Chapter 3 Pulpal and periapical disease

Question 1

Do you need a root canal to treat reversible pulpitis?

Answer 1

-No

Question 2

What are four sequelae of periapical pathology?

Answer 2

• Sinus tract
• Osteomyelitis
• Cellulitis
• Condensing osteitis

Question 3

If you have a non vital pulp with a PA abscess that is an acute inflammation with drainage what do you have?

Answer 3

-Sinus tract

Question 4

What is a periapical cyst from?

Answer 4

-Rest of malassez

Question 5

What is the earliest change of a periapical pathology?

Answer 5

-Widening of the PDL (lamina dura)

Question 6

What are the four localized periapical pathologies?

Answer 6

• Periapical granuloma
• Apical periodontal cyst
• Periapical abscess
• Periapical scar

Question 7

What is the most common periapical pathosis?

Answer 7

-Periapical granuloma (aka apical periodontitis)

Question 8

What type of inflammation is a periapical granuloma associated with?

Answer 8

-Chronic

Question 9

What is a secondary acute inflammatory changes within a periapical granuloma?

Answer 9

-Phoenix abscess

Question 10

What does a periapical granuloma appear as radiographically?

Answer 10

• Radiolucent lesion
• Symmetrical
• Well defined
• Variable in size

Question 11

How do you treat a periapical granuloma?

Answer 11

• Conventional endodontic treatment
• Surgical endodontic treatment
• Extraction

Question 12

What do you get if you have inflammatory stimulation of epithelium in the area (rests of malassez)?

Answer 12

-Periapical cyst

Question 13

What does a periapical cyst appear as radiographically?

Answer 13

• Radiolucent
• Symmetrical
• Well defined

Question 14

What is an accumulation of acute inflamatory cells at the apex of a nonvital tooth?

Answer 14

-Periapical abscess

Question 15

What does an abscess appear as histologically?

Answer 15

-full of neutrophils

Question 16

What is it known as when the defect created by periapical inflammatory lesions that may fill with dense collagenous tissue?

Answer 16

-Periapical Scar

Question 17

What is the classic pattern of an apical periapical cyst?

Answer 17

Found at the root tip

Question 18

What is the lateral periapical cyst?

Answer 18

-Found on the side of the root

Question 19

What is a residual periapical cyst?

Answer 19

-Cyst that remains after tooth has been extracted due to prior infection

Question 20

If you have a spiderweb pattern at the root of the tooth in a histologic slide what do you have?

Answer 20

-Periapical cyst

Question 21

T/F A periapical abscess may be symptomatic or asymptomatic

Answer 21

True

Question 22

When does a periapical scar most commonly occur?

Answer 22

-Surgical endodontic therapy

Question 23

T/F Periapical scars occur when the facial and lingual cortical plates have been lost?

Answer 23

-True

Question 24

If you have an ill-defined radiolucent lesion in the periapical region what do you think of?

Answer 24

-Periapical abscess

Question 25

Chronic hyperplastic pulpitis is what?

Answer 25

-When the inflammation in the pulp is a mass that comes out of the coronal portion of the tooth

Question 26

Epulis granulomatosa is what?

Answer 26

-Hyperplastic granulation tissue coming out of an extraction site within days of extraction (this appears similar to metastatic cancer)

Question 27

What are two common forms of cellulitis?

Answer 27

- Ludwigs angina | - Cavernous sinus thrombosis

Question 28

What is a sinus tract?

Answer 28

-Periapical abscess with pus formation

Question 29

T/F Sinus tracts (fistula) tend to follow the path of least resistance

Answer 29

True

Question 30

An intraoral sinus tract is also known as what?

Answer 30

- Parulis | - Gum boil

Question 31

What are the two types of intraoral sinus tract?

Answer 31

- Hole with surrounding redness | - Enlarged nodular mass

Question 32

What is a cutaneous sinus tract?

Answer 32

-Typically an enlarged nodular mass

Question 33

What teeth usually cause a cutaneous sinus tract?

Answer 33

-Mandibular teeth

Question 34

What does osteomyelitis result in?

Answer 34

- Expanding lytic destruction - Suppuration - Sequestra formation

Question 35

When do most cases of osteomyelitis arise from?

Answer 35

-Odontogenic infections or traumatic fracture

Question 36

Where in the arch do most cases of osteomyelitis occur?

Answer 36

-Mandible

Question 37

What type of osteomyelitis doesn't produce xray changes?

Answer 37

-Acute

Question 38

In acute infection fragments of necrotic bone may become surrounded by new, vital bone is known as what?

Answer 38

-Involucrum

Question 39

What is inflammation of the soft tissue spaces known as?

Answer 39

-Cellulitis

Question 40

T/F The purulence is unable to establish a drainage point in cellulitis

Answer 40

True

Question 41

Where does Ludwig's angina occur?

Answer 41

-Cellulitis of the submandibular region

Question 42

Rapid swelling of the sublingual, submandibular, and submental spaces is associated with what?

Answer 42

-Ludwig's angina

Question 43

What can occur with ludwigs angina?

Answer 43

-May extend to the spaces around the throat and close off the airway leading to death

Question 44

If you have ludwigs angina in the submandibular space what does spread of the infection cause?

Answer 44

-Enlargement and tenderness of the neck

Question 45

If the sublingual space is involved in ludwigs angina what occurs?

Answer 45

-Swelling and elevation of the tongue

Question 46

What leads to cavernous sinus thrombosis?

Answer 46

-Abscess of a maxillary anterior or premolar tooth

Question 47

What is the most often source of the infection for cavernous sinus thrombosis?

Answer 47

-Canine

Question 48

What does a cavernous sinus thrombosis appear as?

Answer 48

- Edematous periorbital enlargement | - Swelling present along the lateral border of the nose

Question 49

What is condensing osteitis aka?

Answer 49

-Focal sclerosing osteomyelitis

Question 50

What is a localized area of bone sclerosis assocaited with apices of teeth with pulpitis?

Answer 50

-Condensing osteitis

Question 51

In an xray is condensing osteitis separated from apex of the tooth?

Answer 51

-No it is not separated

Question 52

If a tooth is asymptomatic and appears like condensing osteitis what else might it be?

Answer 52

-Idiopathic osteosclerosis