Lecture 9 - Pulpal, Periapical and Odontogenic Infections

Question 1

What are the damages of inflammation to pulp?

Answer 1

increases intrapulpal pressure
compromises blood flow
tissue damage
pulpal necrosis?

Question 2

T/F
the pulp is an organ enclosed by hard tissue
the roots of a tooth are enclosed by hard tissue

Answer 2

T

F - bone

Question 3

what is the most common cause of pulpal inflammation and necrosis?

Answer 3

bacterial infection

Question 4

What are other causes of pulpal inflammation and necrosis?

Answer 4

direct pulpal exposure
bacterial penetration through dentinal tubules from caries
direct access due to traumatic fracture
travel from bloodstream (anachoresis)

Question 5

What is necessary for pulpal and periapical disease to occur?

Answer 5

bacteria

Question 6

most bacteria cultured from necrotic pulps are _________, usually gram - _________ bacilli

Answer 6

anaerobic

Question 7

which species are associated with periapical abscesses?

Answer 7

prevotella

porphyromonas

Question 8

which species are responsible for foul odor of necrotic pulps?

Answer 8

prevotella

porphyromonas

Question 9

Give an example of a mixed bacterial infection

Answer 9

endodontic infection

Question 10

Which type of bacteria are found coronally?

Answer 10

saccharolytic bacteria (strep, lactobacilli)

Question 11

which type of bacteria are found apically?

Answer 11

proteolytic bacteria (porphyromonas, prevotella, fusobacterium)

Question 12

Describe the pain of pulpitis.

Answer 12

severe, sharp, throbbing pain

Question 13

for periapical lesions, where are bacteria most numerous?

Answer 13

root canal

Question 14

T/F
most periapical lesions are granulomas and dominated by macrophages
periapical lesions are asymptomatic

Answer 14

T

T

Question 15

describe the pain for acute dentoalveolar (periapical) abscess

Answer 15

aching, throbbing pain

Question 16

What can cause relief for someone with acute dentoalveolar (periapical) abscess?

Answer 16

draining pus

Question 17

The purulent bacterial infection that is dentoalveolar (periapical) abscess is confined to bone at:

Answer 17

the apex

Question 18

Give an example of palliative treatment.

Give an example of definitive treatment.

Answer 18

analgesics, local anesthetics, NOT ANTIBIOTICS - they cannot reach source of problem
extraction of tooth, root canal treatment

Question 19

persistent periapical infections after root canal treatment

Answer 19

persistent apical lesions

Question 20

surgical therapy used to clean apex of bacteria and necrotic tissue

Answer 20

endodontic microsurgery = apicoectomy

Question 21

the apex during treatment of persistent apical lesions is sealed with a biocompatible agent like:

Answer 21

mineral trioxide aggregate (MTA)

Question 22

an infections is said to be odontogenic when:

Answer 22

a dental infection spreads to surrounding tissues

Question 23

T/F
lower facial cellulitis is never dental
antibiotics should be used to manage cellulitis

Answer 23

F - almost always dental

T

Question 24

A cellulitis abscess requires which type of treatment?

Answer 24

drainage through surgery

Question 25

Describe the ratio of microbiology of cellulitis

Answer 25

2-3 anaerobes: 1 aerobes

Question 26

what are the two antibiotics of choice for cellulitis?

Answer 26

clindamycin

penicillin

Question 27

name 3 bone infections

Answer 27

alveolar osteitis (dry socket)
osteomyelitis of jaw
antiresorptive agent-induced osteronecrosis of jaw

Question 28

Describe alveolar osteitis and the feeling of it.

Answer 28

swelling, redness, exposed bone

painful, throbbin, aching

Question 29

Symptoms of osteomyelitis

Answer 29

swelling
pain
erythema

Question 30

is osteomyelitis radiolucent or radiopaque?

Answer 30

radiolucent

Question 31

which kind of patients are susceptible to antiresorptive agent-induced osteonecrosis of jaw?

Answer 31

patients who have taken antiresorptive agents

Question 32

Name the 3 antiresorptive agents

Answer 32

bisphosphonates
denosumab
cathepsin K inhibitors

Question 33

what do antiresorptive agents do?

Answer 33

inhibit osteoclasts and bone remodeling

Question 34

T/F

avoid dental extractions in immunocompromised patients that have used bisphosphonates

Answer 34

T