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5th yr- Finals- CSB revision > Periapical pathology > Flashcards

Periapical pathology Flashcards

1
Q

What are the periapical tissues made up of

A
  1. The root of the tooth
  2. The periodontal ligament space
  3. The lamina dura
  4. The alveolar bone
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2
Q

How is the Periodontal ligament seen on a radiograph

A

Seen as a radiolucent line surrounding the roots of the teeth

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3
Q

Is the periodontal ligament a hard or soft tissue

A

Soft there fore appears as a radiolucent line

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4
Q

How is the lamina dura represented on a radiograph

A

Seen as a radio opaque line next to the periodontal space

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5
Q

Why does the lamina dura appear as an opaque line on a radiograph

A

As it is made up of dense bone

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6
Q

Describe how the periodontal ligament space wold look on a radiograph of a healthy tooth

A

It would be even surrounding the entire tooth surface

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7
Q

Which two characteristic so we common on when describing bone

A
  1. The trabecular pattern
  2. Density of bone
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8
Q

Describe the bone found in the mandible

A

Trabecular is thick and horizontally aligned

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9
Q

Describe the bone found in the maxilla

A

Trabeculae are finer and there’s no predominant pattern

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10
Q

Describe the periapical tissues of deciduous teeth

A
  1. Circumscribed area of radiolucency at the apex
  2. Theres a radio-opaque line of the Lamina dura that is intact around the radicular papilla
  3. The developing root is funnel shape
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11
Q

What is one of the big problem when assessing periapical pathology on a radiograph

A

Super imposed shadows may be visible that can be radiolucent or radio-opaque

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12
Q

Give examples of some radiolucent shadows that may be present on a periapical radiographs

A
  1. Maxillary antrum
  2. Nasopalatine foramen
  3. Mental foramina
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13
Q

What problems can the maxillary antrum present on a radiograph?

A

The floor of the antrum is a radio opaque line that can obstruct the view of the apices of the UL6 and UL7

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14
Q

What can hinder the evaluation of the apices of the upper anterior teeth on a radiograph

A

The soft tissue shadow of the nose

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15
Q

How does the soft tissue shadow of the nose appear on a radiograph

A

Appears as a curved radio density over the apices of the upper anterior teeth

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16
Q

What can obscure the apices of the upper pre molars on radiographs

A

The zygomatic buttress

17
Q

How does the zygomatic buttress appears a radiograph

A

As a radio opaque hockey shaped line in the posterior region the maxilla

18
Q

What can obscure for apicies of the lower teeth

A

The mental foramen

19
Q

How is the mental foramen represented on a radiograph?

A

It is super imposed on the lower fives

20
Q

List the 5 cardinal signs of inflammation following pulpal necrosis

A
  1. Swelling
  2. Pain
  3. Loss of function
  4. Heat
  5. Redness
21
Q

Why does swelling occur after pulpal necrosis

A

Due to accumulation of inflammatory exudate in the apical pDL

22
Q

What is the type of inflammatory repose at the apex dependent on

A
  1. The infecting organisms including its virulence
  2. The body defence system
23
Q

Describe the radiographic presentation of initial acute inflammation

A

PDL may widen or there be no apparent change

24
Q

Describe the radiographic presentation when inflammation begins to spread

A

Loss of radio opaque line of the lamina dura at the apex

25
Q

Describe the radiographic presentation of further spread of inflammation

A

Area of bone loss seen at the tooth apex
presence of rarefying osteitis

26
Q

What does rarefying osteitis mean

A

Rarefying= radiolucent
Osteitis= Inflammation of bone
Radiolucent inflammation of bone

27
Q

Describe the radiographic presentation of initial low grade chronic inflammation

A

No apparent bone destruction but dense sclerotic bone can be seen around the apex called sclerosing osteitis

28
Q

Name the 2 types of inflammatory peripiacl pathology

A
  1. Osteolytic
  2. Osteosclerotic
29
Q

What does osteolytic mean

A

Bone has been bone at the apex of the root

30
Q

What does Osteosclerotic means?

A

Bone is laid down at the apex of the root instead of being lost

31
Q

Describe the radiographic presentation of later stages of chronic inflammation

A

Circumscribed well defined radiolucent areas of bone loss are seen at the apex surrounded by sclerotic dense bone

32
Q

What happens in later stages of chronic inflammation

A

Apical bone is resorbed and destroyed an dose bone is laid down around the area of destruction
periapical granuloma or radicular cysts can also develop

33
Q

Other than bone loss and healing what are some other inflammatory changes that can be seen on a radiograph

A
  1. Pupal sclerosis
  2. External root resorption
  3. Internal root resorption
34
Q

What plural sclerosis?

A

Obliteration of the root canal

35
Q

Other than inflammation what else can cause periapical radiolucencies and radio densities

A
  1. Benign and malignant bone tumours including metatases
  2. Lymphoreticular tumours of bone
  3. Osseous dysplasia
  4. Hypercementosis
36
Q

Give some signs of concern when looking at localised areas of infection

A
  1. Spiking resorption and an irregular radiolucency with a poorly defined border
  2. Tooth mobility in the absence of periodontal disease
  3. Altered sensation or anaesthesia
  4. Signs and symptoms in the presence of good Endodontic treatment
37
Q

What type of radiographs do you need before carrying our Endodontic treatment

A
  1. A good quality preoperative paralleling periapical
  2. One good quality paralleling periapical to determine the working length
  3. A midfll radiograph if you are in doubt about the integrity of the apical constriction
38
Q

What type of radiographs do you need after carrying out Endodontic treatment

A

At least one good quality postoperative radiograph to assesses success of the obturation
A Periapical radiograph one year post treatment

39
Q

What may you still be able to see on a radiographic even if your Endodontics treatment was successful and why

A

May still be able to see periapical radiolucency because:
- Healing may have occurred with fibrous tissue which may leave residual radiolucency
2. Surgical defect can increase radiolucency initially

5th yr- Finals- CSB revision (17 decks)

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