Periodontal/ Endodontic Lesions Flashcards
what is the defining characteristic of an abscess
suppuration - pus - collection of dead and dying neutrophils that have gathered at a site of infections
what is pericoronitis
inflammation around a partially erupted tooth
what is a gingival abscess
localised to gingival margin
what causes gingival abscess
could be skelf in the gum or broken piece of interdental cleaning
what is a periodontal abscess
related to pre-existing deep pocket also associated with food packing and tightening of gingival margin post hygiene phase therapy
biofilm is still under in the pocket when the coronal aspect of the gingiva has healed
what is a pericoronitis abscess
associated with partially erupted teeth - usually 8s
what are endo-periodontal lesions
tooth is suffering from varying degrees of endodontic and periodontal disease
what are the subdivisions of periodontal abscesses
acute or chronic and asymptomatic if free draining
what are signs and symptoms of periodontal abscess
swelling and pain
tooth may be TTP
deep periodontal pocket
bleeding and suppuration
fever/ enlarged lymph nodes
how are periodontal abscesses managed
carry out subgingival instrumentation
drain pus by incision
optimal analgesia
when would you give antibiotics for periodontal abscess
if there are signs of spreading
signs of systemic involvement
what dose of antibiotics would you prescribe for periodontal abscesses
penicillin V 250mg for 5 days
what is an endo-perio lesion
pathological communication between the endodontic and periodontal tissues of a tooth
how do periapical abscesses spread
infection via carious cavity or traumatised crown or infection via PDL goes into pulp and causes periapical infection
what is the most common presentation of a periapical abscess
pus pocket at apex of tooth
what are acute causes of endo-perio lesions
trauma
perforation of canals into periodontal ligaments
what are chronic causes of endo-perio lesions
pre-existing periodontitis
slow and chronic progression without evident symptoms
what are signs and symptoms of endo-perio lesions
deep perio pockets reaching close to apex
negative response to vitality tests
bone resorption in apical region
spontaneous pain
pus
what are the possible scenarios where the endodontium affects the periodontium
necrotic pulp due to caries and then the pus of the necrotic pulp come up and out of a pre-existing pocket
furcle canals communicating with the furcation
bacteria getting into pockets of vital teeth and then goes to apex of tooth which causes pulp necrosis
what canals do you have on the floor of the pulp chamber that can communicate with the furcation
furcul canals
where are majority of lateral and accessory canals found in the tooth
apical third
when might lateral canals be involved in perio-endo lesions
periodontal pocket causes bone loss, lateral canal is exposed to bacteria which ingresses into the pulp and causes infection
how might endodontics might influence periodontium
pulpal inflammation may cause inflammatory reaction in the interradicular tissues
what is the main communication between pulp and periodontium
apical foramen
what are causes of perforation
extensive dental caries
resorption
operator error
what is the developmental groove
invagination in root surface - if periodontium is lost the channel provides a place for accumulation of bacterial biofilm and a route for periodontitis to affect the pulp
what is the current classification of perio-endo lesions
carious lesions that affects pulp and then secondarily the periodontium
periodontal destruction secondarily affects root canal
or bot events occurring at same time
what does endo-perio lesions with root damage indicate
trauma
how are endo-perio lesions treated
endo treatment first
periodontal therapy
offer pain control
0.2% chlorhexidine
