Periapical Inflammatory Pathology Flashcards
what is Periapical inflammatory pathology
what is radiography important for
describe normal periapicl tissue what does the black and white line represent
describe other 3 features of normal periapical tissues
Describe periapical tissues of developing teeth
Describe types of radiolucent shadows found on radiographs
Describe types of radiopaque shadows found on radiographs
what is this feature
Maxillary antrum
what is this feature
soft tissue shadow of the nose
what is this feature
zygomatic buttress
what is this feature
mental foramen
what is this feature
submandibular fossa
describe obvious causes of periapical inflammation
describe accompany history of clinical signs of inflammation
Describe the sequelae of inflammation and responses of apex
what does the inflammatory response in periapilc pathology cause
is it possible to differentiate between an abscess , granuloma or cyst?
no
describe this radiograph in detail
Describe radiographic appearance fo acute inflammatory reactions
What does the initial spread of inflammation lead to
what does further spread of inflammation lead to
What does presence of pus diagnosis indicate
Raging toothache - might not be enough bone resorption
describe radiographic appearance of chronic inflammatory reactions
Describe granulomas and radicular cysts
where does granulation tissue form
site of bone resorption
how can you differentiate between granuloma and radicular cysts
Is this a granuloma or radicular cyst
Periapical granuloma
<1cm
Well defined
Is this a granuloma or radicular cyst
Nice and rounded
Non corticated
Represent cyst
Describe this radiograph
Symmetry
Where the radicular cysts
Large radiolucency
Corticated
Inferior alveolar canal poorly defined
Lesion may go through it
Describe sclerosing osteitis
describe the radiographic appearance of slcerosing osteitis
Describe endo period lesions
when can endo period lesions arise
what are the common radiographic appearance of endo perio lesions
how can inflammatory pathology manifest
Describe the double dense shadows and what they could mean on a radiograph
what does external inflammatory root resorption look like
Describe osteomyelitis
Describe the radiographic appearance of periapicla inflammatory pathology
Describe radiographic appearance post intervention
What are other common causes of periapical radiolucencies and radiopacitites
What is hypercementosis
Cloud like
Fluffy
Fluroide amounts of hypercementosis
Roots are bulbous
Describe periapicla cemento osseous dysplasia
Anterior mandible region
Benign condition
Irregular bone forming in this
Ill defined radiolucency
Vitality testing teeth
what is dense bone island
Pdl is preserved
Lower first molar region
Extend form cortex
Should not see irregular absorption
what are potential signs of concern that malignancy can mimic a localised area of infection
what does this radiograph show
Squamous cell carcinoma - ireggualrity with floating teeth
Endo perio lesion
What is periapical inflammatory pathology?
Periapical inflammatory pathology refers to lesions that form around the apex of a tooth due to inflammation, typically caused by bacterial infection following pulp necrosis.
How do radiographs help in diagnosing periapical inflammatory pathology?
Radiographs are used to visualize the bone changes, such as radiolucencies or radiopacities, around the root. These can indicate bone resorption, sclerosis, or granulation tissue.
What are the normal radiographic features of periapical tissues?
Normal periapical tissues show a uniform, narrow PDL space, a continuous lamina dura, and trabecular bone patterns that vary between the mandible (thicker, horizontal trabeculae) and the maxilla (finer trabeculae).
What is the radiographic appearance of a developing tooth?
A developing tooth appears as a circumscribed radiolucency at the apex, with an intact lamina dura and a funnel-shaped developing root.
What is superimposition in radiographs?
Superimposition refers to the overlap of structures on a 2D radiograph, making it difficult to discern apical pathology. It can occur with normal structures like the maxillary antrum or zygomatic buttress.
What are common radiolucent shadows in periapical radiographs?
Common radiolucent shadows include the maxillary antrum, nasopalatine foramen, and mental foramina. These structures can sometimes obscure periapical pathology.
What are radiopaque shadows in periapical radiographs?
Radiopaque shadows in periapical radiographs often come from the mylohyoid ridge, external oblique ridge, and zygomatic buttress, which can obscure apical pathology.
What are the most common causes of periapical inflammatory pathology?
The most common causes include caries, trauma, deep restorations, poorly placed root fillings, and periodontal bone loss.
What are the symptoms of periapical inflammatory pathology?
Symptoms often include pain, redness, swelling, and loss of function, but many lesions are asymptomatic and discovered incidentally.
What are the possible sequelae of periapical inflammation?
Acute inflammation can progress to a periapical abscess, granuloma, or cyst. Chronic inflammation may result in bone resorption and formation, as well as granulation tissue development.
How does a periapical abscess appear on a radiograph?
A periapical abscess may not show changes immediately (it takes about 7-10 days), but it may result in minimal radiographic changes even with severe symptoms.
What is a periapical granuloma?
A periapical granuloma is a lesion that forms due to granulation tissue around a resorption site. Radiographically, it appears as a well-defined radiolucency at the apex.
What is a radicular cyst, and how does it appear radiographically?
A radicular cyst is a lesion that forms from epithelial proliferation in a granuloma. Radiographically, it appears as a well-defined radiolucency with a round or oval shape, often larger than 1.5 cm in diameter.
What is sclerosing osteitis?
Sclerosing osteitis is a low-grade chronic inflammation that results in dense bone formation around a tooth, often associated with a non-vital lower molar. It appears as a radiopaque mass around the affected tooth.
What is an endo-perio lesion?
An endo-perio lesion involves both the pulp and periodontal tissues, often seen with a widened PDL and periodontal defects extending apically.
What causes double dense shadows in radiographs?
Double dense shadows can occur after periradicular surgery, like an apicoectomy, and reflect perforation of the cortical bone, resulting in bone loss.
What is external inflammatory root resorption?
External inflammatory root resorption occurs when the root surface is resorbed due to inflammation, appearing as an irregular root outline or a blunted apex on radiographs.
What is osteomyelitis?
Osteomyelitis is an infectious inflammation of bone and marrow, which can result from apical pathology or trauma. Radiographically, it appears as a moth-eaten, lytic bone pattern with bone sequestra
How can post-intervention radiographs appear after endodontic treatment?
Post-intervention radiographs may show persistent radiolucency due to healing with fibrous tissue, which may leave a residual radiolucency around the treated tooth.
What are common causes of periapical radiolucencies besides pathology?
Common causes of periapical radiolucencies include normal anatomical structures, artifacts, superimposition, benign conditions like cemento-osseous dysplasia, hypercementosis, and dense bone islands.
What is hypercementosis?
Hypercementosis is the excessive deposition of cementum on the root surface, often causing a bulbous or club-shaped root. It can appear as a radiopaque “halo” around the root.
What is periapical cemento-osseous dysplasia (PCOD)?
PCOD is a benign, self-limiting fibro-osseous lesion usually found in the anterior mandible. Radiographically, it appears as an irregular bone formation with a mix of radiolucent and radiopaque areas. The affected teeth remain vital.
What is a dense bone island?
A dense bone island is a localized area of increased bone density, often found in the mandible, typically around the lower first molar. Radiographically, it appears as a well-defined radiopaque area with no associated inflammation.
