Cariology Flashcards

1
Q

What are the potentially fatal complications of oral infections?

A
  • Intracranial spread by septic emboli
  • Bacterial meningitis
  • Brain abscess
  • Cavernous sinus thrombosis
  • Mediastinitis
  • Bacteraemia
  • Septicaemia
  • Septic shock
  • Necrotizing fasciitis

Each of these complications can arise from untreated oral infections and may require urgent medical intervention.

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2
Q

Define septicaemia.

A

Overwhelming bacterial proliferation & release of toxins in blood.

Septicaemia is a severe condition that can lead to septic shock and multi-organ failure.

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3
Q

What is necrotizing fasciitis?

A

Rapidly progressing necrosis of subcutaneous tissues and fascia accompanied by high fever and toxicity.

It is a life-threatening infection that requires urgent surgical intervention.

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4
Q

What is Ludwig’s angina?

A

A rapidly spreading, septic cellulitis involving submandibular, submental, and sublingual spaces bilaterally.

It can lead to airway obstruction and requires immediate medical attention.

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5
Q

List the clinical presentations of Ludwig’s angina.

A
  • Upward and outward orientation of tongue
  • Firm, diffuse swelling in affected areas
  • Fever and respiratory distress

These symptoms indicate a severe infection that can compromise the airway.

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6
Q

What is the management approach for Ludwig’s angina?

A
  • Appropriate antibiotic medications: penicillins
  • Monitoring and protection of the airway
  • Incision and drainage of the abscess (intraoral or external)
  • Fiberoptic intubation if airway is compromised

Immediate airway management is crucial in cases of severe swelling.

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7
Q

What is osteomyelitis?

A

Infection of bone marrow.

It can result from dental infections and may present with significant pain and swelling.

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8
Q

Identify the predisposing factors for osteomyelitis.

A
  • Reduced host resistance
  • Diabetes mellitus
  • Leukaemia
  • Malnutrition
  • Chronic alcoholism
  • Immunosuppression
  • Radiation
  • Osteoporosis
  • Peripheral vascular diseases

These factors can increase the risk of developing bone infections.

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9
Q

What is the pathogenesis of osteomyelitis?

A

Accumulation of pus in marrow spaces results in increased intramedullary pressure, leading to necrosis of bone due to lack of nutrients.

This condition can progress rapidly and necessitates prompt treatment.

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10
Q

What are the histopathological features of osteomyelitis?

A
  • Localised pus with lymphocytes and plasma cells
  • Osteoblastic and osteoclastic activity
  • Involucrum (attempt at repair)
  • Sequestrum (dead bone detached from vital bone)

These features can help in diagnosing and managing the condition.

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11
Q

Describe the clinical classification of osteomyelitis.

A
  • Based on anatomical location: Intramedullary, Subperiosteal, Periosteal
  • Based on duration and severity: Acute, Chronic
  • Based on presence or absence of suppuration: Suppurative, Non-suppurative

This classification helps in determining the appropriate treatment approach.

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12
Q

What is the significance of S. mutans in caries?

A
  • Rapid generation of acid from sucrose
  • Synthesis of extracellular polysaccharides
  • High numbers in plaque associated with developing lesions

S. mutans is a primary bacterium involved in the caries process.

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13
Q

Fill in the blank: A bacterial disease of calcified tissues of teeth characterized by demineralization is known as _______.

A

[caries]

Caries is a dynamic process that involves both dissolution and reprecipitation of minerals.

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14
Q

What are the histological zones of enamel caries?

A
  • Translucent zone
  • Dark zone
  • Body

These zones reflect the progression of enamel caries and can guide treatment decisions.

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15
Q

What are the acute sequels of untreated caries?

A
  • Periapical osteitis
  • Cellulitis
  • Abscess
  • Phoenix abscess
  • Pericoronitis
  • Folliculitis
  • Fistula

These conditions can arise from untreated dental caries and may require surgical or medical intervention.

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16
Q

True or False: Chronic dento-alveolar abscess is an abscess spreading from dental tissues to alveolar bone.

A

True

This condition is a common sequel of untreated dental caries.

17
Q

What is the treatment regimen for early lesions of osteomyelitis?

A
  • Incision and drainage
  • Supportive therapy: rehydrate patient, rich nutritional diet
  • Hyperbaric oxygen therapy

Early intervention is critical to prevent progression.

18
Q

What is the pore volume of the translucent zone in enamel?

A

1% pore volume

The pores are the size of a H2O molecule.

19
Q

What are the characteristics of the dark zone in enamel?

A

2-4% pore volume with some remineralization concurrent with destruction

20
Q

What is the range of pore volume in the body of enamel?

A

2-25% pore volume

21
Q

What is the surface zone of enamel described as?

A

A thin layer (approx. 40µ) that is highly mineralized with high F- and Mg++ levels

22
Q

True or False: Enamel has cellular sensors that trigger defense reactions.

A

False

23
Q

List the types of caries based on the site of attack.

A
  • Pit/fissure caries
  • Smooth surface caries
  • Cemental/root caries
  • Recurrent caries
24
Q

List the classifications of caries based on the rate of attack.

A
  • Rampant/acute caries
  • Slowly progressive/chronic caries
  • Arrested caries
25
Q

What indices are used for clinical assessment of caries experience?

A

dmf for deciduous teeth or DMFT indices for decayed, missing, and filled teeth

26
Q

What are the histological zones of dentine caries?

A
  • Reactionary/tertiary dentine
  • Sclerotic/translucent zone
  • Demineralized zone
  • Bacterial invasion
  • Zone of destruction
27
Q

What are the three main routes through which microbes spread from the dento-alveolar complex?

A
  • Direct invasion/extension
  • Lymphatic spread
  • Haematogenous spread
28
Q

What are the defense reactions mediated by the pulpo-dentinal complex?

A
  • Sclerosis
  • Reactionary dentine
  • Sealing off of dead tracts
29
Q

What are the clinical findings in necrotic pulp?

A
  • Visual checks for decay, fracture lines, swelling, sinus tracts
  • Sensitive palpation
  • Percussion pain
  • Mobility assessment
  • Thermal test response
  • Electrical pulp test response
  • Selective anesthesia
  • Test cavity
  • Radiographic findings
30
Q

What are the components of host defenses?

A
  • Local immunity
  • Systemic immunity
  • Epithelial lining (mucosal immunity)
  • Humoral immunity
  • Saliva
  • Complement system
  • Colonization by normal flora
  • Cellular immunity
31
Q

Fill in the blank: Pathogenicity is the ability of a microbial species to produce _______.

A

[disease]

32
Q

What factors determine the virulence of cariogenic microbes?

A
  • Adhesion
  • Invasiveness
  • Toxigenicity
  • Communicability
33
Q

What is a biofilm?

A

An aggregate of microorganisms embedded within a self-produced matrix of extracellular polymeric substance (EPS)

34
Q

What is dental plaque?

A

An oral biofilm that adheres to the teeth and consists of many species of both fungal and bacterial cells

35
Q

What does the accumulation of microorganisms in dental plaque result in?

A

High concentrations of bacterial metabolites leading to dental disease