Acute Periodontal Lesion (Final) Flashcards
Acute periodontal lesions include: (3)
- periodontal abscesses
- necrotizing periodontal diseases
- endo perio lesions
A dental emergency makes up ____ % of all emergency patients and is the ___ most common reason for ER visits.
7-14%; 3rd
(periodontal abscesses)
60% of dental emergency visits are due to:
untreated periodontitis
___% of patients in active periodontal treatment result in dental emergencies
13.5% (due to periodontal abscess)
_____% of patients in periodontal maintenance result in dental emergencies (due to periodontal abscess)
37% (due to periodontal abscess)
Etiologies of periodontal abscesses include: (6)
- pulp necrosis
- periodontal infections
- periocoronitis
- trauma
- surgery
- foreign body impaction
Localized accumulation of pus located within the gingival wall of the periodontal pocket, with an expressed periodontal breakdown occurring during a limited period of time:
Periodontal abscess
Describe the clinical symptoms of periodontal abscess:
easily detectible
List the sequence of events leading to periodontal abscess formation: (8)
- occlusion of existing periodontal pocket
- bacterial invasion of soft tissue wall
- leukocytic infiltration (neutrophils)
- vascular thrombosis
- edema & swelling
- tissue necrosis & liquefaction
- collagenolysis & bone resorption
- production of purulent exudate
The pain from a periodontal abscess is caused by:
pressure
The most common symptoms of acute periodontal disease (in order of decreasing frequency):
- pain
- swelling & edema
- lymphadenopathy
- fever
Multiple periodontal abscess formation is often a manifestation of:
- diabetes (uncontrolled or undiagnosed)
- AIDS (compromised immune system)
- depressed immune system (steroid therapy, chemotherapy)
The MOST common underlying cause for multiple periodontal abscess formation is:
Diabetes (uncontrolled or undiagnosed)
What type of bacteria make up 65% of the microbial flora found in a periodontal abscess?
gram-negative anaerobes
Bacteria that produce _____, as P. gingivalis and P. intermedia are important in the pathogeneses of the periodontal abscess since they increase the availability of nutrients, and thereby increase the number of bacteria within the abscess environment
proteinases
Bacteria that produce proteinases such as _____ and _____ are important in the pathogeneses of the periodontal abscess since they increase the availability of nutrients, and thereby increase the number of bacteria within the abscess environment
P. gingivalis & P. intermedia
Bacteria that produce proteinases such as P. gingivalis and P. intermedia are important in the pathogeneses of the periodontal abscess since they:
increase the availability of nutrients and thereby increase the number of bacteria within the abscess formation
List some of the bacteria found in periodontal abscesses:
- treponema (spirochetes)
- fusobacterium nucleatum
- prevotella intermedia
- porphyromonas gingibalis
- peptostreptococcus micros
- tanerella forsythia
- candida albicans
What type of food can trigger abscess formation?
- popcorn
- almonds with skin (and anything with skin)
- chia seeds (and any small seeds)
Histopathology of periodontal abscess includes: (5)
- acute inflammatory infiltrate
- vascular hyperemia & thrombosis
- lysis of collagen matrix in the lamina propria and gingival fibers
- ulceration and apical proliferation of JE
- osteoclastic mediated bone resorption
Any time you have a perio abscess, you need to rule out _____.
How do you do this?
endodontic origin; sensibility test
If the abscess is a draining abscess how might you determine the origin?
trace it on a radiograph with gutta percha points
Periodontal abscess in a periodontitis patient could represent:
disease exacerbation
Periodontal abscess in a periodontitis patient could represent disease exacerbation. What might this be due to?
- presence of tortuous pocket
- furcation involvement
- vertical defect
- composition of microflora
- deceased host defense
When do we commonly see acute exacerbation of periodontitis leading to an abscess?
- in untreated periodontitis
- patients that are non-responsive to periodontal therapy
- patient on supportive periodontal therapy
A periodontitis patient might develop a periodontal abscess following treatment. This could occur:
- post-scaling
- post-surgery
- post- medications (such as antimicrobials & nifedipine)
Wheat post treatment medications can lead to periodontal abscess in a patient with periodontitis?
- antimicrobials
- nifedepine
Periodontal abscess in non periodontitis patients can be due to:
- impaction of foreign bodies
- harmful habits (like nail biting)
- orthodontic factors
- gingival enlargement
- alteration of the root surface
Periodontal abscesses in non periodontitis patients can be due to alteration of root surfaces such as in:
- dens invaginatus
- cemental tears
- enamel pearls
- iatrogenic conditions (such as perforations)
- severe root damage (VRF or cracked tooth syndrome)
- External root resorption
List the clinical signs of a periodontal abscess:
- pain
- localized swelling and fluctuence
- purulent exudate
- deep periodontal pocket
- tooth exhibits VITAL pulp
- fistula presentation
- tooth mobility
- sensitivity to percussion
- low grade fever
- lymphadenopathy
List differential diagnosis for periodontal abscesses: (6)
- periapical abscess
- acute pulpitis
- tooth or root fracture
- pericoronitis
- lateral periodontal cyst
- gingival cyst
List three periodontal abscess complications:
- Tooth loss
- Bacteremia following abscess treatment
- chronic or episodic bacteremia from untreated periodontal disease