March 17- Inflammatory Lesions of the Jaw- FINAL

Question 1

What is the most common pathologic condition of the jaw?

Answer 1

Inflammatory Lesions

Question 2

What is the initial source of inflammation?

Answer 2

Necrotic Pulp

(in the lecture she said that “inflammation can be caused from lesions, pulp damage and trauma” but necrotic pulp is listed as the source of inflammation in the notes)

Question 3

What is wrong here?

Answer 3

Internal Resorption

Question 4

What is luxation and avulsion?

Answer 4

Luxation: partial displacement of the tooth due to trauma (intrusion means the tooth looks shorter because it has been displaced inward. Extrusion means the tooth looks longer because it has been partially pulled out).

Avulsion: complete displacement of the tooth due to trauma.

Question 5

Describe internal resorption and what can cause it?

Answer 5

§ Crown or root

§ Round-to-ovoid radiolucency

§ Asymptomatic

§ Involves pulp chamber, canals and dentin

Cuases: Trauma, Pulp capping, Pulp polyps

Question 6

What is Wrong here?

Answer 6

Ortho-related Resorption

(the roots have shrunk!)

Question 7

What is Wrong here?

Answer 7

External Resorption

Question 8

Describe External Resorption and what causes it?

Answer 8

It is the resorbing of the actual external root (the apex of the root looks cut off) - confusing in the notes so I am guessing here.

Lamina Dura and bone are abnormal. It cannot be detected clinically and you do not provide treatment.

Causes: Abnormal forces, Trauma, Chronic infl., Cysts, Impacted teeth

Question 9

What is wrong with the pulp in these teeth?

Answer 9

Pulpal Sclerosis

(Diffuse calcification associated with aginng)

Question 10

What is wrong with the pulp in this tooth?

Answer 10

Pulpal Stone

Question 11

What is wrong with the teeth here and how doe sit happen?

Answer 11

Pulpal Obliteration

1. Irritation of the pulp 2. Stimulaon of secondary dentin 3. Obliteration of the pulp cavity 4. Tooth is Non vital (No treatment)

Question 12

Name 4 causes fro inflammatroy lesions of the Jaw.

Answer 12

Periapical Lesions

Osteomyelitis

Osteoradionecrosis

Bisphosphonate related jaw necrosis

Question 13

Name the cardinal signs of Inflammation

Answer 13

Pain

Redness

Swelling

Heat

Loss of function

Question 14

Define Rarefraction and Sclerosis

Answer 14

Rarefraction: condition of being less dense

Sclerosis: diffuse increase in density, increase “radiopacity” of a tissue

Question 15

Rarefying Osteitis refers to 3 histopathological entities:

Answer 15

1. Radicular abscess
2. Radicular granuloma
3. Radicular Cyst

(impossible to differentiat radiographically)

Question 16

Define Sclerosing/Condensing Oteitis

Answer 16

localized inflammatory response of bone to pulpal necrosis or periodontal disease - radiopaque lesion (mineral content) - radiographic images is not a good judge - earliest evidence of pulpal necrosis… In dental images… increase of the PLS width

Question 17

What is worng with the bone here?

Answer 17

Rarifying Osteitis

Condensing osteitis

Furcation Involvement

Question 18

What is worng with the bone here?

Answer 18

Rarifying Osteitis

Question 19

What is wrong with the bone here

Answer 19

Rarifying osteitis

Huge condensing osteitis

Question 20

What is the most common pathologic condition of the jaw? Describe it.

Answer 20

Periapical inflammatory lesions

Teeth are direct pathway. Bone invasion from from caries and periodontal disease. Around apex of the root. Radiolucent or Radiopaque. Can’t be evaluated on a clinical basis… Initial source of the lesion is the necrotic pulp

Question 21

What is the difference between chronic and acute periapical lesions?

Answer 21

Acute usually have no radiographic findings while chronic lesions do in the form of granulomas, cysts, abcess and bone changes.

Question 22

What are the different changes that can occur in inflammation of the Jaw?

Answer 22

• Removal of bone mineral content (rarefration)
• Deposition of bone mineral content (sclerosis)
• Enlargement of bone
• Resoption of tooth roots
• Deposition of cementum (hypercementosis)

Question 23

What is the radioluscency here?

Answer 23

Radicular Cyst

Question 24

What are combined Perio-Endo lesions and what do they always present with radiographically?

Answer 24

Periodontal lesions > inflammatory lesion in bone Extension into bone from the overlying sot tissues

+

Periapical lesions > necrotic pulp (caries/trauma)

Always present with rarifying osteitis

Question 25

What kind of Lesion is this?

Answer 25

Perio - Endo Lesion

Question 26

Describe a Periapical Abscess

Answer 26

Localized collection of pus

Acute = pain (intense, throbbing constant)

Chronic = long-standing, long-grade, pus-producing process… can produce a fistula

Question 27

What is Pericoronitis?

Answer 27

Pericoronitis: Inflammation disorder affecting tissues surrounding the crown of a partially erupted tooth

Question 28

What is wrong here?

Answer 28

Sclerosing Osteitis

Question 29

What is wrong here?

Answer 29

Osteosclerosis

(Note: not sclerosing osteitis! The teeth look vital without caries. There are continuous borders to the radiopacity and there is no radioluscent outline. Therefore the lesion is not linked to the tooth)

Question 30

What is wrong here?

Answer 30

Osteosclerosis

(Note: not sclerosing osteitis! The teeth look vital without caries. There are continuous borders to the radiopacity and there is no radioluscent outline. Therefore the lesion is not linked to the tooth)

Question 31

Describe a Granuloma

Answer 31

Radulscent

Ruptured Lamina dura

Chronic

Can be Asymptomatic

Previous sensibility to heat and cold

Evolution to cyst or abscess

Widened of periodontal space

Lamina dura not visible

Question 32

What is happening here?

Answer 32

Hypercementosis

(note that there is increased thickness on the INSIDE of the PDL space)

Question 33

What is this?

Answer 33

Loculus of Maxillary sinus (normal anatomy)

Question 34

What is the unlabelled arrow?

Answer 34

Nasopalatine Foramen (normal anatomy)

Question 35

What is this?

Answer 35

Mental Foramen

(radioluscency in between mandibular premolars)

Question 36

Describe Condensing Osteitis

Answer 36

• Well-defined
• Long-standing pulpitis
• Low-grade infl./mild irritation
• Most common radiopacity
• Physiologic reaction to infl.
• No treatment in the area
• Will have widening of PDL space and lamina dura

Question 37

What is this?

Answer 37

Lateral Periodontal Cyst

(longstanding so has cortical bone barriers)

Question 38

What is this due to?

Answer 38

Malignancy

Question 39

What is the difference between osteitis and osteomyelitis?

Answer 39

“osteitis” – inflammation of bone

“osteomyelitis” – infection of the substance of bone by pyogenic organisms

More on osteomyelitis: - Is when the infection spreads in the bone marrow and is no longer contained to the vicinity of the tooth root apex. - Generalized inflammatory response of bone that may involve cortical and cancellous bone, bone marrow and the periosteum. - May arise from: odontogenic inf.; infected fractures; hematogenous spread of infection (distant site).

Question 40

Describe radiograpbhic and clinical findings of osteomyelitis

Answer 40

Radiographically no changes from pre-exosting periapical lesion

Clincially: Purulent drainage, war, skin, fever

Question 41

Describe radiographic findings in osteomyelitis

Answer 41

Relatively localized chronic osteomyelitis - persistence of outline of socket, sclerosis of adjacent bone, small sequestrum near bottom of original socket

Question 42

What is wrong here?

Answer 42

Osteomyelitis

(bone sequestration and less bone density on the left)

Question 43

What is wrong with the left mandible

Answer 43

Chronic OSteomyelitis

Question 45

How does osteoradionecrosis and bisphophate related ostenecrosis differ from osteomyelitis radiographically?

Answer 45

They dont really. Need history.

Question 46

What made this grown man cry?

Answer 46

Oral Candida

Question 47

What is a “poop canal”?

Answer 47

Google Image result of Poop Canal: