Chapter 3 Pulpal and Periapical Disease Flashcards
What are the three types of pulpitis?
Reversible pulpitis
Irreversible pulpitis
Chronic Hyperplastic pulpitis (instead of a carious lesion going out the apical foramen it goes out the crown instead)
What is the differental diagnosis for a periapical pathology?
Periapical granuloma
Apical periodontal cyst
Periapical abscess
Periapical scar
What are the sequelae of periapical pathology?
Sinus tract
Osteomyelitis
Cellulitis
Condensing osteitis
What is a periapical granuloma?
Most common periapical pathosis
Also called periapical periodontits
Inflammed granulation tissue at the end of a non-vital tooth
Chronic inflammation
Clinical presentation: most are asymptomatic, not typically mobile, usually not sensitive to percussion, tooth does not respond to thermal or electrical pulp testing
What is a pheonix abscess?
A secondary acute infection following a periapical granuloma
What are the three types of periapical cysts?
Residual, Lateral radicular, Apical
Inflammation stimulates the epithelium in the area (rest cells of Malassez)
What is a periapical abscess?
Accumulation of acute inflammatory cells at the apex of a non vital tooth
What is a periapical scar?
It is when there is improper healing of a periaplical inflammatory lesion and it fill in with dense collagenous tissue instead of bone
Define a sinus tract?
Pus disects through the bone destroying it
Perforates the cortical plates and enters the soft tissue
Follows the path of least resistance so could end up going different places depeding on that path
What are 2 type of sinus tracts?
Intraoral sinus tract: also called parulis or gum boil, marks the exit point of the sinus tract on the oral mucosa
Cutaneous sinus tract: enlarged nodular mass, most common with mandibular teeth
Define osteomyelitis
acute or chronic inflammation of bone usually do to bacterial infection
most common after odontogenic infection of traumatic fracture
Symptoms: fever, lymphadenopathy, sensitivity, soft tissue swelling
Involucrum
What is an involucrum?
During acute infection (osteomyelitis) fragments of necrotic bone may become surrounded by new, vital bone
Define cellulitis
When sinus tracts exit the bone and the infection spreads diffusely through the overlying soft tissues
What are the 2 types of dangerous cellulitis?
Ludwig’s angina
Cavernous sinus thrombosis
What is this?
Ludwid’s angina
Cellulitis of the mandibular region
70% develop from abscesses of mandibular molars
Involves three spaces: submandibular, sublingual, and submental
Woody tongue
Bull neck
Treatment: Maintain airway, I&D, Abx, and eliminate the orignal cause of infection
What is this?
Cavernous sinus thrombosis
caused by abscess in the maxillary anterior and premolar region
edematous periorbital enlargement
Surgical drainage + high dose Abx
