Perio-endo lesions Flashcards

1
Q

with a perio-endo lesion, do infections occur simultaneously or are they seperate?

A

separate

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2
Q

3 avenues of communication for pulp and peridontium

A

dentinal tubules
lateral and accessory canals
apical foramen

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3
Q

Tubules can loose the overlying cementum coverage by….

A

periodontal disease
scaling and root planning
surgical procedures
developmentally

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4
Q

Dentinal trivia

A

tubules are 1-3 micrometersin diameter
decrease in old age and response to inflammation
vary from 8000 at DCJ to 57000 at apical end

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5
Q

what % of max 2nd PM’s have lateral canals?

A

59.5%

78% of them are in apical region

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6
Q

what % of all teeth have lateral or accessory canals?

A

30-40%

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7
Q

a study showd that __% of accessory canals were in the furcation area.
__% in mand molars
__% in maxillary molars
__% had canals in furcation only

A
  1. 4%
  2. 4%
  3. 4%
  4. 5%
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8
Q

what is the most direct route of communication between pulp and peridontium?

A

apical foramen

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9
Q

advanced pulpitis leads to

A

pulp necrosis

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10
Q

where does resoprtion occur in chronic radicular abscess?

A

root apex

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11
Q

periodontal tissue breakdown is also known as…

A

retrograde periodontitis

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12
Q

retrograde periodontits starte where and moves in what direction?

A

apex and works cervically

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13
Q

orthograde periodontitis starts where and moves in what direction?

A

start in sulcular area and moves apically

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14
Q

T/F, early inflammation has a large effect on peridontium

A

F, initial inflammation actually is trying to prevent it from spreading

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15
Q

T/F when tissue is necrotic the inflammation can spread to surrounding peridontium?

A

T,

it spreads through foramen, accessory canals and dentin tubules

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16
Q

what bacteria pathogens cause inflammatory response in peri-endo lesions?

A

Aggregatibacter actionmycetemcomitans.

Tannerella forsythensis.
 Fusobacterium nucleatum.
 Porphyromonas gingivalis.
 Prevotela intermedia.
 Eikenella corrodens
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17
Q

whats the predominant spirochete found in inflammation?

A

treponema denticola

18
Q

whats the fungi predominant in inflammation?

A

candida albicans

19
Q

whats the virus predominant in inflammation?

A

epstein-barr virus

human cytomegalovirus as well

20
Q

what are some contributing factors to perio-endo lesions?

A

poor restorations-
root canals can get contaminated by delaying placement of crown
improper space for posts
inadequate seal from endo procedure.

21
Q

what kinds of trauma can contribute to perio-endo lesions?

A

crown fractures
crown root fractures
vertical fractures
oblique and horizontal fratures

22
Q

trauma resulting in vertical fractures ranges from

A

3.69-10.99%

23
Q

Resorption is defined as

A

physiologic or pathologic process resulting in a loss of dentin, cementum, and or bone

24
Q

what are the types of resoprtions?

A

external resorption
internal resorption
replacement resorption

25
resoprtion is usually associated with what?
trauma | but also occurs with orthodontics, tumors, cysts, pulpal inflammation and perio disease
26
with a perio-endo lesion you need to have a differential diagnosis which determines the primary cause of the lesion. Coming up with the diagnosis should include....
``` patientes symptoms coronal integrity shape and size of radiographic lesions perio probing tooth vitality ```
27
reversible pulpitis can be treated by...
adjusting occlusion, retreating faulty restorations, closing exposed tubules
28
urreversible pulpitis leads to ____ and has sharp un-triggered pain.
necrotic pulp
29
Patients objective symptoms include...
``` presentation of abseccess or fistula palpation over tooth pain on percussion redness radiographs narrow probings usually indicate endodontic origin while broader probings indicate periodontal origin ```
30
coronal integrity of perodontal infections vs endodontic infections
perio- doesnt usually involve the crown so the crown is absent of defects endo- often is associated with coronal defects like caries, failing restorations, cracks
31
Radiographs are ___ data but the interpretaion of them is ______
objective, subjective
32
Vitality of perio-endo lesions
teeth with perio infection alone test vital while perio-endo dont
33
vitality with irreversible pulpitis
usually have lingering pain to thermal testing and sometimes get relief from cold stimulus
34
vitality with reversible pulpitis
these pts have a quick response to hot or cold( 5-10sec)
35
2 main factors in considering your treatment are
pulp vitality | extent of periodontic defect
36
primary endodontic infection
( advanced pulpitis) | only endo
37
primary periodontal infection
only perio
38
perio-endo infection
involves both endo and perio
39
primary endodontic infection with secondary periodontal involvment means what?
that endo is the cause of the perio issues. So if this Pt had endo done, the perio issue should clear up
40
after performing endo on a person with primary endo infection with secondary perio infection, how long do you wait to re-evaluate?
2-3 months | this time allows for healing
41
what is considered a "true" perio-endo lesion?
when periodotnal disease is causing the endodontic problem
42
ture perio-endo lesions require what for therapy
both endodontic and periodontal therapies