3 pulpal and periapical Flashcards

1
Q

pulp polyp =

A

chronic hyperplastic pulpitis

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2
Q

accelerated aging and teeth

A

progeria

widespread deposition of secondary dentin

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3
Q

obstruction of pulp chamber and canal with secondary dentin

A

calcific metamorphosis
usually trauma
yellow discoloration of crown

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4
Q

calcific metamorphosis

A

obstruction of pulp chamber and canal with secondary dentin

usually trauma
yellow discoloration of crown

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5
Q

3 shapes of pulpal calcifications

A

denticles, pulp stones, diffuse linear calcifications

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6
Q

globules of gamma globulin

A

russel bodies

plasma cell product

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7
Q

russel bodies

A

globules of gamma globulin

plasma cell product

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8
Q

rushton bodies

A

linear or arch-shaped calcifications

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9
Q

linear or arch-shaped calcifications

A

rushton bodies

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10
Q

pyronine bodies

A

basophilic particles (plasma cell product)

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11
Q

pulse granuloma

A

hyaline bodies/giant-cell hyaline angiopathy
eosinophilic material surrounded by lymphocytes and giant cells
may contain inflammatory cells or calcifications
pools of inflammatory exudate that undergoes fibrowiw and dystrophic calcifications

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12
Q

celluitis what is and 2 relevanet types

A

abscess spread through facial soft tissues

ludwing’s angina and cavernous sinus thrombosis

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13
Q

three features of cavernous sinus thrombosis

A

proptosis (exophthalmos), chemosis (edematous conjunctiva), ptosis (dropping eyelid)

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14
Q

proptosis, chemosis, ptosis

A

caverbous sinus thrombosis

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15
Q

broadly, courses of osteomyelitis

A

acute suppurative and chronic suppurative

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16
Q

necrotic bone separated from adjacent vital bone

A

sequestrum

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17
Q

necrotic bone surrounded by newly-formed vital bone

A

involucrum

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18
Q

sequestrum vs involucrum

A

sequestrum: necrotic bone separated from adjacent vital bone
involucrum: necrotic bone surrounded by newly-formed vital bone

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19
Q

types/causes of **diffuse sclerosing osteomyelities

A

diffuse ssclerosing – infx present
primary chronic – no bacterial sourse
chronic tendoperiostitis

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20
Q

primary chronic osteomyelitis 2/2 masticatio muscle overuse

A

chronic tendoperiostitis

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21
Q

chronic tendoperiostitis

A

primary chronic osteomyelitis 2/2 masticatio muscle overuse

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22
Q

widespread primary chronic osteomyelitis – what is; skin lesions

A

chronic recurrent multifocal osteomylitis

no skin lesions

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23
Q

sy ndrome with primary chronic osteomylitis

A
SAPHO
synovitis
acne
pustulosis
hyperostosis
osteomyelitis
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24
Q

alveolar osteitis aka and what;s going n

A

fibrinolytic alveolitis

lysis of fibrin releases kinins (pain mediators)

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25
Q

role of fibrin in alevolar osteitis

A

lysis –> release of kinins (pain mediators)

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26
Q

when is primary dentin formed

A

before completion of crown

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27
Q

when is seconadry dentin formed

A

after primary; throughout life

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28
Q

when is tertiary dentin formed

A

laid down in areas of focal injury

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29
Q

demographic for more rapid secondary dentin

A

more rapid in M

also in Ca-related dzz eg arthritis, gout, kidney stones, gall stones, atherosclerosis, HT

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30
Q

accelerated aging and teeth

A

progeria

widespread deposition of secondary dentin

31
Q

calcific metamosprhosis of teeth why and look

A

early obstruction of pulp chamber and canal w secondary dentin, after trauma
yellow discoloration of teeth

32
Q

interface dentin aka and what is

A

fibrodentin

initial layer of reparative dentin (atubular)

33
Q

initial layer of reprative dentin

A

interface dentin

atubular

34
Q

tubules from dead primary odontoblasts

A

dead tracts

filled w degenerated odontoblastic processes

35
Q

pulp calcs prevalence and assoc

A

20%; assoc w chronic pulpitis, age, and familial

36
Q

conditions w prominent pulp calcs

A

dentin dysplasia Id and II, pulpal dysplasia, tumoral calcinosis and calcinosis universalic, Ehlers Danlos, ESRD

37
Q

forward metaplasia

A

proroplasia

eg when odontogenic lining of inflammatory cysts becomes resspiratory

38
Q

pulse granuloma what is

A

pool of inflammatory exudate; fibrosis and dystrophic calc; surrounded by lymphocytes and giant cells

39
Q

parulis

A

mass of granulation tissue at opening of sinus tract

40
Q

conditions that favor widespread infx

A

diabetes, neutropenia, malignancy, immunosuppression, corticoid use, cytotoxic drug use

41
Q

abscess draining thorugh skin

A

cutaneous sinus

42
Q

acute edematous spread of acute inflammation through soft tissue

A

cellulitis

43
Q

dangerous head and neck cellulitides

A

Ludwings angina and cavernous sinus thrombosis

44
Q

ludwigs angina location and origin

A

cellulitis of submandibular region
70% from lower molar teeth infx
also tonsillar/pharyngeal abscess, oral laceration, frx of md or dub-md sialadenitis

more in AIDS, tranplsant, aplastic anemia, diabetes pts
airway obstruction major concern

45
Q

tongue in ludwig

A

woodt

elevated, enlarged, protruded when Ludwig in subligual space

46
Q

neck in ludwig

A

bull

enlarged and tender (subMD space spread)

47
Q

cavernous sinus thrombosis location and origin

A

cavernous sinus in dura; mx infections

48
Q

cavernous sinus thrombosis clinical look

A

periorbital enlargement involving eyelid and conjunctiva

proptosis, chemosis (conjunctival edema), ptosis in 90% of cases

49
Q

osteomyelitis locations

A

most in MD of males

mx cases when assoc w NUG or noma

50
Q

three categoreis of diffuse sclerosing osteomyelitis

A

diffuse sclerosing osteomyelitis – infx present
primary chronic osteomylitis – similar to classic chronic but no bacteria, suppuration, or sequestra
chronic tendoperiostitis

51
Q

chronic tendoperiostitis

A

primary chronic osteomylitis 2/2 overuse of masseter (MD angle/body) or digastric (anterior MD/PM region)

can see parafunctional habits (bruxism, clenching, nail biting)

52
Q

SAPHO molecular basis

A

autoimmune to derm bacteria, cross react with bone

poss HLA-B27?

53
Q

CRMO and skin

A

chronci recurrent multifocal osteomyliis

no skin lesions but can appear up to 20 years later – palmoplants pustulosis, psoriasis, acne, hidradenitis suppurativa

54
Q

condensing osteitis aka, who, where

A

focal sclerosing osteomyelitis
localized areas of bone sclerosis assoc w apices of teeth w pulpitis or necrosis
children and young adults
ddx: FCOD (has RL border) and idiopathic osteosclerosis (separated ffrom apex)

55
Q

bone scar

A

residual area of condensing osteitis after imflammation resolves

56
Q

residual area of condensing osteitis after imflammation resolves

A

bone scar

57
Q

garre osteomyelitis better term:

A

periostitis ossificans or osteomylitis w proliferative periostitis

58
Q

radio look of osteomylitis w proliferative periostitis

A

onion skinning

active osteoblasts on covex surface of curvy bony spicules

59
Q

causes of periosteal bone formation

A

most – osteomylitis and neoplasms (Ewing sarcoma, LCH, osteosarc, hemangioma)

also: trauma, cysts, infantile, cortical hyperostosis, fluororis,s avitaminosis C, hypertrophic osteoarthropathy, and congenital syphilis)

60
Q

histo periosteal rxn to inflammation

A

parallel rows of vital bone

61
Q

locations for periosteal rxn to inflammation

A

most are unifocal in molar and PM 2/2 caries

also perio infx, frx, buccal bifurcation cysts, and non-odontogenic infx

62
Q

dry socket what happened

A

clot is lost –> bare bony socket

63
Q

why can clot get lost

A

trauma, estrogen, bacteria can stimulate fibrinolysins
increased freq in impacted 3 molars, poor oral hygiene, inexperienced surgeon, traumatic exo, oral contraceptive use, and presurgical infx (pericoronitis)

also inadeq irrigation, smoking, heavy spitting/sucking

64
Q

dry socket tx:

A

xray to rule out tip or foreign body

irrigation, analgesics, maybe topical abx

65
Q

normal pulp:

cold, heat, electric, percussion, pain

A
cold - 1-2 sec
heat - no 
EPT - normal 
percussion - no 
pain - severe
66
Q

reversible pulpitis:

cold, heat, electric, percussion, pain

A
cold - acute pain, sweets also
heat - sometimes
EPT - lower
percussion - no 
pain - acute
67
Q

irreversible pulpitis:

cold, heat, electric, percussion, pain

A
cold - early: uncomfy; lateL cold relieves pain
heat - severe/sharp
EPT - early: low; late: high
percussion - no 
pain - throbbing lingering
68
Q

periapical infection clinical

A

acute: dull throbbing pain, negative or delayed vitality, pain on percussion
chronic: no pain

69
Q

reactionary vs reparative dentin

A

 Reactionary: mild stimuli

 Reparative: Severe stimuli; first – interface dentin = atubular + acellular = fibrodentin

70
Q

detectable pulpal calcs

A

> 200 μm to be detected by radiograph

71
Q

ludwig and teeth:

A

70% related to molars
submand/subling/submental spaces
submand –> pharyng –> retropharyng

72
Q

cavernous sinus thrombosis and teeth

A

10% related to teeth
anterior pathway: canine tooth –> canine space –> valveless facial veins –> angular vain –> inf ophth vein –> sinus

psoterior pathway: mx PM/M –> buccal/infratemporal space –> emissary vein –> inferior petrosal sinus –> cavernous sinus

73
Q

SAPHO what is, cause, location, components

A
cause unknown, individuals with Autoimmune are predisposed
 Axial skeleton (anterior chest)
 Concurrent neutrophilic skin
 Adults
 -ve for bacteria
Synovitis
Acne
Pustulosis
Hyperostosis
Osteitis that mirrors primary chronic osteomyelitis
74
Q

CRMO what is

A
Believed to be a pediatric variant of SAPHO or wide spread variant of primary chronic
osteomyelitis.
Chronic
Recurrent
Multifocal
Osteomyelitis