exposure

shows at 7 days and peak rate at 10-20days

What cells are responsible for cementum and dentin resorption

odontoclasts

What percent of PA lesions have ERM

52%