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AU2017 Oral Micro Final > Lecture 9- Odontogenic infections > Flashcards

Lecture 9- Odontogenic infections Flashcards

1
Q

most common cause of pulpal inflammation and necrosis is …

A

bacterial infection

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2
Q

… are necessary for pulpal and periapical disease to occur

A

bacteria (pulp exposures in germ free rats shows that the pulp forms reparative dentin)

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3
Q

… is critical for success of pulpal therapy

A

good seal (pulpotomies and root canal treatments)

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4
Q

most bacteria cultured from necrotic pulps are …. and gram …. bacilli

A

anaerobic

negative

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5
Q

based on cultivation studies, … and … are significant bacteria because they have been associated with periapical abscesses

A

prevotella

porphyromonas

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6
Q

… and … species are responsible for the foul odor of some necrotic pulps

A

prevotella

porphyromonas

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7
Q

endodontic infections are … bacterial infections

A

mixed

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8
Q

nutrients differ in the canal so in pulpal infections, coronally where there are salivary constituents (carbs) there are …. bacteria like … and …

and more apically, serum and cellular proteins are the predominant species so … bacteria grow here like …. , …. and ….

A

saccharolytic
streptococci and lactobacilli

proteolytic
fusobacterium, porphyromonas, and prevotella

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9
Q

if the only pain the patient has with pulpitis is when they drink something cold (NOT spontaneous pain) then it is….

A

reversible!

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10
Q

periapical lesions will lead to … which is when osteoclasts make a hole in the bone to make space for the neutrophils that are being recruites

A

apical periodontitis

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11
Q

since pulp is necrotic in periapical lesions/apical periodontitis, patients are often …

A

asymptomatic (only detected o nradiograph)

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12
Q

bone resorption takes place in periapical lesions/apical periodontitis to allow

A

inflammatory cells to accumulate

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13
Q

most periapical lesions are … that are …. dominated (but other inflammatory cells present)

A

granulomas

macrophage

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14
Q

…. abscess is an acute exacerbation of periapical lesion. not sure what causes the shift though, could be bacterial species or lowered immune response

A

acute dentoalveolar (periapical)

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15
Q

in an acute dentoalveolar (periapical) abscess, …. bacterial infection is confined to bone at apex. and … and … are seen in the apical tissues

A

purulent

bacteria and PMNs

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16
Q

Is pain present in an acute dentoalveolar (periapical) abscess?

A

yes, very painful, tooth is sensitive to pressure (aching/throbbing pain)

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17
Q

What brings relief to the patient with an acute dentoalveolar periapical abscess?

A

drainage of pus through extraction or endodontic acess

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18
Q

in an acute dentoalveolar periapical abscess, spontaneous drainage may occur 2 ways:

A
  1. fistula to surface (not bad)

2. into tissue leading to orofacial involvement (BAD)

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19
Q

T/F spontaneous drainage through fistula to surface of an acute dentoalveolar abscess is common with primary teeth

A

true. roots are short and bone is NOT dense)

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20
Q

what is the palliative treatment for tx of pulpal/ periapical disease?

A

long-acting anesthetic

21
Q

Why are antibiotics not effective in pulpal and periapical disease?

A

b/c blood supply is compromised

22
Q

when can antibiotics help in pulpal or periapical disease?

A

when infection is in the tissues where there is blood supply

23
Q

T/F antibiotics work well with getting rid of pus from abscesses

A

false. they wont get into the pus and kill the bacteria, need surgical accompaniment

24
Q

whats the definitive treatment for pulpal or periapical disease?

A

root canal treatment: cleaning of canals and a good coronal seal

25
Q

Root canals work 95% of the time but sometimes fail. why?

A
  • biofilm still present at apex

- debris in inaccessible regions of canals

26
Q

treatment for persistent apical lesions

A

endodontic microsurgery also called apicoectomy

27
Q

an endodontic microsurgery or apicoectomy is used to

A

clean apex of bacteria and necrotic tissue

28
Q

Endodontic microsurgery/ apicoectomy procedure steps

A
  • apex accessed surgically
  • tip of apex removed
  • apical foramen is cleaned
  • sealed with biocompatible agent such as MTA (mineral trioxide aggregate)
29
Q

when dental infections spread to surrounding tissues they are called…

A

odontogenic infections

30
Q

odontogenic infections range from …. to the alveolar area, extending to adjacent …. or to …. infection

A

localized (dentoalveolar infections)

facial tissues

disseminated systemic

31
Q

when periapical infections spread to surrounding tissues the usual course is an initial …. or tissue invasion

A

cellulitis

32
Q

… is when bacteria invade the tissues and the tissues themselves become infected

A

cellulitis

33
Q

treatment for cellulitis?

A

antibiotics (good blood supply)

34
Q

areas of … and … in tissues may form secondary to cellulitis

A

necrosis

abscess

35
Q

lower facial cellulitis is almost always

A

dental related

36
Q

T/F upper facial cellulitis has a dental origin half of the time

A

true

37
Q

in cellulitis, the tissue is … and …

there is no… and it is not

A

swollen
hard (indurated)

pus
fluctuant

38
Q

cellulitis may proceed to a 2nd phase …

A

abscess formation

39
Q

an abscess will be … and erythematous

and it will have …

A

fluctuant

pus

40
Q

are abscesses vascular or avascular

A

avascular

41
Q

… and … are the most widely used antibiotics because

A

inexpensive
low side effects
wide spectrum

42
Q

… is the alternative choice antibiotic is penicillin isnt working

A

clindamycin (broad spectrum and expensive though)

43
Q

will extraction of the tooth cure cellulitis?

A

no because infection is already in the tissues

44
Q

3 types of bone infections

A

Alveolar osteitis (dry socket)

Osteomyelitis os the jaw

medication induced osteonecrosis of the jaw (MRONJ)

45
Q

Alveolar osteitis (dry socket) is delayed healing of extraction site because of …

A

premature breakdown of fibrin clot exposing bone and biofilm starts to form on bone first

46
Q

symptoms of alveolar osteitis (dry socket)

A 
swelling 
redness
throbbing pain
mal-odor
oozing
47
Q

treatment of alveolar osteitis (dry socket)

A

gauze soaked in vasoline with iodine

48
Q

can you use antibiotics for dry sockets?

A

not effective beacause biofilm is the problem

49
Q

treatment for osteomyelitis of the jaw?

A

surgical debridement and long term antibiotic therapy

AU2017 Oral Micro Final (10 decks)

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