Interpretation of trauma, plural lesions and periapical lesions

Question 1

what is trauma? how does it affect the dentition?

Answer 1

• an injury produced by an external force
• may affect the crowns and tooth of teeth as well as alveolar bone
• may result in injuries of teeth and bone and injuries such as intrusion, extrusion and avulsion

Question 2

what are fractures? what does this include?

Answer 2

the breaking of a part

• may affect crowns and roots of teeth or the bones of the maxilla or mandible
• includes: crowns factors, root fractures, jaw fractures

Question 3

what are crown fractures?

Answer 3

• most often involves anterior teeth
• may involve enamel, dentin and/or pulp
• the radiograph permits evaluation of the proximity of the damage to the pulp chamber and for evaluation of the root for any additional fractures

Question 4

what are root fractures?

Answer 4

• most often occur in the maxillary central region
• may be vertical or horizontal, single or multiple
• if the x-ray beam is parallel to the plane of the fracture, it will appear as a radiolucent line
• if the x-ray beam is not parallel to the plane of the fracture, it may not be apparent at all

Question 5

what are jaw fractures?

Answer 5

• most often observed in the mandible, the panoramic radiograph is best film for visualizing mandibular fractures. on radiograph, the fracture appears as a radiolucent line
• maxillary fractures are typically difficult to detect on dental radiographs

Question 6

what does displacement of teeth involve?

Answer 6

• luxation

- avulsion

Question 7

what is luxation? what are the 2 types?

Answer 7

• the abnormal displacement of teeth
• intrusion: is the abnormal displacement of teeth into bone
• extrusion: is the abnormal displacement of teeth out of bone

Question 8

what is avulsion?

Answer 8

• the complete displacement of a tooth from alveolar bone

- the periapical radiograph shows a tooth socket without a tooth (knocked out tooth)

Question 9

what is physiologic resorption?

Answer 9

• a process seen with the normal shedding of primary teeth

- roots of primary teeth are resorbed as the permanent teeth move in an occlusal direction

Question 10

what is pathologic resorption?

Answer 10

• a regressive alteration of tooth structure observed when a tooth is subjected to abnormal stimuli
• may be external resorption or internal resorption

Question 11

what is external resorption?

Answer 11

• seen along the periphery of the root surface. often associated with reimplanted teeth, abnormal mechanical forces, trauma, chronic inflammation, tumors and cysts, impacted teeth, or idiopathic causes
• most often involves the apices of teeth. the apical region appears blunted, the length of the root is shorter than normal

Question 12

what is internal resorption?

Answer 12

• occurs within the crown or root of a tooth
• involves the pulp chamber, pulp canals and surrounding dentin
• appears as a round-to-ovoid radiolucency in the mid crown to mid root portion of the tooth

Question 13

why do we need radiographs to see pulp? what can be seen on radiographic regarding the pulp?

Answer 13

• examination of the pulp chambers and canals is impossible without dental radiographs
• radiographs may detect conditions such as:
  
  • pulpal sclerosis
  • pulpal obliteration
  • pulp stones

Question 14

what is pulpal sclerosis?

Answer 14

• a diffuse calcification of the pulp chamber and pulp canals of teeth; results in a pulp cavity of reduced size
• associated with aging
• of little clinical significance unless endodontic therapy is indicated

Question 15

what are pulp stones?

Answer 15

• calcifications found in the pulp chamber or pulp canals, appear on radiographs as round, ovoid or cylindrical radiopacities
• may vary in shape. size and number
• do not cause symptoms
• do not require treatment

Question 16

what can be visible of periapical radiolucent lesions on a radiograph?

Answer 16

• periapical granuloma
• periapical cyst
• periapical abscess

Question 17

what can be visible of periapical radiopaque lesions on a radiograph?

Answer 17

• condensing osteitis
• sclerotic bone
• hypercementosis

Question 18

where are periapical lesions?

Answer 18

• located around the apex of a tooth

- may appear either radiolucent or radiopaque

Question 19

what is a periapical cyst?

Answer 19

• a lesion that develops over a long period
• the most common of all tooth-related cysts
• typically asymptomatic
• treatment is either endodontic therapy or extraction with curettage of the apical region

Question 20

what is a periapical abscess? what are the 2 types?

Answer 20

• a localized collection of pus in the periapical region of a tooth
• acute: painful, nonfatal, sensitive to pressure, percussion and heat. may not appear on radiographs
• chronic: usually asymptomatic, pus drains through bone or the periodontal ligament space. appears as a round or ovoid apical radiolucency

Question 21

what are condensing osteitis?

Answer 21

• a well-defined radiopacity
• seen below the apex of a tooth with a history of long-standing pulpitis
• may vary in shape and size; does not appear to be attached to the tooth root
• most common periapical radiopacity observed in adults; most commonly in the mandibular first molar

Question 22

what is sclerotic bone?

Answer 22

• a well defined radiopacity seen below the apices of vital, non carious teeth
• unknown cause
• not attached to the tooth
• varies in shape and size
• margins may be smooth or irregular and diffuse
• asymptomatic

Question 23

what is hypercementosis?

Answer 23

• the excess deposition of cementum on root surfaces
• may result from supereruption, inflammation, or trauma
• most often affects the apical area, which appears enlarged and bulbous
• affected teeth are vital and do not require treatment