microbiology of pulp and periodical diseaase

Question 1

periapical abcess

Answer 1

abscess at the apex of the tooth

Question 2

cellulitis

Answer 2

spreading of infection into surroduing tissues

Question 3

routes of entry to the pulp

Answer 3

carious dentine
subigingival plaque bactiera
tooth facture/mechanical exposure
anachoresis (diseased tissue attracts bacteria present in bacteraemia)

Question 4

invasion of dentinal tubules

Answer 4

• can travel through a hole in dentine into the tubules
• can travel though cracks in the dentine
• can enter through restorations
• can also enter via periodontal attachment loss
• can also come in from a root canal infection, entering the pulp from the apex and radiating outwards

Question 5

generalised bacteria found in pulpal infection

Answer 5

anaeobic

Question 6

which bacteria is commonly found in failing endodontics

Answer 6

enterococcus faecalis

Question 7

routes of spread of infection from the apex

Answer 7

1) Maxillary sinus
2) into adjacent fascial spaces
3) into superficial soft tissue (localised abscess) or through overlying oral mucosa/skin producing a sinus (linking abscess to mouth/skin, or through soft tissue causing cellulitis)
4) into alveolar bone (causes osteomyelitis)
5) into OC
6) into nasal passage

Question 8

pathogenic factors

Answer 8

p gingival releases enzymes (proteases or gingipains)

other anaerobes have metabolic by products or bacterial structures (capsules, peptidoglycan, endotoxin,fimbriae