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D2 Fall > Clinical Radiology - Interpretation of Periapical Conditions > Flashcards

Clinical Radiology - Interpretation of Periapical Conditions Flashcards

1
Q

Inflammatory conditions of apical periodontium of pulpal origin

A

Periapical inflammatory disease

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2
Q

Irreversible decomposition of the pulp

A

Pulp necrosis

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3
Q

Destruction of microvascular and lymph systems, and ultimately, nerve fibers

A

Pulp necrosis

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4
Q

Rigid dentin walls and lack of collateral circulation; inadequate drainage of inflammatory fluids -> increased pressure on tissues and progressive destruction until entire pulp is necrotized

A

Pulp necrosis

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5
Q

What are the 3 types of irritation of the pulp that can cause pulp necrosis?

A

Bacterial
Mechanical
Chemical

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6
Q

Can pulp necrosis be determined radiographically?

A

No

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7
Q

What conditions may indicate that pulp necrosis is likely present?

A

Deep restoration
Carious lesions
Fractures

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8
Q

Preserve a tooth by removed infected/damaged pulp; prevents or treats periapical inflammatory disease

A

Endo therapy

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9
Q

Steps of endo therapy

A
  1. Access
  2. Remove pulp tissues
  3. Shape, cleanse, decontaminate canals w/ files + irrigating solutions
  4. Fill canals w/ gutta percha
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10
Q

What are the 3 periapical lesions? Are they all treated the same way?

A

Abscess
Granuloma
Cyst

Yes, they are all treated the same way

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11
Q

Synonym for periapical lesion

A

Apical periodontitis

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12
Q

T/F: Periapical inflammatory disease can be acute or chronic, and asymptomatic or symptomatic

A

True

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13
Q

Bacteria and products of degradation can reach the periapical tissues

A

Pulp necrosis

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14
Q

In inflammation, there is an ___________ of bone metabolism

A

imbalance

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15
Q

Osteoblastic bone production is favored

A

Sclerosis (sclerosing osteitis)

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16
Q

Osteoclastic bone resorption is favored

A

Rarefaction (rarefying osteitis)

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17
Q

What are the 4 modulating factors of inflammation/the balance of bone metabolism?

A

Pathogenicity of microorganism
Host immune response
Tissue vascularity
Time

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18
Q

Periapical region of a tooth with pulp necrosis

A

Epicenter

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19
Q

Radiolucencies at inter-radicular bone are associated with what?

A

Accessory canal

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20
Q

T/F: Sometimes, a potential condition (like caries, deep restoration, or fracture) that leads to necrosis is NOT clear

A

True

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21
Q

How do you determine pulp necrosis?

A

Pulp vitality test

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22
Q

What is the result of pulp vitality test?

Necrosis

A

Negative

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23
Q

What is the result of pulp vitality test?

Vital

A

Positive

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24
Q

T/F: Early or acute periapical inflammatory disease may show no radiographic signs

A

True

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25
Q

What are early radiographic signs of periapical inflammatory disease?

A

Widening of PDL space
Loss of lamina dura

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26
Q

As the periapical lesion enlarges, bone rarefraction is observed. What does this look like?

A

Apical radiolucency

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27
Q

What does diffuse mean?

A

Poorly defined

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28
Q

Which are well-defined and which are diffuse?

Abscesses
Granulomas
Cysts

A

Abscesses = diffuse
Granulomas = well-defined
Cysts = well-defined + corticated

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29
Q

Periapical inflammatory diseases can have effects on surrounding tissues seen as peripheral areas of sclerosing osteitis. What does this look like on an X-Ray?

A

Radiopacity

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30
Q

Another name for peripheral areas of sclerosing osteitis

A

Condensing osteitis

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31
Q

What is another effect peripapical inflammatory disease has on surrounding structures, specifically within the maxillary sinus?

A

Regional mucositis

32
Q

Inflammatory mediators stimulate the adjacent mucosal lining

A

Regional mucositis in maxillary sinus

33
Q

What is another effect peripapical inflammatory disease has on surrounding structures, specifically on the root?

A

Root resorption

34
Q

Inflammatory rxn in periapical region may trigger odontoclastic activity

A

Root resorption

35
Q

What is another effect peripapical inflammatory disease has on surrounding structures, especially if the infection has to do with a primary tooth?

A

Disrupted eruption of underlying permanent tooth

36
Q

Localized enamel defect on permanent teeth caused by periapical disease of deciduous tooth

A

Turner hypoplasia

37
Q

Reduction in quality, presenting as pits, grooves, thin, or missing enamel. Results from changes during the stage of matrix formation

A

Enamel hypoplasia

38
Q

The extension of defect in turner hypoplasia depends on severity of the __________ or __________

A

infection; trauma

39
Q

A more widespread response to bone inflammation

A

Osteomyelitis

40
Q

Can affect cancellous bone, cortical bone, and periosteum

A

Osteomyelitis

41
Q

Acute or chronic osteomyelitis?

Pain, swelling of adjacent tissues, fever, lymphadenopathy, leukocytosis

A

Acute osteomyelitis

42
Q

Acute or chronic osteomyelitis?

Tooth mobility, sensitivity to percussion, purulent drainage

A

Acute osteomyelitis

43
Q

Acute or chronic osteomyelitis?

Can be a sequela of inadequately treated acute phase

A

Chronic osteomyelitis

44
Q

Acute or chronic osteomyelitis?

Less severe symptoms

A

Chronic osteomyelitis

45
Q

Ill-defined radiolucency in bone

A

Osteomyelitis

46
Q

Fragment of diseased bone that may have undergone necrosis as a consequence of ischemic injury

A

Sequestrum

47
Q

Sequestrum is present in which disease?

A

Osteomyelitis

48
Q

Radiopaque islands of bone on a radiolucent backround

A

Sequestrum

49
Q

Dense fibrous membrane covering surfaces of bone, consisting of outer fibrous layer and inner cellular layer

A

Periosteum

50
Q

New bone formation of bone surface as a result of periosteal stimulation

A

Periosteal rxn

51
Q

Periosteal rxn is seen in which disease?

A

Osteomyelitis

52
Q

Which disease?

CBCT may show increased width of body of mandible in affected area, increased bone density, and perforation of buccal cortical plate

A

Osteomyelitis

53
Q

Which disease?

Altered bone metabolism - cancellous bone is replaced by a mix of fibrous CT containing varying amounts of immature, abnormal bone

A

Periapical cemento-osseous dysplasia (PCOD)

54
Q

Which disease?

Lesion does not arise from PDL space; appearance of PDL may vary

A

Periapical cemento-osseous dysplasia (PCOD)

55
Q

Which disease?

In early stages, there is a radiolucency that mimics periapical inflammatory disease, but the tooth is vital

A

Periapical cemento-osseous dysplasia (PCOD)

56
Q

Which disease?

In more mature stages, there will be a mixed radiolucent and radiopaque appearance

A

Periapical cemento-osseous dysplasia (PCOD)

57
Q

Does Periapical cemento-osseous dysplasia (PCOD) require treatment?

A

NO

58
Q

Which disease?

In very late stages, it is almost completely radiopaque with a thin radiolucent ring around it

A

Periapical cemento-osseous dysplasia (PCOD)

59
Q

Which disease?

Usually affects the anterior mandible and is more common in non-caucasian women

A

Periapical cemento-osseous dysplasia (PCOD)

60
Q

Which disease?

Typically asymptomatic; may affect single or multiple teeth, and may merge

A

Periapical cemento-osseous dysplasia (PCOD)

61
Q

Which disease?

NOT related to periapical inflammatory disease

A

Periapical cemento-osseous dysplasia (PCOD)

62
Q

What is it called when the cemento-osseous dysplasia presents as a single lesion in the posterior region?

A

Focal cemento-osseous dysplasia

63
Q

What is it called when the cemento-osseous dysplasia presents as multiple bilateral lesions, possibly in both jaws?

A

Florid cemento-osseous dysplasia

64
Q

Which disease?

Affects women of African descent

A

Florid cemento-osseous dysplasia

65
Q

Which disease?

Asymptomatic, but in some cases, expansion and pain are present

A

Florid cemento-osseous dysplasia

66
Q

Which disease?

No tx required unless the dysplastic bone becomes exposed

A

Florid cemento-osseous dysplasia

67
Q

Which disease?

If dysplastic bone becomes exposed, osteomyelitis may develop, with mucosal ulceration and fistulous tracts with suppuration and pain. Tx involves surgical resection and ABs (poor diffusion due to avascular nature)

A

Florid cemento-osseous dysplasia

68
Q

Which disease?

Localized growth of cortical bone into the cancellous bone space

A

Idiopathic osteosclerosis

69
Q

Which disease?

Well-defined periapical radiopacity

A

Idiopathic osteosclerosis

70
Q

What is another name for Idiopathic osteosclerosis?

A

Dense bone island/enostosis

71
Q

Which disease?

Well-defined apical radiopacity found in mandibular molar and premolar areas

A

Idiopathic osteosclerosis

72
Q

Which disease?

Persistent radiolucency after successful endo therapy

A

Fibrous scar

73
Q

Which disease?

Dense CT that is radiolucent, surrounded by normal bone

A

Fibrous scar

74
Q

Which disease?

The surrounding healing bone may present concentric or radiating patterns

A

Fibrous scar

75
Q

Which disease?

Clinical correlation is important for diagnosis; make sure to compare current and previous images

A

Fibrous scar

76
Q

What is the SLOB rule?

A

Same = lingual
Opposite = buccal

77
Q
A

D2 Fall (45 decks)

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