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Endodontics 2020 > Periapical pathology Test #2 > Flashcards

Periapical pathology Test #2 Flashcards

1
Q

What changes occur in the periapical tissues as a consequence of pulpal necrosis?

A

-Pathological

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2
Q

The interaction between the pulpal irritants and the host defense results in what?

A

-Activation of an extensive array of reactions to protect the host

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3
Q

What does resorption prevent in periapical pathology?

A

-Osteomyelitis

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4
Q

The reactions in periapical pathology are complex and usually mediated by what?

A
  • Nonspecific mediators of inflammation

- Specific immune reactions

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5
Q

What are some inflammatory mediators?

A
  • Vasodilation
  • Increase vascular permeability
  • Recruit inflammatory cells from blood ciruclation
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6
Q

What does SAP stand for?

A

-Symptomatic apical periodontitis

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7
Q

What does AAP stand for?

A

-Asymptomatic apical periodontitis

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8
Q

What does AAA stand for?

A

-Acute apical abcess

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9
Q

What does CAA stand for?

A

-Chronic apical abcess

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10
Q

In SAP the first extension of pulpal inflammation goes where?

A

-Periradicular tissues

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11
Q

What are the irritants that cause SAP?

A
  • Inflammatory mediators from irreversible pulpitis
  • Bacterial toxins from necrotic pulp
  • Chemicals
  • Hyperocclusion
  • Overistrumentation
  • Overextension of obturation material
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12
Q

What is liquefactive necrosis?

A

Pus

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13
Q

What are the signs and symptoms of SAP?

A
  • Spontaneous pain
  • Acute pain to biting or percussion
  • Hot, cold or electric sensitivity
  • May or may not respond to pulp vitality tests
  • May or may not have PA radiolucency
  • Widened (thickened) PDL
  • PMNs/macrophages
  • Liquefaction necrosis
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14
Q

What is the treatment for SAP that is vital?

A
  • Remove irritant (reduce occlusion, time)

- RCT

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15
Q

What is the treatment for necrotic SAP?

A

-RCT

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16
Q

What causes AAP?

A

-Pulpal necrosis

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17
Q

What is AAP a sequel to?

A

-SAP

18
Q

Is AAP chronic or acute?

A

-Chronic

19
Q

T/F AAP is generally asymptomatic

A

True

20
Q

What are the signs and symptoms of AAP?

A
  • Little or no pain
  • No response to pulp vitality tests
  • Slightly sensitive to palpations
  • Widened PDL to extensive lesion
  • Granuloma
  • Apical cyst
21
Q

What is an apical cyst?

A

-Stratified squamous epithelium surrounded by CT containing all cellular components found in granuloma

22
Q

What do you see in a granuloma?

A
  • PMNs
  • Mast cells
  • Macrophages
  • No epithelium
23
Q

What percent of AAP signs are granulomas?

A

-59%

24
Q

What percent of AAP signs are cysts?

A

-22%

25
Q

What signs of AAP are scars?

A

12%

26
Q

What is the treatment of AAP?

A

-Remove cause by RCT or extraction

27
Q

What is a variant of AAP?

A

-Condensing osteitis

28
Q

What type of bone do you get an increase of in condensing osteitis?

A

-Trabecular bone

29
Q

T/F Condensing osteitis usually goes away following RCT

A

True

30
Q

What causes AAA?

A

-Localized or diffuse liquefaction lesion of pulpal origin

31
Q

What does AAA destroy?

A

-Periapical tissues

32
Q

What type of pulp do you see with AAA?

A

-Necrotic

33
Q

What is an abscess within a granuloma associated with?

A

AAA

34
Q

What are the signs and symptoms of AAA?

A
  • Rapid onset of acute spontaneous pain to percussion, biting, and palpation
  • Moderate to sever discomfort and swelling
  • Pus
  • Surrounding the abscess is granulomatous tissue
  • Lymphadenophy
  • Periapical radiolucency
  • No response to pulp vitality tests
  • Varying degree of mobility
  • Frequently febrile
35
Q

What is the treatment of AAA?

A
  • RCT eventually’

- Possible incision and drainage

36
Q

What is the cause if CAA?

A

-Inflammatory lesion of pulpal origin

37
Q

What do you see in the histology of CAA?

A

-Same as AAA

38
Q

What are the signs and symptoms of CAA?

A
  • Generally asymptomatic
  • Not sensitive to biting
  • May feel different to percussion
  • No response to pulp vitality tests
  • Apical radiolucency
  • Mucosal or facial sinus tract (they will have some kind of intra or extra oral draining sinus tract)
39
Q

What periapical pathology will have some kind of intra or extra oral draining sinus tract?

A

-CAA

40
Q

What is the most common cuase of the intermittently suppurating cutaneous sinus tract in the face and neck?

A

-Chronic dental infection

41
Q

What is the treatment for CAA?

A

-RCT

42
Q

What pulpal pathologies do you do RCT on?

A
  • Hyperplastic pulp
  • Irreversible pulpitis
  • Necrotic pulp
  • SAP
  • AAP
  • AAA
  • CAA
  • Condensing osteitis

Endodontics 2020 (20 decks)

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