Diseases Of Pulp And Periodontium Flashcards
What is pulp hyperaemia? What are symptoms?
Increased blood flow to the pulp as a response to stimuli
- pain lasting seconds
- pain stimulated by hot or cold or sweet foods
- pain resolves after stimulus removed
- caries approaching pulp but can still be restored
What are some symptoms of acute pulpitis?
Constant severe pain
Reacts to thermal stimuli
Poorly localised pain
Referral of pain
No or minimal response to analgesics
How might one diagnose acute pulpitis?
History
Visual exam
Negative TTP - usually
Pulp testing id equivocal
Radiographs
Diagnostic LA
Removal of restorations
How might one diagnose acute apical periodontitis?
TTP
Non vital tooth - unless traumatic
Slight mobility increase
Radiographic loss of lamina dura and radiolucency
Widening of PDL space
How might a patient get traumatic periodontitis?
How might it be diagnosed?
Parafunction
Clinical exam of occlusion
TTP
Tooth vital
Generalised widening of PDL
Symptoms of acute apical abscess?
Severe unremitting pain
Acute tenderness in function and percussion
No swelling, redness or heat… YET
5 cardinal signs of inflammation?
Heat
Redness
Swelling
Pain
Loss of function
What symptoms may present when the abscess perforates through bone?
Pain often remits - unless in palate
Swelling, redness and heat becomes increasingly apparent in the soft tissues
As swelling increases, pain returns
Initial reduction in TTP as pus escapes tooth and into soft tissues
How might one treat acute apical abscess?
Provide drainage
- soft tissue incision
- extraction
- pulpal extirpation
- peri radicular surgery
Consider antibiotics dependant on
- severity
- absence of adequate drainage
- patients medical condition
What local factors may indicate use of antibiotics
Toxicity
Airway compromisation
Dysphagia
Trismus
Lymphadenitis
Location - such as floor of mouth
What systemic factors may indicate use of antibiotics
Immunocompromised patients - HIV or chemotherapy or steroid use long term
Diabetes
Elderly
What is a periapical granuloma?
Chronic apical periodontitis
Chronically inflamed granulation tissue at apex of tooth (plasma cells lymphocytes and few histocytes with fibroblasts and capillaries)
Not a true granuloma
What is the ethology of a periapical (radiuclar) cyst?
Caries, trauma or periodontal disease
Death of dental pulp
Apical bone inflammation
Dental granuloma
Epithelial proliferation
Periapical cyst formation
