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Radiographic Interpretation > Lecture 4- Pulpal & Periapical Disease & Periapical Radiolucencies > Flashcards

Lecture 4- Pulpal & Periapical Disease & Periapical Radiolucencies Flashcards

1
Q

Four aspects of pulpal interpretation:

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

Describe the pulp chamber of a younger patient:

A

larger pulp chamber & RC space is larger

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3
Q

How old is this patient?

A

pulp chamber of kid

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4
Q

Why might a younger patient be more prone to carious exposures of the pulp?

A

Larger pulp horns- pulp is closer to the occlusal surface

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5
Q

How old is this patient?

A

pulp chamber of kid

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6
Q

As we age, our pulp chambers:

A

shrink

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7
Q

How old is this patient?

A

older- small pulp chamber & secondary dentin formation

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8
Q

As the pulp chamber gets smaller, it usually:

A

maintains shape

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9
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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10
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 chambers of the adjacent teeth. We can see a periapical radiolucency on #7. This tooth probably became non-vital at a young age.

When the tooth became non-vital, so the secondary dentin did not form

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11
Q

Why does the pulp chamber appear non-existent?

A

due to secondary dentin formation- probably still a pulp chamber in there just very small

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12
Q

Comparing the first & second molars, we can note:

A

localized secondary dentin formation- distal pulp horn of 1st molar- This can also be referred to as tertiary dentin formation that is formed due to the carious lesion on the 1st molar.

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13
Q

Additional dentin formation caused by irritation from deep carious lesion:

A

secondary/tertiary dentin formation

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14
Q

How can we tell if tertiary dentin is formed (what distinguished this from primary dentin?)

A

shape of pulp chamber is changed

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15
Q

We generally refer to the calcifications in the pulp as:

A

pulp stones

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16
Q

Describe pulp stones:

A
  • occur in the RC space or pulp chamber
  • can be single or multiple
  • can vary in size
  • teeth are still vital (no clinical significance unless trying to do endo)
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17
Q

What can be seen in this radiograph?

A

pulp stones in the molars

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18
Q

What can be seen in the radiograph?

A

pulp stones

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19
Q

A more widespread diffuse form of pulp stones, where the calcification can almost completely fill the pulp chamber and often times fills the root canal spaces:

A

pulpal sclerosis

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20
Q

What can be seen in the following image?

A

pulpal sclerosis

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21
Q

Inflammation of the pulp that causes resorption of the dentin in the root and it starts from within the pulp and goes outward

A

Internal root resoprtion

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22
Q

Describe the margins in internal root resoprtion:

A

smooth and well defined

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23
Q

Internal root resorption is inflammation of the pulp that causes resorption of the ___ in the root. It starts from within the pulp and goes outward.

A

dentin

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24
Q

The area of internal resoprtion of a root is typically described as:

A

ovoid or round

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25
Q

What is the treatment for internal root resoprtion?

A

RCT (to try to stop the resorptive process)

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26
Q

What can be seen in the following radiograph?

A

internal root resorption

27
Q

What can be seen in the following radiograph?

A

internal root resoprtion

(this image also has some external root resorption)

28
Q

Root resorption caused by EXTERNAL forces

A

External root resorption

29
Q

With external root resorption, the remaining surfaces are usually:

A

smooth

30
Q

As the tooth resorbs in external root resorption, the PDL and lamina dura:

A

move with the resorbing root

31
Q

What can be seen in the following radiograph?

A

external root resoprtion

32
Q

You see this benign tumor in a patient, and you know that its slow growing due to the displacement of teeth. What else can be seen (that has occurred due to this tumor)

A

external root resoprtion

33
Q

What can be see in the following radiograph?

A

external root resorption

(associated with an inflammatory PA lesion)

34
Q

T/F- Internal root resorption always requires therapy. External root resorption may or may not require treatment

A

True

35
Q

List some causes of periapical radiolucencies:

A
  1. periapical abscess
  2. periodical granuloma
  3. periapical cyst
  4. residual/recurrent cyst
  5. periapical memento-osseous dysplasia
  6. fibrous healing defect
36
Q

Periapical INFLAMMATORY lesions include: (3)

A
  1. peripapical abscess
  2. peripalical granuloma
  3. periapical cyst
37
Q
  • Reversible/irreversible pulpitis
  • Acute apical abscess

These are both examples of:

A

Acute pulpal/periapical disease

38
Q

This patient comes in on E-chair and is complaining of periapical pain of the second molar. You take a radiograph, and note the periodontal ligament space and lamina dura are intact.

Radiographically you may not see any evidence of disease here.

A

reversible puulpitis

39
Q
  • PDL space thickening
  • discontinuity of lamina dura
  • periapical radiolucency

these findings are characteristic for:

A

apical abscess

40
Q

What can yo see in this radiograph?

A

apical abscess

41
Q

What is the first sign you may see on a radiograph for an apical abscess?

A

PDL space widening

42
Q

What is the second radiographic signs for an apical abscess?

A

discontinuity of the lamina dura

43
Q

What is the the third radiographic signs for an apical abscess?

A

periapical radiolucency

44
Q

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

A

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

45
Q

What can we see in the following radiograph?

A

apical abscess (the start of one)

46
Q

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

A

acute

47
Q

What can be seen in the following radiograph? Describe it

A
  • Ill defined radiolucency at apex of tooth
  • Apical abscess
48
Q

List the chronic periapcial inflammatory lesions: (4)

A
  1. chronic apical abscess
  2. periapical granuloma
  3. periapical cyst
  4. periapical rarefying osteitis
49
Q
  1. chronic apical abscess
  2. periapical granuloma
  3. periapical cyst
  4. periapical rarefying osteitis

The following are:

A

chronic periapical inflmattory lesions

50
Q

Three radiographic lesions that are often indistinguishable:

A
  1. chronic apical abscess
  2. periapical granuloma
  3. periapical cyst
51
Q

Instead of saying this is either a
1. chronic apical abscess
2. periapical granuloma
3. periapical cyst

we might just say:

A

this is a periapical rarefying osteitis

52
Q

What is the treatment for the following?

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

RCT

53
Q

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

A

sclerotic bone

54
Q

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

A

sclerotic bone - chronic apical abscess

55
Q

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

A

sclerotic bone - chronic apical abscess

56
Q

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

A

periapcial granuloma

57
Q

Periapical granulomas often develop from:

A

periapical abscesses

58
Q

Radiographically, the appearance of a periapical granuloma is quite:

A

variable

59
Q

What can be seen in the following image?

A

periapical granuloma

60
Q

Periapical ____ often form from periapical granulomas

A

Periapical cysts

61
Q

What can bet seen in the following image?

A

periapical cyst

62
Q

Cystic degeneration of a periapical granuloma which results in a fluid filled cavity:

A

periapical cyst

63
Q

Periapical cyst tend to be ____ in shape:

A

rounded (hydraulic)

64
Q

What can be seen in the pano?

A

periapical cyst

Radiographic Interpretation (10 decks)

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