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Neville and Damm > Ch 3 Pulpal Pathology > Flashcards

Ch 3 Pulpal Pathology Flashcards

1
Q

Define pulpal necrobiosis

A

partial pulpal necrosis

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2
Q

What is the other term for chronic hyperplastic pulpitis?

A

pulp polyp

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3
Q

What type of dentin exhibits slow and gradual deposition that increases after the age of 35 to 40? What can advance this formation (esp in males)?

A

physiologic secondary dentin…calcification-related diseases (arthritis, gout, kidney stones, etc)

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4
Q

What condition is assoiciated with early, widespread formation of secondary dentin?

A

progeria

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5
Q

What is the term for significant traumatic injury that can lead to early obliteration of the pulp chamber and canal? What color might the tooth look clincally?

A

calcific metamorphosis…yellow

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6
Q

Term for haphazardly organized new dentin in response to attrition, fracture, erosion, etc.

A

tertiary dentin

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7
Q

What is the term for dentin formation due to mild/moderate stimulus? (more regular
in appearance)

A

reactionary dentin

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8
Q

What is the term for dentin formation due to more severe stimulus causing death of odontoblasts?

A

reparative dentin (formed by new odontoblasts)

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9
Q

What is the term for dentin that is the initial layer of reparative dentin and is atubular?

A

interface dentin (fibrodentin)

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10
Q

What is the term for when odontoblasts die an their tubules are filled degenerated osteoblastic processes?

A

dead tracts

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11
Q

How much time does it take to see excess dentin production on radiographs?

A

3 months to 1 year

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12
Q

Histologically - where is tertiary dentin localized to?

A

the pulpal end of the odontoblastic process that was affected

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13
Q

What are the three types of pulpal calcifications?

A
  1. Denticles 2.Pulp stones 3. diffuse linear calcifications
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14
Q

What type of pulpal calcification am I? a result of an epitheliomesenchymal interaction within the developing pulp…what “shape” do these make?

A

denticles! “thimble-shaped”

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15
Q

What type of pulpal calcification am I? develop around a central nidus of pulp tissue (e.g., collagen fibril, ground substance, necrotic cell remnants)

A

pulp stones

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16
Q

What type of pulpal calcification am I? exhibit areas of
fine, fibrillar, irregular calcification that often parallel the
vasculature…frequency increases with age

A

diffuse linear calcifications

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17
Q

Which of the pulpal calcifications are NOT detectible radiographically?

A

diffuse linear calcifications

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18
Q

What are the 7 disease processes associated with pulpal calcifications?

A
  1. Dentin dysplasia Id
  2. Dentin dysplasia II
  3. Pulpal dysplasia
  4. Tumoral calcinosis (calcium deposits around joints, dialysis)
  5. Calcinosis universalis (deposits in skin, subcut, etc)
  6. Ehlers-Danlos syndrome
  7. End-stage renal disease
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19
Q

What is the alternate name for a periapical granuloma?

A

chronic apical periodontitis

20
Q

What is the term for the period of time when in the early stages of infection PMNs predominate and radiographic alterations are not present?

A

acute apical periodontitis

21
Q

What is the term for secondary acute inflammatory changes within a periapical granuloma?

A

phoenix abscess

22
Q

What condition has been synonymous with the now defunct “Garre Osetomyelitis?”

A

Osteomyelitis WITH proliferative periostitis (onion skinning)

23
Q

What is a Russell body comprised of?

What are russell bodies associated with?

A

globules of gamma globulin lol

-Periapical granulomas

24
Q

What are the basophilic particles sometimes seen in a periapical granuloma?

A

pyronine bodies

25
Q

What size lesion generally indicates periapical endodontic surgery (apico)?

A

lesions larger than 2 cm

26
Q

What bony deficiency can promote the formation of a periapical scar? What is the treatment?

A

When the buccal and lingual cortical plates have been lost..NOT indicated for repeat surgery

27
Q

What are the 4 possible sources for the epithelial lining in a periapical cyst?

A
  1. usually a rest of Malassez
  2. crevicular epi
  3. sinus lining
  4. epi lining of sinus tract
28
Q

What is the term for a periapical cyst still partially attached to a tooth root following extration?

A

periapical pocket cyst

29
Q

What is the term for a periapical cyst that is separate from the tooth apex?

A

periapical true cyst

30
Q

Do residual periapical cysts resolve?

A

“many” reduce in size and can spontaneously resolve (so I guess bx to verify its not OKC/Amelo, then leave it alone - or no biopsy if hx is known)

31
Q

What is the term for linear or arch-shaped calcifications seen in the EPITHELIAL LINING of periapical cysts?

A

Rushton bodies (remember Russell bodies are in periapical granulomas)

32
Q

What are the other two terms for pulse granulomas? What is their etiology?

A
  1. hyaline bodies
  2. giant-cell hyaline angiopathy

extravasated serum that undergoes fibrosis and occasionally dystrophic calcification

33
Q

What is the term for the PDL exhibiting acute inflammation, but no frank abscess formation?

A

acute apical periodontitis

34
Q

Most dental-related abscesses perforate _______ because the bone is thinner on the this surface. Except for max lat inc, pal root max molars, mand 2nd and 3rd molars

A

buccally

35
Q

What are a few conditions that put patients at higher risk for developing cellulitis s/p dental infection?

A
  1. corticosteroid / cytotoxic meds
  2. malignancy
  3. DM
  4. immunosuppressive (neutropenia, aplastic anemia, AIDS)
36
Q

Latin origin for Ludwig angina

A

angere = to strangle (Ludwig was a German physician in 1836)

37
Q

What % of cavernous sinus thrombosis cases are caused by dental infection?

A

10%

38
Q

What % of Ludwig angina is caused by a mandibular molar abscess?

A

70% (the rest being peritonsillar or parapharyngeal abscesses, tongue piercing, oral lacerations, fractures of the mandible, or submandibular sialadenitis)

39
Q

What is the term for protrusion of the tongue during Ludwig angina?

A

woody tongue

40
Q

What is the term for enlargment and tenderness of the neck above the level of the hyoid bone during Ludwig angina?

A

bull neck

41
Q

Proptosis (protrusion of eye), chemosis (blister in eye), and ptosis (upper eyelid drooping and covering pupil) are noted in greater than 90% of patients with what condition?

A

cavernous sinus thrombosis

42
Q

5 steps in treatment of Ludwig angina

A
  1. maintain airway (intubation, tracheotomy, tracheostomy)
  2. eliminate original focus of infection
  3. IV antibiotics (penicillin, clinda,metro)
  4. Culture and sensitivity tests
  5. +/- corticosterioids to help with swelling and abx
43
Q

What is the mortality rate for Ludwig angina?

A

10% (complications such as pericarditis, pneumonia, mediastinitis, sepsis, empyema, and respiratory obstruction)

44
Q

When are corticosteroids used to treat cavernous sinus thrombosis?

A

corticosteroids are used if pituitary insufficiency develops

45
Q

What is the mortality rate for cavernous sinus thrombosis?

A

30%

Neville and Damm (72 decks)

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