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Oral Pathology - My deck > Chapter 3 > Flashcards

Chapter 3 Flashcards

1
Q

Name the 4 things a periapical radiolucency can be.

A

A periapical cyst, granuloma, abscess or scar.

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2
Q

Name 4 sequelae of periapical pathology.

A

Sinus tract, osteomyelitis, cellulitis, condensing osteitis.

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3
Q

_____ % of all lesions found in the periapical region are pulpal in etiology.

A

95% of all lesions found in the periapical region are pulpal in etiology.

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4
Q

What is the most common periapical pathosis?

A

A periapical granuloma

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5
Q

What is another name for a periapical granuloma?

A

Chronic apical periodontitis

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6
Q

What is a periapical granuloma?

A

A mass of inflamed granulation tissue at the apex of a nonvital tooth. (granulation: chronic inflammatory cells, angiogenesis)

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7
Q

Is a periapical granuloma chronic or acute inflammation?

A

Chronic inflammation

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8
Q

When might a periapical granuloma be found?

A

During the transition from a periapical abscess and/or apical periodontal cyst

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9
Q

What term describes secondary acute inflammatory changes within a periapical granuloma?

A

Phoenix abscess

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10
Q

What does a periapical granuloma clinically present as?

A

Most are asymptomatic, with the tooth typically not mobile and usually insensitive to percussion, thermal or electrical pulp tests.

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11
Q

What does a periapical granuloma radiographically present as?

A

RL lesion of variable size, but symmetrical and well defined with a punched out border, and loss of lamina dura at the root tip. Root resorption can be seen

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12
Q

What are the treatment options for a periapical granuloma?

A

Conventional or surgical endodontic treatment, or extraction

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13
Q

What term defines an inflammatory stimulation of epithelium (rests of malassez) in the area of the root tip?

A

Apical periodontal cyst

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14
Q

What are two other names for an apical periodontal cyst?

A

Periapical cyst or Radicular cyst

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15
Q

What does an apical periodontal cyst radiographically present as?

A

A RL lesion variable in size, that is symmetrical and may show static behavior or very slow growth, so it may have a corticated rim. The lesion will be well defined, with a punched out border, and loss of lamina dura in the area of the root tip. Root resorption may be seen.

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16
Q

What does an apical periodontal cyst histologically present as?

A

A cystic lumen lined with epithelium, and a spider web pattern

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17
Q

What are the 2 other variations of an apical periodontal cyst?

A

A residual periapical cyst and a lateral periapical cyst.

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18
Q

What is a residual periapical cyst?

A

A cyst that remains after extraction

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19
Q

What is a lateral periapical cyst?

A

A cyst found on the lateral side of the root due to an accessory canal

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20
Q

What term describes an accumulation of acute inflammatory cells at the apex of a nonvital tooth?

A

A periapical abscess

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21
Q

What immune cell will be present in a periapical abscess?

A

Neutrophils (since it is an acute response)

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22
Q

True or False: A periapcal abscess can be symptomatic or asymptomatic

A

True, a periapical abscess can be symptomatic or asymptomatic

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23
Q

What term describes a defect created by periapical inflammatory cells that has filled with dense collagenous tissue?

A

A peripical scar

24
Q

When does a periapical scar most frequently occur?

A

When both the facial and the lingual cortical plates have been lost, which facilitates an exposure to collagenous tissue that can infiltrate the area. Most common following surgical endodontic therapy

25
Q

What does a periapical scar histologically present as?

A

Pink collagen with few blue dots (which are fibroblasts)

26
Q

What term describes a periapical abscess with pus formation that perforates the cortical plate of bone, into soft tissue and drains purulent material?

A

A sinus tract

27
Q

Sinus tracts tend to follow the ______ __ ______ _________.

A

Path of least resistance

28
Q

What term describes the exit point of the sinus tract on the oral mucosa?

A

Intraoral sinus tract, aka a parulis or fistula

29
Q

What does an intraoral sinus tract clinically present as?

A

A hole wit surrounding redness, or an enlarged nodular mass.

30
Q

What term describes the exit point of a sinus tract in overlying skin?

A

A cutaneous sinus tract

31
Q

Are mandibular or maxillary teeth most commonly associated with a cutaneous sinus tract?

A

Mandibular

32
Q

What does a cutaneous sinus tract clinically present as?

A

An enlarged nodular mass, that is red with other shades of yellow, white or purple.

33
Q

What term describes acute or chronic inflammation in bone?

A

Osteomyelitis

34
Q

What is the common cause of the inflammation in osteomyelitis?

A

A bacterial infection. Most cases arise after odontogenic infections or traumatic fracture.

35
Q

What does osteomyelitis usually result in?

A

Expanding lytic destruction of bone, suppuration and sequestra formation (fragment of dead bone floating in soft tissue)

36
Q

Does osteomyelitis usually occur in males or females, and in the maxilla or the mandible?

A

Males, in the mandible

37
Q

What are common symptoms of osteomyelitis?

A

Fever, lymphadenopathy, sensitivity, soft tissue swelling.

38
Q

What is important to remember about radiographic presentation of acute osteomyelitis ?

A

An acute infection does not usually produce radiographic changes

39
Q

What term describes when during an acute infection of osteomyelitis, fragments of necrotic bone that have become surrounded by new vital bone?

A

Involucrum

40
Q

What term describes when purulent inflammation perforates the cortex, but is unable to establish a drainage point so it spreads diffusely through the overlying soft tissue?

A

Cellulitis

41
Q

What are the 2 very dangerous types of cellulitis associated with dental infections?

A

Ludwig’s angina, and cavernous sinus thrombosis

42
Q

What term describes a rapid swelling of the sublingual, submandibular and submental spaces?

A

Ludwig’s angina, which is a medical emergency!!

43
Q

In Ludwig’s angina, what is the main concern?

A

Rapid swelling can extend to the space around the throat and close off the airway!!

44
Q

What does Ludwig’s angina clinically present as?

A

Massive swelling and tenderness of the neck (bull neck), elevation of the tongue due to sublingual involvement (woody tongue)

45
Q

What are the common symptoms of Ludwig’s angina?

A

Pain, restricted neck movement, massive swelling, dysphagia, dysphonia, dysart,hria, drooling, sore throat, respiratory obstruction, , fever and chills– remember a sinus tract/pus will not be present because there was not a point of drainage

46
Q

How is Ludwig’s angina treated?

A

Maintenance of the airway, incision and drainage, antibiotic therapy, elimination of original focus of infection

47
Q

What term describes an edematous periorbital enlargement resulting from an abscess?

A

Cavernous sinus thrombosis

48
Q

What tooth is the most common source of infection in cavernous sinus thrombosis?

A

The canine (anterior maxilla or premolars)

49
Q

What are some possible sequelae of cavernous sinus thrombosis?

A

Protrusion and fixation of the eyeball, pupil dilation with photophobia, excessive lacrimation, loss of sight, meningitis, brain abscesses

50
Q

What term describes a localized area of bone sclerosis associated with apices of teeth with pulpitis?

A

Condensing osteitis

51
Q

What is another name for condensing osteitis?

A

Focal sclerosing osteomyelitis

52
Q

What does condensing osteitis radiographically present as?

A

Increased radiopacity that is associated with a tooth apex that has a thickened PDL or apical inflammatory lesion, with NO radiolucent border.

53
Q

What term describes a central mass of irregular calcification in the pulp?

A

Pulp stones

54
Q

What term describes hyperplastic granulation tissue that extrudes from the pulp chamber?

A

Chronic hyperplastic pulpitis (aka pulp polyp)

55
Q

In what population is chronic hyperplastic pulpitis most common?

A

Children and young adults who have large exposures of the pulp where the entire dentinal roof is missing

56
Q

What term describes hyperplastic growths of granulation that sometimes arise in healing extractions sockets?

A

Epulis granulomatosa

Oral Pathology - My deck (22 decks)

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