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oral path 2 > inflammatory jaw lesions > Flashcards

inflammatory jaw lesions Flashcards

1
Q

1 defense mechanism of body

A

inflammation - but in the 2nd line of defense

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2
Q

periapical abscess

A

accumulation of acute inflammatory cells (neutrophils, not time) and purulence a the apex of the tooth

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3
Q

cause of PA abscess

A

infection of trauma

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4
Q

t/f PA abscess can be symptomatic or asymptomatic

A

true

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5
Q

microscopically, the key cell to an acute abscess is

A

neutrophil

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6
Q

tx of pa abscess

A

elimination of infection focus

endo

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7
Q

pa granuloma

A

chronic apical periodontitis (lymphocytes)
mass of chronically inflamed tissue
defensive reaction
cytokines releases

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8
Q

75% of apical inflammatory lesions are

A

pa granulomas

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9
Q

cells of chronic pa granulomas

A

lymphocytes (no macrophages)

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10
Q

tx of pa granuloma

A

endo or extraction with curettage

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11
Q

radicular cyst arises from

A

stimulation of epithelium at apex of non vital tooth

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12
Q

variants of radicular cyst

A

lateral radicular and residual cyst

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13
Q

3 parts of cysts

A

EPITHELIUM, CT, lumen

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14
Q

t/f radiographically, you can’t tell the difference bt cyst, granuloma, or abscess

A

true

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15
Q

rarefying osteitis

A

cannot be differentiates clinically
generally well defined and radiolucent
most common lesions (cysts, granuloma, abscess)
grow slow, focal

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16
Q

condensing osteitis

A

localized proliferative reaction of bone to low grade inflammatory stimulus

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17
Q

what is most commonly associated with apex of a nonvital tooth

A

condensing osteitis

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18
Q

what is critically associated with an area of inflammation

A

condensing osteitis

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19
Q

radiographic features of condensing osteitis

A

tooth root outline is visible
pdl is widened or shows rarefying oseitis
localized sclerotic radiopaque area in pa region outside the radiolucent area

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20
Q

sequence of events for condensing osteitis

A
  1. disease, pulpal inflammation, pa inflammation, rarefying osteitis
  2. bone deposited around rarefying osteitis
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21
Q

tx of condensing osteitis

A

endo, but left with a bone scar (sclerotic bone that doesn’t go away)s

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22
Q

osteomyelitis

A

acute/chronic inflammation of bone away from initial site

diffuse area

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23
Q

osteomyelitis leads to

A

necrosis and sequestra

24
Q

sequestrum

A

piece of necrotic bone that separated from surrounding viable bone

25
Q

cause of osteomyelitis

A

tooth infection, bacterial infections (pyogenic staph and strep)

26
Q

predisposing conditions of osteomyelitis

A

decreased host resistance, decreased vascular supply to bone

27
Q

pathogenesis of osteomyleitis

A

acute suppurative inflammation, interruption of vascular supply, necrosis and resorption of bone

28
Q

involucrum

A

dead bone that has new vital bone surrounding it

29
Q

features of osteomyelitis

A

pain, paresthesia, swelling, drainage, fever, leukocytosis, tender lymphadenopathy

30
Q

osteomyelitis is more common in

A

the mandible

31
Q

radiographic features of osteomyelitis

A

nno changes in 1st week, later, diffuse radiolucent areas

radiopaque areas representing sequestra

32
Q

tx of osteomyelitis

A

acute: abs, surgery maybe
chronic: difficult, surgery, IV abs

33
Q

t/f you can get a pathologic fracture with osteomyelitis

A

true

34
Q

onion skin pattern is seen in

A

osteomyelitis with proliferative periostitis

35
Q

osteomyelitis with proliferative periostitis is

A

pa inflammation spreading to the periosteum

bony swelling, not painful

36
Q

periosteum responds to osteomyl. with proliferative periostitis by

A

depositing bone

37
Q

osteomyl. with proliferative periostitis occurs in

A

immmunocompromised/young people and mandible

38
Q

radiographic appearance of osteomyelitits with proliferative periostitis

A

parallel layers of new bone depositied bt the cortex and periosteum

39
Q

remodeling of bone occurs is how long with osteomyl. with proliferative periostitis

A

6-12 months

40
Q

causes of periosteal new bone formation

A

osteomyelitis, neoplasms (ewings sarcoma, osteosarcoma), cysts, trauma

41
Q

osteoradionecrosis

A

chronic infection of bone
follows high dose radiation therapy to bone
very painful

42
Q

osteoradionecrosis is more common in

A

mandible

43
Q

cause of osteoradionecrosis

A

greater than 75 grays

less than 60 grays there is a minimal risk

44
Q

pathogenesis of osteoradionecrosis

A

thickening of bvs, destruction of osteoblastc/cytes, abscence of bone formation, trauma or infection

45
Q

t/f. tx is easier than prevention in osteoradionecrosis

A

false

46
Q

tx of osteoradionecrosis

A

abs, surgery, hyperbaric o2, radical surgical resection

47
Q

complications of osteoradionecrosis

A

bony deformity and pathologic fracture

orocutaneous fistulas

48
Q

BMU

A

basic multicellular unit: group of osteoclasts, blasts, and local vascular supply
final remodelong of bone

49
Q

osteoclasts are used for

A

signaling, resorption, and lemellar bone deposition and angiogenesis

50
Q

bisphosphonates are used for

A

cancer or oseteoporosis (oral, smaller dosage)

inhibiting apoptosis of osteoclasts

51
Q

t/f decreased osteoclast function inhibits bone remodeling

A

true

52
Q

zometa, boniva, aredia are IV drugs commonly seen with

A

jaw osteonecrosis

53
Q

other meds that can lead to MRONJ

A

denossumab - antireorptive agent that prevents osteoclastic maturation; anti-neoplastic med or for osteoporosis
antiangiogenic agents - attempt to decrease blood supply to malignancy, vascular endothelial inhibitor

54
Q

ARONJ

A

antiresorptive related osteonecrosis of the jaw

55
Q

BRONJ clinical findings

A

IV bisphosphonates more likely to cause
intraorally show single or multifocal areas of exposed necrotic bone
radiographs may show increased radiopacity prior to necrosis
painful
mandible
post extraction

56
Q

tx and prognosis for BRONJ

A

prevention
improve dental health before future procedures
symptomatic pts: systemic antibiotics and chorhexidine, asymptomatic pts: chorhexidine only
smooth exposed bone

57
Q

what do you include on the differential with osteomyelitis

A

radiation induced osteonecrosis
MRONJ
metastatic disease

oral path 2 (8 decks)

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