Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS3 Oral Pathology > Pulp disorders and periridicular lesions - Pulp > Flashcards

Pulp disorders and periridicular lesions - Pulp Flashcards

1
Q

What is pulpitis?

A

inflammation of the dental pulp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common cause of pulpitis?

A

caries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What can cause severe pain in pulpitis?

A

bacterial products may cause pulp to develop hyperaemia and the patient may experience pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Is early pulpitis reversible or irreversible?

A

reversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can happen when bacteria enter the pulp?

A

a pulp abscess can form or complete pulpal necrosis may occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Clinical features of pulpitis?

A

hard to localise pain

Radiating to the jaw, face, ear or neck

Continuous or intermittent

Can be acute or chronic (reversible or irreversible)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Clinical features of acute pulpitis?

A

severe throbbing pain

Hot and cold stimuli

Keeps pt awake

Severe pain lasts for 10-15 mins

Maybe continuous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Chronic pulpitis clinical features?

A

spontaneous attacks

Dull aching pain

Lasts for an hour or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Clinical features of reversible pulpitis vs irreversible?

A

age (secondary dentine and blood supply to tooth)

Size of various lesion

Symptoms

Radiography

Vitality tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Most common aetiology of pulpitis?

A

microbial insult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Attrition vs abrasion?

A

abrasion - foreign body (e.g tb)

Attrition - tooth to tooth contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How can bacteria reach the pulp? (microbial insult)

A

dental caries

Attrition

Abrasion traumatic restorations

Traumatic cracks and fractures

Invaginated odontomes

Periodontal disease involving apical pockets

Accessory root canals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why does age affects how oulpitis proceeds?

A

younger have more patent tubules and richer blood supply

Bacteria pioneer pulp from further away

older people have secondary dentine and less blood supply, bacteria have to travel further to reach the pulp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does chemical injury cause pulpitis?

A

restorative procedures

Irritant substances directly applied to exposed pulp

They Diffuse through dentine and form Reactionary dentine, leading to Sclerosis and exults in Dead tracts of fish

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Chemical vs bacterial injury?

A

chemical injury one time

Bacterial continuous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does thermal injury cause pulpitis?

A

restorative procedures
- Frictional heat during cavity prep

Need Coolant

Forms Reactionary dentine, causing Sclerosis, leading to Dead tracts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Barotrauma?

A

changes in atmospheric pressure

E.g. divers, pilots etc

If tooth is cracked, rapid expansion causes severe pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How does barotrauma cause pulpitis?

A

aerodontalgia
High altitudes
Divers

Nitrogen bubbles - causing irreversible pulpitis

Fat emboli from altered lipoproteins - causing irreversible pulpitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Does barotrauma cause pulpitis?

A

not directly but can cause irritation

It’s an exacerbating factor of there is a various lesion of breach of integrity of the pulp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Effect of pulp anatomy and pulpitis?

A

a chamber totally surrounded by dentine (confined tissue surrounded by a chamber - dentine) - no space to expand
- no space for swelling, cause collapse of the vasculature and necrosis of teh cells and cause even more inflammatory infiltrate coming in

Limited ability to tolerate oedema

Venous collapse due to rise in pressure

Local tissue hypoxia and anoxia - no oxygen as the blood vessels have collapsed
- leading to Localised necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the initial mild inflammatory response of the pulp caused by caries?

A

infiltration of the sub odontoblastic zones with lymphocytes and macrophages

Response to antigenic products from bacteria and various dentine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What happens to blood vessels when bacteria reach the pulp? (Pulpitis caused by caries)

A

Congested and dilated blood vessels

More exudate coming form blood vessels

Due to confined area it will lead to the collapse and necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What eventually happens in pulpitis caused by caries?

A

formation of exudate:

Compromised circulation

Cell death

Suppuration - pus

Neutrophils

Lose structure leading to Pulp abscess

Causing pain until the pulp is completely necrotic - unless spreads to surrounding tissues

24
Q

Features of a pulp abscess caused by caries?

A

may become static - if the host immune response is strong enough

May reduce in size - if treat tooth and allow to heal

Suppuration surrounded by proliferating granulation tissue (pyogenic membrane) - how the pup keep the abscess contained

Puss may become walled by fibrous tissue

25
Q

what is the end result if caries are untreated?

A

pulp necrosis

Will be sterile unless bacteria reach the pulp

26
Q

In a pulp polyp what type of response occurs?

A

hyperplastic response, granulation tissue formation

27
Q

What can happen to the surface of the polyp?

A

May become epitheliailsed - pink in colour

Occurs through spontaneous grafting of cells in the saliva

28
Q

what does an ulcerated polyp appear like?

A

appears dark red yellow flecked fleshy mass

  • no sensation
29
Q

Why may cavity prep and restorative material cause pulpitis?

A

speed of instrument rotation

Heat generated

Presssure (really rough preparing cavity)

Lack of Coolants

Increased cavity depth - more likely to cause inflammation

Frictional heat

Hard tissue ablation using lasers

And chemical pulpitis from the materials used

30
Q

How does an epithelialised polyp appear?

A

firm, pink, does not bleed easily

No sensation

31
Q

What happens if you over dry dentine - previous inflammation?

A

Odontoblasts nuclei aspirated into the dentine tubules - shown in picture

32
Q

What can you do to the pulp before using an irritating material?

A

pulp capping

Maintain vitality following traumatic exposure and pulpotomy

33
Q

Can the pulp heal without removal of caries?

A

yes, focal pulpitis could heal when tubules are blocked with sclerotic dentine and formation of tertiary

34
Q

True pulp stones resemble what?

A

True Denticles resemble dentine (tubular)

35
Q

What do false pulp stones resemble?

A

False denticles resemble bone (trapped cells)

36
Q

When do pulp stones become interstitial?

A

when they become surrounded by secondary or tertiary dentine

37
Q

What can cause pulp stones?

A

complication of root canal therapy

Increase with age and after restorative procedures

38
Q

What type of pulp stone is shown here and what causes it?

A

dystrophic calcifications

Looks like Snow storm on radiograph

Due to trauma to the apical blood supply leads to pulp obliteration through formation of irregular dentine

39
Q

Pulp necrosis associated with what disease?

A

sickle cell anaemia pts

40
Q

Can the pt experience no pain with an advancing carious lesion towards the pulp?

A

yes,

immune cells in response to advancing caries and low-grade inflammation can spread through the root apex to the apical periodontal tissues without symptoms

41
Q

What are odontomes?

A

Odontomas are hamartomas of aborted tooth formation which account for 22% of the odontogenic tumors. They are the most common benign

42
Q

In a carious lesion, what occurs in the pulp first: bacteria or inflammation?

A

inflammation precedes bacteria

due to toxins.

43
Q

When bacteria reach the pulp through caries, at what distance do you see histological changes in permanent teeth?

A

1mm from pulp

twice the distance in primary teeth - primary has patent tubules so bacteria cause irritation from further away

44
Q

What modifications/differences can change the inflammatory process?

A

The nature of the insult

The severity f the insult

Host defence

Anatomy

45
Q

Once there is cell death due to collapse of the blood vessels, what occurs/ what is the result?

A

Chemical mediators release by the necrotic tissue

Further inflammation

Total necrosis

Some teeth will have protection by the tertiary dentine

46
Q

How does the pulp try to contain the abscess and allow it to not spread?

A

For in fibrous tissue sounding the pulp tissue called a pyogenic membrane

47
Q

What is shown here?

A

Pyogenic membrane
- can see collapse of structures

Containing the abscess

If not treated it will spread

48
Q

What happens if pulpitis card by caries is left untreated?

A

May continue to expand

Bacteria entering the pulp will be destroyed by the neutrophils

If there is a cavity, pus drainage

49
Q

Pulp polyp?

A

Chronic hyperplastic pulpitis, granulation tissue formation

Tissue protrudes beyond the boundaries of the pulp chamber

Paeds pt have highly vascularised teeth and and a wide apical foramina

When tooth has a large cavity the pulp bulges out - from wide open pulp cavities with good apical blood supply

50
Q

Colour of an epithelialised?

A

More pink rather than reddish - protected by epithelium

Don’t bleed as much

51
Q

What happens if you dry dentine that has preexisitng inflammation?

A

Wheat sheaving appearance ofodontoblasts

52
Q

What is wheat sheaving?

A

Fluid collecting into vacuoles and compressing groups of cells together

53
Q

Why can cavity prep and restorative materials affect the pulp differently?

A

The effect of materials is variable

Effect affected by thickness of dentine remaining

Nature of dentine (younger the dentine is patent, older dentine obliterated)

Pulp capping using materials that provide no irritation

54
Q

Younger or older dentine more effected by dental materials?

A

More badly affected as dentine is patent

55
Q

What causes pulp necrosis?

A

Main cause: pulpitis

Trauma to the apical blood supply - apical blood supply is cut and causes ulnar necrosis

—> this causes coagulation necrosis due to ischaemia

Liquefactive necrosis following pulpitis and break down of inflammatory cells

  • if becomes infected could lead to abscess formation
  • foul smell during endontic tx
  • sickle cell anemia

BDS3 Oral Pathology (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions