Periodontitis

Question 1

What is the difference between periapical granuloma and abscess?

Answer 1

Periapical granuloma is a lesion formed as a result of chronic inflammation of the decayed tooth while the abscess is the result of acute inflammation.

Question 2

Which is bigger granuloma or cyst?

Answer 2

A cyst ranges from 1-2 cm in size and can expand even more while a granuloma is usually less than 1 cm.

Question 3

Is a granuloma a cyst?

Answer 3

No, a granuloma is not a cyst but if it is left untreated for a prolonged period of time, can turn into a cyst.

Question 4

What is a periapical granuloma?

Answer 4

A periapical granuloma is a small mass or lesion of granulation tissue present at the apex of a tooth infected by acute or chronic pulpitis.

Question 5

How can you tell the difference between a cyst and a granuloma?

Answer 5

Due to similar features and radiographic appearance, the only definite way to differentiate between a cyst and a granuloma is a histopathological examination.

Question 6

Should granulomas be removed?

Answer 6

Granulomas do not require removal; endodontic root canal treatment of the affected tooth resolves them on their own.

Question 7

Should I be worried about a granuloma?

Answer 7

A granuloma is not as such a piece of bad news or fatal, however, treatment shouldn’t be delayed to save the tooth and bone structure.

Question 8

Do granulomas keep growing?

Answer 8

Granulomas don’t grow beyond a certain point in size.

Question 9

What is the best treatment for granuloma?

Answer 9

The best treatment plan is to perform Root Canal treatment of the affected tooth and regular follow-up appointments with your dentist.

Question 10

X-ray picture depicts a circular well- defined area of bone tissue destruction 0,7х 0,7 cm large in the projection of root apex. What is the most likely diagnosis?

Answer 10

Cystogranuloma

Question 11

A patient consulted a dental surgeon about extraction of the
of the 36 tooth. The tooth decayed long ago. Objectively: the crown of the 36 is destroyed by 2/3, percussion is painless, mucosa around the 36 tooth exhibits no evident pathological changes. X-ray picture of the alveolar process shows a roundish well-defined radiolucency near the apex of the medial root. What is the most likely diagnosis?

Answer 11

Chronic granulomatous periodontitis

Question 12

A 60-year-old patient complains of a growth in the mental region, which is painless and slowly grows in size. Objectively: there is rounded infiltrate with clear margins in the mental region; it is slightly painfiul, the skin under it is very thin. Palpation in the vestibule of mouth reveals dense band going from the growth to the destroyed 33rd tooth. What is the most probable diagnosis?

Answer 12

Odontogenic granuloma of the face

Question 13

A patient complains of an increasing new growth in the left sublingual area, which he first noticed 2 months ago. Some ti- me after that he noticed this new growth to secrete large amount of clear viscous fluid, which was colorless and tasteless; initially this caused the new growth to become smaller but subsequently it started to grow again. Objectively: there is a rounded new growth sized 3x3 cm in the left sublingual area, its consistency is soft and elastic, there is no pain. The mucosa above is thinned out, semitransparent, bluish in shade. What is the most probable diagnosis?

Answer 13

Retention sublingual cyst

Question 14

A 25-year-old patient complains of pain when biting on the 15 tooth. The pain arose two days ago, has a constant aching nature and increased significantly over the last day. Objectively: the crown of the 15 tooth is gray, the medial contact surface exhibits a deep carious cavity communicating with the tooth cavity. Percussion causes acute pain, the gingival mucosa in the projection of the 25 tooth root apex is hyperemic. The regional lymph node is tender. Radiograph shows an ill-defined zone of periapical bone destruction. What is the most likely diagnosis?

Answer 14

Exacerbation of chronic periodontitis

Question 15

A patient complains of the alveolar process deformation of the left upper jaw. Objectively: the crown of the 25th toothis destroyed with cariosity. X-ray image of the paranasal sinuses shows the left one to have veil-like shading with clear dome-shaped margin. X-ray image of the crown of the 25th tooth shows absence of the periodontal fissure at the the palatal root apex. What is the most probable diagnosis?

Answer 15

Radicular cyst that invaded in the maxillary sinus

Question 16

A 27- year-old patient complains about acute pain in the region of the 34 tooth that is getting worse when biting down on food. Roentgenographical survey revealed an ill-defined zone of bone tissue destruction in the periapical region of root of the 34 tooth. What is the most likely diagnosis?

Answer 16

Exacerbation of chronic granulating periodontitis

Question 17

A 20-year-old patient complains about a carious cavity in an upper right tooth. Objectively: the 16 tooth has a deep carious cavity communicating with the tooth cavity, probing at the opening point is painless, percussion of the 16 causes mild pain. There is a fistula on the gingiva in the region of root apex projection of the 16 tooth. What is the most probable diagnosis?

Answer 17

Chronic granulating periodontitis

Question 18

A 25-year-old student complains of a carious cavity in the 22 tooth. The filli- ngs fell out 2 months ago. The tooth had been treated before for pulpitis. Objecti- vely: there is a deep carious cavity with the rests of filling on the medial surface of the 22 tooth. The crown of the 22 tooth is dirty pink. X-ray shows a root canal filled with the filling material by 1/2 of the root length; in the region of the root apex there is a well-defined focus of destruction of bone tissue 0,3x0,3 cm large. What is the most likely diagnosis?

Answer 18

Chronic granulomatous periodontitis

Question 19

A 22 year old patient complained about colour change of the 11 tooth crown. The tooth was treated on account of chronic deep caries a year ago. Immediately after treatment the patient felt slight pain. She didn’t consult a dentist. X-ray picture shows broadening of periodontal fissure in the area of root apex of the 11 tooth. Percussion is painless. What is the most probable diagnosis?

Answer 19

Chronic fibrous periodontitis

Question 20

A 35-year-old female patient consulted a dentist about a painless, slowly growing neoplasm in the area of the 11 and 12 teeth. Examination revealed that the tumour was light-pink, flattened, adjacent to the teeth, had a pedicle. The tumour was up to 1,5 cm large, with smooth surface and dense consistency. It was diagnosed as an epulis in the regiob of the 11 and 12 teeth. What form of epulis are these clinical findings typical for

Answer 20

Fibrous

Question 21

A 40-year-old patient complains of constant intense throbbing pain in the 23 tooth lasting for 3 days. This problem hasn’t bothered him before. Vertical and horizontal percussion is positive, the tooth is mobile, mucous membrane around the 26 tooth is hyperemic and edematous. Palpation of the mucogingival fold in the root apex projection is painful. What is the most likely diagnosis?

Answer 21

Acute purulent periodontitis of the 26 tooth

Question 22

A 47 year old patient complains of permanent pain in the 27 tooth that is getting worse during cutting. Objectively: the patient’s face is symmetric, skin is of normal colouring, mouth opening is not limited, mucous membrane of alveolar process is edematic and hyperemic at a level with the 27 tooth. The 27 tooth has a deep carious cavity communicating with pulp chamber. Percussion of the 27 tooth causes acute pain. What is presumptive diagnosis?

Answer 22

Acute condition of chronic periodonti- tis of the 27 tooth

Question 23

What’s the difference between serous and purulentperiodontitis symptoms?

Answer 23

Serous : but not usually radiate , periodontal edema and pain with swelling , lymphadenopathy.
Purulent : radiating pain. More acute throbbing pain , feel tooth growing ,tooth mobility , hyperemic edematous mucous membrane.

Question 24

What’s three types of Granuloma ?

Answer 24

Simple Granuloma
Epithelial Granuloma
Cyst-like Granuloma

Question 25

Chronic fibrous periodontitis common symptoms?

Answer 25

Slight breading of fissure

Question 26

What’s granulating periodontitis , exacerbation form , and X-ray features ?

Answer 26

Rapid destruction of bone tissue accompanying with periodontal tissues polifiration , fistula or healed , ill defined zones of bone destruction.
Exacerbation painful with fistula , cyanotic mucous membrane ,

Question 27

What’s granulomatous periodontitis and X ray features ?

Answer 27

Protective response against infection , Granuloma capsule, painless, well defined round zone at the apex 0.3*0.3 cm