diseases of pulp and periodontist Flashcards
what is hyperaemia characterised by
- increased blood supply in pulp chamber
what is a chronic sinus
- get a big bubble forming which then bursts and get a bad taste and then goes away and is better for a while but then whole process will start again
what are symptoms of pulp hyperaemia
- pain ;asting seconds
- stimulated by hot/cold or sweet foods
- resolves after stimulus removed
what causes pulp hyperaemia
- caries approaching the pulp
what are the symptoms of pulp hyperaemia the same as
- reversible pulpitis
what are the clinical symptoms of acute pulpitis
- constant severe pain
- reacts to thermal stimuli
- poorly localised pain = often get referral of pain
- no or minimal analgesic response
- can have less symptoms if pulp is exposed as less pressure on it
how to diagnose acute pulpitis
- negative TTP
- pulp testing equivocal
- radiographs
- diagnostic LA = numb to see if pain goes
- removal of restorations
what are the symptoms of acute apical periodontitis
- pain easy to localise now because it has spread to apical tissues
- very TTP
- slight increase in mobility
- tooth can feel high in the mouth for pt so they can’t bite down
- tooth is non-vital
- shouldn’t see a radiolucency on radiograph but can see loss of clarity of lamina dura
what are the causes of traumatic perio
- parafunction
how to diagnose traumatic perio
- clinical exam of occlusion
- TTP
- normal vitality
- radiographs show general widening of pdl
what is the treatment for traumatic perio
- occlusal adjustment
- therapy for parafunction
what is the most common pus producing abscess
- acute apical abscess
what are other causes of pus
- periodontal abscess = formed in periodontium
- pericoronitis
- sialadenitis = infection of salivary gland
what organisms are associated with dental abscesses
- polymicrobial
- anaerobes play important role
what are clinical features of acute apical asbcess
- initially almost identical to acute apical periodontitis - prior to eroding through bone and into soft tissues
- severe unremitting pain
- acute tenderness in function
- acute tenderness on percussion
- no swelling, redness or heat until spread into soft tissues
what are the 5 cardinal signs of inflammation
- heat
- redness
- swelling
- pain
- loss of function
what are the symptoms of acute apical abscess once perforated through bone
- pain often remits as less pressure
- swelling, redness, heat become increasingly apparent
- there is an initial reduction in TTP as pus escapes into soft tissues
- as swelling increases, pain returns
what does the site of swelling depend on in acute apical abscess
- anatomy
- position of tooth in the arch, tooth length, muscle attachments
- potential spaces in proximity = submittal. sublingual, submandibular, buccal, infraorbital, lateral pharyngeal, palate
what is the treatment for acute apical abscess
- provide drainage = soft tissue incision (I/o or e/o)
- remove source/cause = extract tooth, pulp extirpation, periradicular surgery
- AB’s determined by severity, absence of adequate drainage, medical condition
what are local factors which determine need for AB’s
- toxicity
- airway compromisation
- dysphagia
- trismus
- lymphadenitis
- location = e.g. floor of mouth
what are systemic factors which determine need for AB’s
- immunocompromised pts = acquired causes, drug induced, blood disorders
- diabetes = poorly controlled
- elderly
what is a periapical granuloma
- mass of chronically inflamed granulation tissue at apex of tooth = plasma cells, lymphocytes few histiocytes with fibroblasts and capillaries
- not a true granuloma because not granulomatous inflammation
what is the aetiology of a PA radicular cyst
- caries, trauma, PD
- death of pulp
- apical bone inflammation
- dental granuloma
- stimulation of epithelial rests of Malassez
- epithelial proliferation
- periapical cyst formation
