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Radiographic Interpretation > L4- Pulpal & Periapical Disease & Periapical radiolucencies > Flashcards

L4- Pulpal & Periapical Disease & Periapical radiolucencies Flashcards

1
Q

Four aspects of pulpal interpretation:

A
  1. size
  2. secondary dentin
  3. pulp stones/pulpal scerlosis
  4. internal/external resorption
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1
Q

Describe the pulp chamber of younger patients:

A

Pulp chamber & RC space is larger

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2
Q

Why are younger patients more prone to carious exposures of the pulp?

A

Larger pulp horns = pulp is closer to the occlusal surface

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3
Q

Looking at this image, what is the age of the patient?

A

kid

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4
Q

Looking at this image, what is the age of the patient?

A

older patient

(small pulp chamber, secondary dentin formation)

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5
Q

As the pulp chamber gets smaller, it usually:

A

maintains the same shape

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6
Q

Why does the pulp chamber get smaller with age?

A

Part of aging process + stress of occlusal forces & secondary dentin formation

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7
Q

What do you notice in this image? What might be the reason?

A

The pulp chamber of tooth #7 is larger than the pulp chamber of the adjacent teeth. We can see a periapcical radiolucency on #7. The tooth probably became non-vital at a younger age- so secondary dentin formation stopped

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8
Q

Why does the pulp chamber appear non-existent?

A

Secondary dentin formation

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9
Q

Comparing the first & second molars we can note:

A

localized secondary dentin formation (distal pulp horn of first molar)

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10
Q

Additional dentin formation caused by irritation from deep carious lesion:

A

secondary/tertiary dentin

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11
Q

How can you tell if tertiary dentin is formed (what distinguishes this from primary dentin?)

A

Shape of pulp chamber has changed

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12
Q

We generally refer to calcifications in the pulp as:

A

pulp stones

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13
Q

Describe pulp stones:

A
  • can occur in RCT space or pulp chamber
  • can be single or multiple
  • can very in size although normally small
  • teeth are still vital (no clinical significance unless you need to do endo on these teeth)
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14
Q

What can be seen in the radiograph?

A

pulp stones

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15
Q

What can be seen in the radiograph?

A

pulp stones (molars)

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16
Q

A more widespread, diffuse form of pulp stones where the calcifcation can almost fill the pulp chambers & often times also fills the RC spaces:

A

pulpal sclerosis (teeth are still vital)

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17
Q

What can be seen in the following radiograph?

A

pulpal sclerosis

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18
Q

Inflammation of the pulp causes resorption of the dentin in the root, starting from within the pulp & goes outwards:

A

Internal root resorption

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19
Q

Describe the margin in internal root resorption:

A

smooth & well defined

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20
Q

Internal root resorption is inflammation of the pulp that causes resorption of the _____ in the root. It states from within the pulp & goes outward:

A

dentin

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21
Q

The area of internal root resoprtion is usually describe as:

A

ovoid or round

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22
Q

What is the treatment for internal root resorption?

A

RCT (to try to stop the resorption process)

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23
Q

What can be seen in the following image?

A

internal root resorption

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24
Q

What can be seen in the following image?

A

internal root resorption

(also some external resorption as well)

25
Q

Root resorption caused by external forces that begins outside the tooth and works its way inward:

A

External root resorption

26
Q

With external root resorption, the remaining surfaces are usually:

A

smooth

27
Q

As the tooth resorbs in external root resorption, what happens to the PDL & lamina dura

A

They follow the tooth- moving with the resorbing tooth

28
Q

What can be seen in the following image?

A

external root resorption

29
Q

We seen this benign tumor in a younger patient. We note that its slow growing due to the displacement of teeth. What has occurred due to this tumor?

A

external root resorption

30
Q

What can we see in the following image?

A

External root resorption

(associated with an inflammatory PA lesion)

31
Q

T/F: Internal root resorption always requires therapy, whereas external root resorption may or may not

A

True

32
Q

List some causes of periapical radiolucencies:

A
  1. periapical abscess
  2. periapical granuloma
  3. periapical cyst
  4. residual/recurrent cyst
  5. periapical cemento-osseou dysplasia
  6. fibrous healing defect
33
Q

Periapical INFLAMMATORY lesions include:

A

1.periapical abscess
2. periapical granuloma
3. periapical cyst

34
Q

-reversible/irreversinle pulpitis
-acute apical abscess

These are both examples of:

A

ACUTE pulpal/periapical disease

35
Q

The patient comes in on E-chair & is complaining of periapcial pain of the second molar. Radiographically you note that the PDL & lamina dura are intact.

Radiographically you may not see any evidence of disease here

A

Irreversible pulpitis

36
Q

-PDL space thickening
-Discontinuity of lamina dura
-Periapical radiolucency

These are all:

A

Radiographic findings at apex

37
Q

What is the first radiographic sign you may see of an apical abscess?

A

PDL space widening

38
Q

What is the second radiographic signs you may see of an apical abscess?

A

Periapical radiolucency

39
Q

What is the third radiographic sign you may see of the apical abscess?

A

periapical radiolucency

40
Q

What do you see when looking at the mesial apex of the first molar?

A

slight PDL widening (mesial root of 1st molar), but lamina dura is intact

41
Q

What can be seen in the following radiograph?

A

Apical abscess

42
Q

Once you have an apical abscess, it is no longer considered:

A

acute

43
Q

What can be seen in the following radiograph?

A

-ill-defined radiolucency at apex of tooth
-apical abscess

44
Q

-chronic apical abscess
-periapical granuloma
-periapical cyst
-periapical rarefying osteitis

These are all:

A

chronic periapical inflammatory lesions

45
Q

Three radiographic lesions that are often indistinguishable:

A
  1. chronic apical abscess
  2. periapical granuloma
  3. periapical cyst
46
Q

List the four types of chronic periapical inflammatory lesions:

A

-chronic apical abscess
-periapical granuloma
-periapical cyst
-periapical rarefying osteitis

47
Q

Instead of saying there is a:
1. chronic apical abscess
2. periapical granuloma
3. periapical cyst

We might just say:

A

this is a periodic rarefying osteitis

48
Q

What is the treatment for the following?

  1. chronic apical abscess
  2. periapical granuloma
  3. periapical cyst
A

RCT

49
Q

When you have a chronic apical abscess, you may or may not see:

A

sclerotic bone

50
Q

What can seen be seen in the following radiograph? What is this a characteristic of?

A

Sclerotic bone; chronic apical abscess

51
Q

What can seen be seen in the following radiograph? What is this a characteristic of?

A

Sclerotic bone; chronic apical abscess

52
Q

A periapical radiolucency that instead of being filled with inflammatory fluid or pus, it is filled with granulation type tissue:

A

Periapical granuloma

53
Q

Periapical granulomas often develop from:

A

periapical abscesses

54
Q

What can be seen in the following image?

A

Periapical granuloma

55
Q

Radiographically, the appearance of a periapical granuloma is quite:

A

variable

56
Q

Periapical ____ often form from periapical granulomas

A

cysts

57
Q

Cystic degeneration of a periaoical granuloma that results in a fluid filled cavity:

A

periapical cyst

58
Q

What can bet seen in the following image?

A

periapical cyst

59
Q

Periapical cyst tend to be ____ in shape:

A

rounded (hydraulic)

60
Q

What can be seen in the following image?

A

periapical cyst

61
Q

2721

A

Radiographic Interpretation (11 decks)

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