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Oral Pathology 2nd Year > Pulp > Flashcards

Pulp Flashcards

1
Q

4 causes of pulp inflammation?

A
  1. mechanical injury (drilling)
  2. thermal injury (need water with drilling)
  3. chemical injury (acid etch on dentin)
  4. bacterial injury (MOST COMMON)
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2
Q

5 signs of inflammation?

A

Heat
redness
swelling (edema) - fluid from vasculature
pain (b/c fluid is puttin pressure on nerve endings
loss of function

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3
Q

Why is it when people say a tooth is dead its actually usually not completely dead?

A

because the cementum is still alive because it recieves its blood supply from PDL

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4
Q

5 components of pulp

A
  1. blood vessels
  2. lymphatic channels (removes edema/swelling)
  3. nerves
  4. odontoblasts (@periphery)
  5. undifferentiated connective tissue cells (mesenchymal cells)
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5
Q

What are the predominant cells histologically in ACUTE irreversible pulpitis? (2 types)

A
  1. PMN’s (polymorphonuclear neutrophils)

2. macrophages

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6
Q

What are the predominant cells histologically in CHRONIC irreversible pulpitis? (3 types)

A
  1. macrophages
  2. lymphocytes
  3. plasma cells
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7
Q

Can you get spontaneous pain with chronic irreversible pulpitis?

A

NO

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8
Q

If pain lingers for 1 minute or more with removal of stimulus what is the diagnosis?

A

acute irreversible pulpitis

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9
Q

Will a patient reach 80 on EPT for acute/chronic irreversible pulpitis?

A

NO

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10
Q

What is treatment for acute and chronic irreversible pulpitits?

A

RCT/EXO

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11
Q

will a patient be sensitive to percussion with reversible and irreversible pulpitis?

A

No (rare cases yes, such as multi rooted teeth, one with complete necrosis and the other may still have some viable pulp remaining)

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12
Q

Can apical periodontitis secondary to pulpal pathosis occur on a viable tooth?

A

NO

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13
Q

What does Granulation Tissue consist of? (2 things)

A

1- increase in fibroblasts/fibrous tissue

2- increase in endothelial cells and blood vessels

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14
Q

A periapical abscess is what type of infalammation?

A

Acute inflammation

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15
Q

why may we not be able to properly use LA for a periapical abcess?

A

Because LA only works in a certain range of pH, often these periapical abscesses alter the pH so much that LA is not effective.,

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16
Q

How do we treat periapical abscess?

A

IAD - incision and drainage

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17
Q

What is a scenario where a patient would not feel a periapical abscess?

A

Parulis has formed. elevated soft tissue lesion where puss is draining. Patient may not feel this because the puss is draining and not putting pressure on nerve endings

18
Q

How do we treat a periapical abscess?

A

First, IAD. Then we need to deal with the infection by performing a RCT or EXO

19
Q

How can we determine the source of infection with a periapical abscess?

A

We can often use gutta percha to enter the abscess and it will lead to the source of the infection. Than we will treat that tooth (RCT/EXO)

20
Q

What would we see histologically if we biopsied periapical abscess?

A

“Sea of Neutrophils”

21
Q

What is present in a parulis?

A

Granulation tissue - increase in firboblasts/fibrous tissue and an increase in endothelial cells/blood vessels.

22
Q

Is a periapical abscess painful?

A

YES, may not be if a parulis has formed (because puss is draining)

23
Q

What is the FIRST THING we would see with apical periodontitis secondary to pulpal pathosis?

A

Widening of PDL space (Lamina Dura may still be intact)

24
Q

What is a Granuloma? (+ 3 things seen histologically)

A

A chronic inflammation (granulomatous inflammation) characterized by:
1- epithelioid histiocytes
2- multinucleated giant cells
3- peripheral mantle of lymphocytes/plasma cells

25
Q

Is granulomatous inflammation the same thing as granulation tissue?

A

NO

26
Q

What is a cyst?

A

A pathological cavity, lined by epithelium containing fluid or semi-fluid material

27
Q

How can we differentiate apical radicular cyst from periapical granuloma?

A

ONLY histologically

28
Q

Why do mand anteriors rarely have cavities?

A

Because they are constantly bathed in saliva

29
Q

Will an apical radicular cyst be sensitive to percussion?

A

May not because it is chronic inflammation

30
Q

What kind of tissue is present in an apical radicular cyst

A

granulation tissue

31
Q

How do patients get periapical fibrous scar?

A

RARE, but usually after RCT

32
Q

What is a periapical fibrous scar composed of?

A

dense connective tissue

33
Q

What is the difference between osteitis and osteomyelitis?

A

Osteitis -> Inflammation of bone

Osteomyelitis -> inflammation of bone and bone marrow

34
Q

What is a characteristic of chronic focal sclerosing osteomyelitis?

A

Increase in bone formation (stimulated osteoblasts)

35
Q

How do we treat chronic focal sclerosing osteomyelitis?

A

RCT/EXO

36
Q

What is difference between rarifying and condensing osteitis?

A

Rarifying -> decreased bone density

Condensing -> increased bone density

37
Q

Difference between surgical and non-surgical RCT?

A

non surgical -> go through root

surgical -> lay back soft tissue flap and go through bone, clean it out and place gutta percha

38
Q

What is a key characteristic of chronic osteomyelitis with proliferative periostitis?

A

layering of radiolucent/radiopaque bone cortex (radiologists call it onion skin)

39
Q

Are periapical granulomas symptomatic?

A

They are often Asymptomatic but pain can develop if acute exacerbation occurs

40
Q

In what scenario would sensitivity to percussion occur?

A

peri-apical inflammation

Oral Pathology 2nd Year (9 decks)

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