Pulp & Periapical Disease Flashcards

1
Q

what is the flow chart for caries when it extends to pulpal tissue?

A
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2
Q

what are the symptoms of a pulp hyperaemia?

A
  • pain lasting for seconds
  • pain stimulated by hot/cold or sweet
  • pain resolved after stimulus removed
  • caries approaching pulp but tooth can still be restored without treating pulp
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2
Q

what are the symptoms of acute pulpitis?

A
  • constant severe pain
  • react to thermal stimuli
  • poorly localised pain
  • referral of pain
  • no/minimal response to analgesics
  • open symptoms less severe
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3
Q

how can you diagnose acute pulpitis?

A
  • history
  • visual exam
  • negative to TTP (not had time to spread to periapical region)
  • radiographs
  • removal of restorations
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4
Q

how do you diagnose acute periodontitis?

A
  • easy to make
  • TTP
  • tooth is non-vital (unless traumatic)
  • slight increase in mobility

Radiographs:
- loss of clarity of lamina dura
- radiolucent shadow
- widening of apical PDL space

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4
Q

what are the causes of TRAUMATIC periodontitis?

A

parafunction (clenching/grinding)

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5
Q

what is the most common pus production infection?

A

acute apical abscess

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6
Q

what organisms are involved in dental abscess’?

A
  • polymicrobial
  • anaerobes play an important part (S. aureus, P. gingivalis, prevotella species etc)
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7
Q

what are symptoms of an acute apical abscess?

A

similar to acute apical periodontitis;

  • severe unremitting pain
  • acute tenderness in function & permission

BUT

no swelling, redness or heat (YET!)

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8
Q

what are the 5 cardinal signs of inflammation?

A
  • Heat
  • Swelling
  • Tender
  • Redness
  • Loss of function
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9
Q

where are some areas/spaces that an acute apical abscess could drain to?

A
  • Submental space
  • sublingual space
  • submandibular space
  • buccal space
  • infraorbital space
  • palate
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10
Q

what is the treatment for an acute apical abscess?

A

Provide Drainage:
- soft tissue excision intraorally OR extraorally
- remove source/cause (XLA, extirpation, periradicular surgery)

Antibiotic need determined by:
- severity
- absence of adequate drainage
- patient’s medical condition

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11
Q

what are the LOCAL factors when assessing need for antibiotics in an abscess pt?

A
  • toxicity of swelling
  • airway compromisation
  • dysphagia
  • trismus
  • location (floor of mouth)
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12
Q

what are the SYSTEMIC factors when assessing need for antibiotics in an abscess pt?

A
  • immunocompromised pts
  • diabetes
  • elderly
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13
Q

what is reversible pulpitis?

A

level of inflammation that tooth can return to normal IF the cause is removed

mild-moderate tooth pain when STIMULATED, no pain without stimulus, no mobility, no TTP

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14
Q

what is irreversible pulpitis?

A

high level inflammation and pulp damaged beyond point of recovery

sharp, throbbing, severe pain upon stimulation, pain persists after stimulation removed

Tx: RCT/XLA

15
Q

describe periapical granuloma (chronic apical periodontitis)

A

mass of chronically inflamed granulation tissue at apex of tooth (plasma cells, lymphocytes etc)

16
Q

etiology of periapical (radicular) cyst?

A
  • caries, trauma, periodontal disease
  • death of pulp
  • apical bone inflammation
17
Q
A