Lecture 9 - Pulpal, Periapical and Odontogenic Infections Flashcards
What are the damages of inflammation to pulp?
increases intrapulpal pressure
compromises blood flow
tissue damage
pulpal necrosis?
T/F
the pulp is an organ enclosed by hard tissue
the roots of a tooth are enclosed by hard tissue
T
F - bone
what is the most common cause of pulpal inflammation and necrosis?
bacterial infection
What are other causes of pulpal inflammation and necrosis?
direct pulpal exposure
bacterial penetration through dentinal tubules from caries
direct access due to traumatic fracture
travel from bloodstream (anachoresis)
What is necessary for pulpal and periapical disease to occur?
bacteria
most bacteria cultured from necrotic pulps are _________, usually gram - _________ bacilli
anaerobic
which species are associated with periapical abscesses?
prevotella
porphyromonas
which species are responsible for foul odor of necrotic pulps?
prevotella
porphyromonas
Give an example of a mixed bacterial infection
endodontic infection
Which type of bacteria are found coronally?
saccharolytic bacteria (strep, lactobacilli)
which type of bacteria are found apically?
proteolytic bacteria (porphyromonas, prevotella, fusobacterium)
Describe the pain of pulpitis.
severe, sharp, throbbing pain
for periapical lesions, where are bacteria most numerous?
root canal
T/F
most periapical lesions are granulomas and dominated by macrophages
periapical lesions are asymptomatic
T
T
describe the pain for acute dentoalveolar (periapical) abscess
aching, throbbing pain
What can cause relief for someone with acute dentoalveolar (periapical) abscess?
draining pus
The purulent bacterial infection that is dentoalveolar (periapical) abscess is confined to bone at:
the apex
Give an example of palliative treatment.
Give an example of definitive treatment.
analgesics, local anesthetics, NOT ANTIBIOTICS - they cannot reach source of problem
extraction of tooth, root canal treatment
persistent periapical infections after root canal treatment
persistent apical lesions
surgical therapy used to clean apex of bacteria and necrotic tissue
endodontic microsurgery = apicoectomy
the apex during treatment of persistent apical lesions is sealed with a biocompatible agent like:
mineral trioxide aggregate (MTA)
an infections is said to be odontogenic when:
a dental infection spreads to surrounding tissues
T/F
lower facial cellulitis is never dental
antibiotics should be used to manage cellulitis
F - almost always dental
T
A cellulitis abscess requires which type of treatment?
drainage through surgery
Describe the ratio of microbiology of cellulitis
2-3 anaerobes: 1 aerobes
what are the two antibiotics of choice for cellulitis?
clindamycin
penicillin
name 3 bone infections
alveolar osteitis (dry socket)
osteomyelitis of jaw
antiresorptive agent-induced osteronecrosis of jaw
Describe alveolar osteitis and the feeling of it.
swelling, redness, exposed bone
painful, throbbin, aching
Symptoms of osteomyelitis
swelling
pain
erythema
is osteomyelitis radiolucent or radiopaque?
radiolucent
which kind of patients are susceptible to antiresorptive agent-induced osteonecrosis of jaw?
patients who have taken antiresorptive agents
Name the 3 antiresorptive agents
bisphosphonates
denosumab
cathepsin K inhibitors
what do antiresorptive agents do?
inhibit osteoclasts and bone remodeling
T/F
avoid dental extractions in immunocompromised patients that have used bisphosphonates
T
