Exam 4-Pulpitis/Periapical- Lecture2 Flashcards
WHAT IS Acute inflammation due to pulpal necrosis with spread of NOXIOUS products into the periapical region?
Periapical Abscess
What are the two things a periapical abscess can develop from?
1.Periapical Granuloma 2.Apical periodontal cyst
Are periapical abscesses symptomatic or asymptomatic?
CAN BE BOTH!
In a symptomatic periapical abscess, does pain typically increase or decrease over time?
INCREASE
In a symptomatic periapical abscess, the intensity of pain may vary from ______ to ______
mild to severe
In a symptomatic periapical abscess, there can be pain on ________, mastication, and/or palpation over the periapical region
percussion
In a symptomatic periapical abscess, _______ in the periapical region or vestibule may accompany it
swelling
In a symptomatic periapical abscess, It is an ACTIVE infection—_______ symptoms may be noted
SYSTEMIC (headache, fever, chills, malaise)
In an asymptomatic periapical abscess, you may still have _______ even if there is no pain
swelling
A periapical abscess may not produce any obvious _________ changes
radiographic
In a radiograph of a periapical abscess, a radiolucent lesion may be present, and if it is, it is often ______, with possible thickening of the ________
ill-defined…PDL
What are three possible treatments for a periapical abscess?
1.Endo 2.Ext 3.Analgesics for pain (WHAT ABOUT ANTIBIOTICS???)
A periapical SCAR is very rare and typically can arise after the healing from what three pathologies?
1.periapical granuloma 2.apical periodontal cyst 3.periapical abscess
A periapical scar typically occurs when there is destruction of cortical bone in what area(s)?
BOTH buccal and lingual aspects of the involved tooth
When is the MOST COMMON occurrence of a periscopical scar?
following SURGICAL endo therapy
What TERM is this describing? Periapical abscess with pus formation…Pus dissects through the bone, destroying bone in its path
Sinus Tract
A sinus tract tends to follow the path of ___________
least resistance
A sinus tract perforates cortical plate of bone and extends into ________
soft tissue
A sinus tract may drain with what type of frequency?
intermittent
What are the two possible places a periapical abcess-sinus tract can exit?
1.oral cavity 2. skin surface
If a sinus tract exits in the oral cavity: its called a ______ or a “______”
par-u-lis or a “gum boil”
If a sinus tract exits in the oral cavity: What are the two clinical presentations of this area?
- A “hole” with surrounding redness or 2.An enlarged, nodular mass
If a sinus tract exits in the oral cavity and presents as an enlarged, nodular mass its likely to be ______ to white to red to purple with ANY combination of colors possible
Yellow
If a sinus tract exits in the oral cavity and presents as an enlarged, nodular mass its going to be sessile or moveable?
sessile
If a sinus tract exits in the oral cavity and presents as an enlarged, nodular mass: Most are found on the _______ aspect due to the thinner nature of the cortical plate located here.
BUCCAL
So if a sinus tract exits in the oral cavity it is likely to be buccal…HOWEVER, these three areas can see LINGUAL perforation thanks to the anatomy around them…
1.Maxillary Lateral Incisors 2.Palatal Roots of Maxillary Molars 3.Mandibular 2nd and 3rd molars(thick buccal shelf!!)
So if a sinus tract exits in the SKIN it typically presents as WHAT?
an enlarged nodular mass
So if a sinus tract exits in the SKIN it is a ____ lesion with other shades of yellow, white, purple mixed in
RED
So if a sinus tract exits in the SKIN what teeth are most commonly the culprit?
Mandibular teeth most commonly (gravity and trapped under the mylohyoid muscle)
What is the term for a periapical inflammation spreading into adjacent bone without drainage??
Osteo-myel-itis
What is inflammation unable to establish a drainage point that begins to spread through soft tissues??
Cellulitis
Cellulitis typically spreads between tissue layers (planes) often producing ______ infections
SPACE
What are the two types of cellulite associated with dental infections?
1.Ludwigs Angina 2.Cavernous Sinus Thrombosis
Ludwig’s angina: Typically results from abscess of WHICH TOOTH??
A mandibular molar tooth
Ludwig’s angina: Rapid swelling of the sublingual, submandibular, and _______ areas
submental
Ludwig’s angina: _______ involvement causes swelling and elevation of the tongue
Sublingual
Ludwig’s angina: DANGER: May extend to the spaces around the throat and close off the ______
AIRWAY
Ludwig’s angina: _______, though rare, can occur
DEATH
Cavernous sinus thrombosis typically results from WHICH TWO groups of teeth?
1.Maxillary Anterior 2. Maxillary Premolar
Cavernous sinus thrombosis: Which specific tooth is the MOST COMMON source of infection?
Maxillary Canine
Cavernous sinus thrombosis: Painful swelling involves periorbital tissues like the ______ and _______
eyes and conjunctiva
Cavernous sinus thrombosis: Swelling may also involve ______ border of nose; may extend to _______
lateral…forehead
Possible sequelae of a cavernous sinus thrombosis—________ and fixation of the eyeball
Protrusion
Possible sequelae of a cavernous sinus thrombosis—Pupil _______ with photophobia
DILATION
Excessive lacrimation (tearing) can be a sign of what problem?
Possible sequelae of a cavernous sinus thrombosis
Possible sequelae of a cavernous sinus thrombosis— Loss of ______ in the involved eye
sight
All of these are possible sequelae of what condition?? Meningitis, Brain abscess, Death
cavernous sinus thrombosis
What is the number one metastatic cancer you are likely to see as a periapical radiolucency in women?
Breast cancer
What is the number one metastatic cancer you are likely to see as a periapical radiolucency in men?
Lung cancer
After Breast and Lung metastatic cancer what other 3 cancers can present as a periapical radiolucency in either males or females?
1.kidney 2.thyroid 3.colon
