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BDS3 PERIODONTOLOGY > Perio-Endo & Periodontal Abscess > Flashcards

Perio-Endo & Periodontal Abscess Flashcards

1
Q

What are the features of a gingival abscess?

A
  • localised to gingival margin
  • no bone loss associated
  • commonly caused by local trauma/food packing/interproximal cleaning
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2
Q

What are the features of a periodontal abscess?

A
  • usually related to pre-existing periodontal deep pocket
  • associated with food packing
  • associated of gingival margin post PMPR
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3
Q

What are the features of a pericoronal abscess?

A
  • associated with partially erupted tooth
  • most commonly 8s
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4
Q

What are the features of a endodontic-periodontics lesion?

A
  • tooth is suffering from varying degrees of endodontic and perio disease
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5
Q

What is the SDCEP definition of a periodontal abscess?

A

Infection in a periodontal pocket which can be acute or chronic and asymptomatic if freely draining

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6
Q

What do periodontal abscesses cause?

A

Rapid destruction of periodontal tissues (bone dissolving), with a negative effect on the prognosis of the affect tooth

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7
Q

What are the signs and symptoms of a periodontal abscess?

A
  • swelling
  • pain
  • tooth may be TTP in lateral direction
  • deep perio pocket
  • bleeding
  • suppuration
  • enlarged regional lymph nodes
  • fever
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8
Q

How are periodontal abscesses treated according to SDCEP guidelines?

A
  • carry out sub gingival instrumentation short of the base of the perio pocket
  • drain pus if present, by incision or through perio pocket
  • recommend analgesia
  • only prescribe antibiotics if there are signs of spreading systemic infection
  • recommend use of chlorohexidine mouthwash
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9
Q

During treatment of periodontal abscesses, why is it important that sub-gingival instrumentation is important?

A

to avoid iatrogenic damage to the already weak tissues

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10
Q

What strength of chlorohexidine mouthwash should be prescribed?

A

0.2%

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11
Q

IF systemic antibiotics are required, what would be prescribed?

A
  • penicillin V 250mg (5days)
  • amoxicillin 500mg (5days)
  • metronidazole 400mg (5days)
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12
Q

what is an endo-periodontal lesion?

A

A pathological communication between the endodontic and periodontal tissues of a given tooth

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13
Q

What could cause an acute perio-endo lesion?

A
  • trauma
  • perforation
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14
Q

What could cause a chronic perio-endo lesion?

A
  • pre-existing periodontitis
  • slow and chronic progression without evident symptoms
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15
Q

what are some signs & symptoms of perio-endo lesions?

A
  • deep periodontal pockets reaching or close to the apex
  • negative or altered response to pulp vitality tests
  • bone resorption in the apical or furcation region
  • spontaneous pain
  • pain or palpation & percussion
  • purulent exudate
  • tooth mobility
  • sinus tract
  • crown & gingival
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16
Q

What is the most common sign of a perio-endo lesion?

A

Swelling up around the apex of the tooth

17
Q

What percentage of all teeth have lateral & accessory canals?

A

30-40%

18
Q

What is the main route of communication between the pulp & the periodontium?

A

The apical foramen

19
Q

Why can communication between the pulp and periodontium be problematic?

A
  • microbial and inflammatory byproducts may exit the apical foramen causing peri-radicular pathoses
  • the apex is a portal of entry for inflammatory byproducts from deep periodontal pockets to affect the pulp
20
Q

What does perforation cause?

A

Results in communication between the root canal system and either peri-radicular tissues, periodontal ligament or the oral cavity

21
Q

What can cause perforation?

A
  • extensive dental caries
  • resorption
  • operator error during root canal instrumentation etc
22
Q

Why might endo-periodontal lesions associated with trauma/iatrogenic factors occur?

A
  • root/pulp chamber furcation perforation
  • root fracture or cracking
  • external root resorption
  • pulp necrosis draining through the periodontium
23
Q

How are perio-endo lesions treated according to the SDCEP guidelines?

A
  • carry out endo treatment of affected tooth
  • recommend analgesia
  • ONLY prescribe antibiotics if signs of spreading/systemic infection
  • recommend use of 0.2% Chlorohexidine mouthwash to aid acute symptoms
  • review within 10 days & carry our supra/subgingival scaling if necessary
24
Q

Does endodontic disease affect periodontal health?

A

When the pulp becomes infected, it elicits an inflammatory response in the periodontal ligament at the apical foramen and/or adjacent to openings of the small portals of exit

BDS3 PERIODONTOLOGY (4 decks)

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