Dental abscesses

Question 1

What are the types of abscess ?

Answer 1

periapical
periodontal
pericoronal
Gingival

Question 2

What is a periapical abscess ?

Answer 2

seen at the apex of the tooth that is non vital pulp
pulp has broken down and festered leading toe exudates
advancing carious lesions have killed the pulp
AKA dentoalveolar abscess

Question 3

What is a periodontal abscess ?

Answer 3

perioodontitis leads to pocket formation
food and debris collect in the tooth- leads to abscess originating in the pocket
vital pulp

Question 4

What is a pericoronal abscess ?

Answer 4

infected operculum around a partially erupted tooth or impacted 8
operculum leads to food and debris collection-plaque stagnation - leads to pus and abscess formation

Question 5

What exacerbates pericoronitis ?

Answer 5

trauma of the operculum due to the opposing tooth

Question 6

What is a gingival abscess ?

Answer 6

pus collection in the gingiva without affecting the tooth/PDL

Question 7

What are the differences in the location of periapical and periodontal abscesses ?

Answer 7

periapical abscess- located over the apex

periodontal abscess- located in the pocket

Question 8

What are the differences in pulp vitality between perioodontal and periapical abscesses ?

Answer 8

periapical abscess- pulp necrosis

periodontal abscess- vital pulp confirmed with tests

Question 9

What is the difference in caries status between periodontal and periapical abscesses ?

Answer 9

periodontal abscess- usually caries free- usually

periapical abscess- advanced deep caries leads to pulp death

Question 10

How can we tell if a periapical abscess is chronic or not ?

Answer 10

dishcarge through a sinus tract

can insert a warm GP stick to track location of the abscess

Question 11

What might an acute apicla abscess be associated with ?

Answer 11

TTP
palpation
mobility

Question 12

What are the potential complications from dentoalveoalr infection ?

Answer 12

osteomyelitis 
ludwigs angina 
cavernous sinus thrombosis 
pericoronitis 
metastatic abscess 
dry socket- alveolar osteitis

Question 13

What is osteomyelitis ?

Answer 13

inflamamtion of the medullary bone with extension to the cortical bone and periosteum
maxilla is less effected as least trabecular bone

Question 14

What is alveolar osteitis ?

Answer 14

dry socket 
inflammation of the alveolar bone 
due to failure of blood clot formation 
leaves exposed bone post extraction 
more common in the mandible- poor blood supply

Question 15

What is ludwigs angina ?

Answer 15

progression of a dentoalveoalr infection
wideapread infection and swelling of the submental, sublingual and submandibular places
swelling of the neck make sit hard to breathe
can spread through fascial spaces to mediastinum

Question 16

What is cellulitis ?

Answer 16

infection escapes from bone and spreads through tissue

Question 17

Where can infection spread form maxillary teeth ?

Answer 17

maxillary sinus 
palate
buccal space 
vestibule 
superficial facial fascia from anterior

Question 18

Where can infection spread from mandibular 1-3 ?

Answer 18

submental space

Question 19

Where can infection spread from mandibular 1-6 ?

Answer 19

sublingual space

Question 20

Where can infection spread from mandibular 6-8 ?

Answer 20

submandibular space

buccal space to submasseteric space to pterygomandibualr space to lateral pharyngeal to retropharyngeal and mediastinum

Question 21

What are the aims of endodontic access cavities ?

Answer 21

Pulp chamber has been accessed and fully unroofed

cavity is smooth and walls are clean and in continuity with the chamber

straight line access to orifice and apex

not unecessarily extended

no damage to floor or walls of chamber

Question 22

What are the instruments and burs you should use for endo access ?

Answer 22

initial access with tapered bur
pulp chamber unroofing- endo z burr as soon as you feel the drop- non end cutting so you don’t perforate the chamber floor
briault probe to assess for ledges

Question 23

How would you prepare an upper 1 ?

Answer 23

outline is just under the cingulum within the marginal ridges

Question 24

How many canals and what is their length in the upper 1 ?

Answer 24

1 canal

23.5 mm

Question 25

How many canals and what is their length in the upper 2 ?

Answer 25

1 canal

22 mm

Question 26

How many canals and what is their length of the upper 3 ?

Answer 26

1 canal

26.5 mm

Question 27

How many canals and what is their length in the upper 4 ?

Answer 27

2 canals

21mm

Question 28

What is the access like for an premolar ?

Answer 28

within the buccal and lingual cusps
very central move the bur bucco-palatally
create an oval outline

Question 29

How many canals and what is their length in an upper 5 ?

Answer 29

one canal

21.5 mm

Question 30

How many canals and what is their length in an upper 6 ?

Answer 30

4 canals - 2 in the MB root

21 mm

Question 31

What is upper molar access like ?

Answer 31

more mesial

the access is distal to the marginal ridge and mesial to the oblique ridge

Question 32

What is the canals and length for the upper 7 ?

Answer 32

3 canals - 20 mm

Question 33

What is the canal length and number for lower 1 ?

Answer 33

2

21mm

Question 34

What is the canal length and number for the lower 2 ?

Answer 34

2

21mm

Question 35

What is the canal length and number for the lower 3 ?

Answer 35

2

23mm

Question 36

What is the canal length and number for the lower 4 ?

Answer 36

1

21mm

Question 37

What is the canal length and number for the lower 5 ?

Answer 37

1 canal

21 mm

Question 38

What is the canal length and number for the lower 6 ?

Answer 38

3 canals - 2 distal can be 4

21 mm

Question 39

What is the canal length and number for the lower 7 ?

Answer 39

3 canals

20 mm