Diseases of the pulp and periodontium Flashcards
What is pulp hyperaemia?
Increased blood supply due to trauma or caries (reversible pulpitis)
What are the clinical features of pulp hyperaemia?
Pain lasting for seconds
Pain stimulated by hot/cold or sweet foods
Pain resolves after stimulus
Caries approaching pulp but tooth can still be restored without treating pulp
What are the features of acute pulpitis?
Constant Severe Pain
Reacts to Thermal Stimuli
Poorly Localised Pain/Referred pain- brain struggles to realise which branch of CN5
No (or Minimal) Response to analgesics- cannot reach pulp
Open Symptoms Less Severe
How is diagnosis of acute pulpitis achieved?
History- best method
Visual examination
Negative Tenderness to Percussion (usually)
Pulp testing is equivocal
Radiographs- pulp chamber will look no different on radiographs
Diagnostic’ Local Anaesthetic
Removal of Restorations
What can acute pulpitis go on to become?
Chronic pulpitis
Acute Apical Periodontitis
What is chronic pulpitis?
When inflammation and infection is underlying and flares up (becomes acute) intermittently
What occurs in acute periodical peridontitis?
Inflammation progresses out of pulp chamber and into surrounding periodontal tissue
What are the features of AAP?
Very TTP- feels high in mouth
Tooth is non-vital (unless traumatic)
Slight increase in mobility
Radiographically:
Loss of clarity of Lamina Dura
Delay in changes at the apex of the tooth- widening of apical periodontal space
What may a radiolucent shadow suspected to be AAP actually be?
May indicate an ‘old’ lesion e.g. Flare up of apical granuloma
What causes Traumatic Periodontitis?
Parafunction (Tooth clenching or grinding)
What are the features of traumatic periodontitis?
Occlusally- posturing, functional positioning
TTP
Vital
Widening of PDL space radiographically
How do you treat traumatic periodontitis?
Occlusal adjustment
Therapy for parafunction
What can AAP progress onto?
Acute apical abscess
Chronic apical infection (granuloma)
What are the types of pus producing dental infections?
Acute apical abscess (most common)
Periodontal Abscess
Pericoronitis
Sialadenitis
What is pus made of?
Dead neutrophils and immune cells