Disease Of The Pulp And Periodontium Flashcards

1
Q

Clinical features of pulp hyperaemia

A

Pain lasting for seconds

Pain stimulated by hot/cold/sweet foods

Pain resolves after stimulus

Caries approaching pulp but can be retreated without affecting the pulp

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2
Q

Clinical features of acute pulpitis

A

Constant severe pain

Reacts to thermal stimuli

Poorly localised pain

Referral of pain

Minimal response to analgesics

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3
Q

How to diagnose acute pulpitis

A

History, visual, -ve tenderness to percussion, radiographs

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4
Q

How to diagnose acute apical periodontitis

A

Tenderness to percussion, non-vital, slight mobility, radiographs

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5
Q

What would you see in the radiographs of acute apical periodontitis

A

Loss of clarity in the laminate dura

Radiolucent shadow

Widening of periodontal space

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6
Q

What is traumatic periodontitis caused by diagnoses and treatment

A

Parafunction (clench)

Clinical examination of the occlusion, tender to percussion, normal vitality, radiographs

To treat you do occlusal adjustment and therapy for parafunction

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7
Q

What’s the most common Pus producing infection

A

Acute apical abscess

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8
Q

What other pus producing infection are there

A

Periodontal abscess

Pericoronitis

Sialadenitits

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9
Q

What causes dental abscesses

A

Organisms- polymicrobial anaerobes

Usually staphylococcal lymphadenitis of childhood

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10
Q

What are symptoms of acute apical abscesses before it perforated bone

A

Severe unremitting pain
Acute tenderness in function
Acute tenderness on percussion

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11
Q

What’s symptoms after acute apical abscess perforates bone

A

Pain often remits

Swelling, redness, heat

Swelling increases pain returns

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12
Q

5 clinical signs of inflammation

A

Heat
Redness
Swelling
Pain
Loss of function

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13
Q

The site of the swelling will depend upon what in an acute apical abscess

A

The position of the tooth in the arch

Root length

Muscle attachments

Potential spaces in proximity to lesion
Submental Space
Sublingual Space
Submandibular Space
Buccal Space
Infraorbital Space
Lateral Pharyngeal Space (a.k.a. Parapharyngeal Space)
Palate

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14
Q

Acute Apical Abscess – Treatment

A

Provide Drainage

-Soft tissue incision intraorally
-Soft tissue incision extraorally

Remove source/cause
-Extract tooth
-Pulp extirpation
-Periradicular surgery

Need for antibiotics determined by

Severity
Absence of adequate drainage
Patient’s medical condition

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15
Q

What is reversible pulpitis

A

Denotes a level of inflammation in which returning to a normal state is possible if noxious stimuli removed

Mild-moderate tooth pain when stimulated, no pain without stimulus, subsides within seconds (<5 secs), no mobility, no pain on percussion

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16
Q

What is irreversible pulpitis

A

Denotes a higher level of inflammation in which dental pulp has been damaged beyond point of recovery

Sharp, throbbing, severe pain upon stimulation, and pain may be spontaneous or occur without stimulation, pain persists after stimulation removed (>5 secs); tx: RCT or extraction

17
Q

Describe periapical granuloma (chronic apical periodontitis)

A

Mass of chronically inflamed granulation tissue at apex of tooth (plasma cells, lymphocytes, and few histiocytes with fibroblasts and capillaries).

NOT a true granuloma because not granulomatous inflammation! (Note that granulomatous inflammation has epithelioid histiocytes mixed with lymphocytes and giant cells)

18
Q

What is the etiology of periapical (radicular) cyst

A

Caries, trauma, periodontal disease
Death of dental pulp
Apical bone inflammation
Dental Granuloma
Stimulation of epitheialial rests of Malassez
Epithelial Proliferation
Periapical Cyst Formation