Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CSB > Periapical inflammatory pathology > Flashcards

Periapical inflammatory pathology Flashcards

1
Q

What 3 things must be completed before a radiographic examination

A

History
Examination
Review of prior imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What 2 things are present on a radiograph with normal periapical tissues

A

Radiolucent (black) line of PDL space that is even width around the tooth
Radioopaque (white) line of lamina dura that is continuous around root

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the trabecular bone density and pattern in the mandible

A

Thick bone density
Horizontally aligned

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the trabecular bone density and pattern in the maxilla

A

Finer bone density
No predominant pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What 3 things are present on a radiograph of periapical tissues of developing teeth

A

The apical papilla- circumscribed area of radiolucency at the apex
Radioopaque line of the lamina dura is intact
Funnel shaped developing root

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do plain radiographs show

A

2D imagine of complex 3D structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe superimposition in dental radiographs

A

Normal anatomical structures superimposed to the apical tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of imaging does superimposition occur on

A

Intro oral and extra oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does superimposed images appear as

A

Radiolucent or radioopaque shadows

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why is superimposition an issue in periapical radiographs

A

Can mimic or obscure apical pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Name 6 places where superimposition causes radiolucent shadows

A

Maxillary antrum
Nasopalatine foramen
Mental foramina
Oral air space
Mental fossa
Submandibular foss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What effect do radiolucent shadows have on the PDL

A

PDL may appear more radiolucent or widened but will still be continuous and well defined

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What effect do radiolucent shadows have on the lamina dura

A

Lamina dura may appear less obvious or not visible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What effect do radiolucent shadows have on the alveolar bone

A

Radiolucency in the alveolar bone at the tooth apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name 4 places where superimposition causes radioopaque shadows

A

Mylohyoid ridge
External oblique ridge
Zygomatic buttress
Soft tissues of the nose/lip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What effect can radioopaque shadows have on apical tissues

A

May obscure them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is periapical inflammatory pathology

A

Lesions that form around the apex of a tooth in response to inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What causes periapical inflammatory pathology

A

Usually caused by bacterial invasion of the root canal system and pulp necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe how periapical inflammation occurs

A
  1. Bacterial ingress via caries, cracks, etc
  2. Becomes reversible pulpitis, then irreversible pulpitis, then pulp necrosis, then root canal system becomes infected
  3. Bacterial and necrotic pulpal products leak out apical foramen
  4. Periapical periodontitis occurs to confine infection/bacterial egress
  5. Results in bone resorption, formation of granulation tissue (cysts may also occur) resulting in a radiolucency
  6. Note- Bone formation can also occur (or combination of resorption and formation), may result in corticated margin and/or general sclerosis of adjacent bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the 5 signs of inflammation

A

Swelling
Pain
Heat
Redness
Loss of function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What happens in the apical tissues after pulpal necrosis/bacterial ingress

A

An inflammatory exudate accumulates in the apical tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What type of inflammatory response at the apex of the tooth is dependent on what 2 things

A

The infecting organism and its virulence
Host response/defence mechanisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Certain features of periapical inflammatory pathology are more common in what 2 types of inflammation

A

Acute
Chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

In a PA radiograph, you cannot differentiate between what 3 things

A

Abscess
Granuloma
Cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What happens in initial acute inflammation

A

Inflammatory exudate accumulates in the apical PDL. This is acute apical periodontitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What happens radiographically in initial acute inflammation

A

No change
Widening of the apical PDL space
Lamina dura intact or partially visible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What happens in the initial spread of inflammation

A

resorption and destruction of the apical bony socket

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What happens radiographically in the initial spread of inflammation

A

Loss of apical lamina dura
Periapical radiolucency

29
Q

What does the appearance of an abscess radiographically depend on

A

course of disease, treatment received

30
Q

How long does it take for radiographic appearances of an abscess to catch up with the symptoms

A

approx 10 days

31
Q

Radiographically what may you see with an abscess

A

Ill defined radiolucency described as rarefying osteitis

32
Q

What happens with further spread of inflammation

A

further spread an destruction of the apical alveolar bone

33
Q

What can you see radiographically with further spread of inflammation

A

further bone loss at the tooth apex (increased size, more radiolucent)

34
Q

What does rarefying osteitis mean

A

Rarefying= radiolucency
Osteitis= inflammation of bone

35
Q

What happens with initial low-grade chronic inflammation

A

minimal destruction of the apical bone
Dense bone laid down in apical region

36
Q

Radiographically, what can you see with initial low grade chronic inflammation

A

dense sclerotic radioopaque bone around the apex, often with varying degrees of apical ligament space widening or radiolucency
Sclerosing osteitis

37
Q

What is sclerosis osteitis known as

A

Condensing osteitis
Focal sclerosing osteitis

38
Q

What are the symptoms of sclerosing osteitis

A

Often symptomless

39
Q

Where is sclerosing osteitis often evident around

A

roots of lower first molars

40
Q

What can you see radiographically with sclerosing osteitis

A

May be no radiolucent component
May be halo of sclerosing osteitis surrounding an area of rarefying osteitis

41
Q

What happens in the later stages of chronic inflammation

A

apical bone is resorted and dense bone is laid down around the area of destruction

42
Q

Name 2 histological diagnoses

A

Periapical granuloma
Radicular cyst

43
Q

What can you see radiographically with Later stages of chronic inflammation

A

Circumscribed, well defined radiolucent area of bone loss at the apex surrounded by sclerotic dense bone, may be corticated

44
Q

What’s similar about apical granulomas and radicular cysts

A

Both largely asymptomatic unless secondarily infected
Well defined and can be corticated or uncorticated depending on chronicity

45
Q

What is the diameter of 2/3 granulomas

A

Less than 1cm

46
Q

What does it mean if a granuloma is 1-1.5cm in diameter

A

The granuloma is a cyst

47
Q

What is the diameter of 2/3 cysts

A

More than 1.5cm

48
Q

What are endo-perio lesions

A

lesions that involve both the pulp and periodontal tissues

49
Q

What were endo-perio lesions previously known as

A

Perio-endo lesions or combined lesions

50
Q

What are the 2 main types of endo-perio lesions

A

Endo-periodontal lesion with root damage
Endo-periodontal lesions without root damage

51
Q

What are the 3 types of endo-periodontal lesions with root damage

A

root fracture or cracking
Root canal or pulp chamber perforation
External root resorption

52
Q

What are the 2 types of endo-periodontal lesions without root damage

A

endo-periodontal lesion in periodontitis patients
endo-periodontal lesion in non-periodontitis patients

53
Q

what are the 3 grades of endo-periodontal lesions in periodontitis patients

A

Grade 1- narrow deep periodontal pocket in 1 tooth surface
Grade 2- wide deep periodontal pocket in 1 tooth surface
Grade 3- deep periodontal pockets in more than 1 tooth surface

54
Q

what are the 3 grades of endo-periodontal lesions in non-periodontitis patients

A

Grade 1- narrow deep periodontal pocket in 1 tooth surface
Grade 2- wide deep periodontal pocket in 1 tooth surface
Grade 3- deep periodontal pockets in more than 1 tooth surface

55
Q

What is the common radiographic appearance of endo-perio lesions

A

Signs of apical pathology with a wide periodontal ligament space or communicating periodoctal defect

56
Q

How does most inflammatory pathology manifest
However…

A

Apically
However it can manifest anywhere along the root surface

57
Q

Why can inflammatory pathology manifest along the root surface

A

Due to the presence of
Normal anatomy- lateral and frugal canals
Iatrogenic- perforation
Pathologic- perforations, cracks, fractures

58
Q

What may double dense shadows be related to

A

clinically apparent chronic sinus

59
Q

When can double dense shadows also be seen

A

following peri-radiculat surgery i.e. apicectomy

60
Q

In double dense shadows, imaging appearance reflects what

A

Perforation of the vortices and degree of bone loss which is present

61
Q

Radiographically what can you see with external root resorption

A

root may look irregular in outline or have a blunted apex

62
Q

What is osteomyelitis

A

Infectious inflammation of bone and bone marrow

63
Q

What are the 4 causes of osteomyelitis

A

Apical pathology
Surgery
Trauma
Idiopathic

64
Q

What are the 5 variable clinical and imaging features of osteomyelitis

A

Indolent to aggressive
Sclerosis
Lyric/moth eaten appearance
Bony sequestra
Periostea’s bone formation

65
Q

Describe the radiographic appearance of periapical inflammatory pathology

A

No change
Widening of apical PDL (well defined, corticated)
Chronic-may see scleorsing osteitis, external root resorption

66
Q

Describe the radiographic appearance post endodontic treatment even if satisfactory

A

Healing with fibrous tissue may leave residual radiolucency
Radiolucency may initially increase in size following apical surgery

67
Q

Name 3 other common causes of periapical radiolucencies and radioopacities

A

Normal anatomy, artefact, superimposition
Benign (cemento-ossesous dysplasia, hypercementosis, dense bone islands)
Benign and malignant tumours including metastases

68
Q

What can malignancy mimic

A

A localised area of infection

69
Q

List 5 potential signs of concern

A

Spiking restoration and an irregular radiolucency with a portly defined border
Tooth mobility in the absence of periodontal disease or floating teeth
Hair on end/sunburst appearance
Alternated sensation or anaesthesia
No improvement despite treatment

CSB (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions