Brainscape's Knowledge GenomeTM

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


See full index

AU 15- Oral Micro > Pulpal and Odontogenic Infections > Flashcards

Pulpal and Odontogenic Infections Flashcards

1
Q

Why is the pulp considered to be a “unique organ”?

A
  1. it is enclosed by hard tissue and is non-shedding

2. inflammation is particularly damaging (there is no give)

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

How does increased intrapulpal pressure result in tissue damage?

A

the pressure cuts off blood flow

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

What is the most common cause of pulpal inflammation and necrosis?

A

bacterial infection

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

How does infective bacteria reach the pulp? (4 ways)

A
  1. Direct exposure
  2. penetration through dentinal tubules (from caries)
  3. direct access from traumatic fracture
  4. from the bloodstream (unlikely)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is anachoresis?

A

bacteria traveling from the blood stream…remember its unlikely to be the cause of pulpal inflammation

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

If a tooth is fractured, what is the standard of care?

A

Remove the surface layer and seal it up! (infection can happen very quickly after the pulp is exposed via fractures in enamel and dentin)

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

If the pulp is non-vital, _____ _______ _____ in dentinal tubules is disrupted and the tooth is more vulnerable to invasion by microbes.

A

positive fluid pressure (innate protection)

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

What are two ways in which trauma can result in tissue death?

A
  1. damage the blood supply

2. sever at the apex

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

True or False: Bacteria are not necessary to cause pulpal and periapical disease.

A

False, bacteria is necessary! the germ-free-rats proved it

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

A good _____ is critical for success of pulpal therapy (pulpotomies and root canal treatment).

A

seal

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

Most bacteria cultures from necrotic pulps are _______ and usually gram negative.

A

anaerobic

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

Pulpal and periapical diseases have _______ strain(s) of bateria per tooth and are ________, not saccharolytic.

A

multiple

proteolytic

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

Based on cultivation studies, which two bacterial species are associated with periapical abscesses?

A

Prevotella and Porphyromonas

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

What is characteristic of prevotella and porphyromonas?

A

FOUL ODOR

P.P is stinky

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

Pulpal infections have ______ micro-environments, variable ____ concentrations, and differing ______ needs as depth changes.

A

complex
oxygen
nutrient

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

Within the canal, sccharolytic bacteria are found _____ and proteolytic bacteria are found ______.

A

coronally

apically

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

What is pulpitis?

A

early stage endodontic infection where bacteria have entered the pulp

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

What are the two types of pulpitis and how do they differ (pain response)?

A

Reversible: lowered threshold with prolonged pain response to stimuli such as COLD

Irreversible: SPONTANEOUS onset of pain is severe, sharp, or throbbing

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

What stage of pulpal infection occurs just after pulpitis?

A

Periapical Lesions (shift the inflammatory response to surrounding tissue at apex because the blood supply is cut off to the pulp)

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

True or False: Periapical lesions are often asymptomatic and only detected on radiographs.

A

True
because the pulp is necrotic…the inflammatory response is effective and the bacteria are confined to the periapical tissues

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

Most periapical lesions are ________.

A

granulomas

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

Periapical granulomas are ______ dominated.

A

macrophage

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

What kind of abscess is associated with: pain that is relieved through drainage of pus?

A

Acute Dentoalveolar Abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How does an Acute Dentoalveolar Abscess form and how does it appear?

A

exacerbation of a periapical lesion with a shift in bacterial species or a lowered immune response (seen as purulent bacterial infection that is confined to bone at the apex)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Drainage of a Acute Dentoalveolar Abscess to the ____ brings relief. Whereas, drainage of the abscess to the ______ is serious due to orofacial involvement.

A

surface = relief

tissue space = orofacial involvement

26
Q

What is the difference between pallative and definitive treatment of pulpal/periapical diseases?

A 
Pallative = relieving symptoms
Definitive = ridding of the cause
27
Q

Pharmacologic treatment with analgesics or local anesthetics are examples of _____ treatment.

A

pallative

28
Q

Extraction and root canal therapy are examples of ______ treatment.

A

definitive

29
Q

Why are antibiotics not effective against infections that are confined to the pulp or apical periodontium?

A

Blood supply is cut off

30
Q

What are three reasons why periapical infections persist after root canal treatment?

A
  1. biofilm presence on the surface of the tooth apex
  2. debris remained within an inaccessible region of the canal
  3. foreign body fragments were displaced during instrumentation
31
Q

What is an effective treatment procedure for a persistent apical lesion?

A

Endodontic Microsurgery (aka: Apicoectomy)

  • surgical access to apex via gingival flap
  • removal of apex tip
  • cleaning of apical foramen
  • sealed with Mineral Trioxide Aggregate (MTA)
32
Q

When dental infections spread to surrounding tissues, they are called ______ infections.

A

odontogenic

33
Q

An odontogenic infection that is localized to the alveolar area is classified as a _________ infection.

A

dentoalveolar

34
Q

An odontogenic infection can extend to adjacent facial structures or become a _______ ______ infection.

A

disseminated systemic

35
Q

What is the usual course of periapical infections that spread to surrounding tissues?

A

an initial cellulitis or tissue invasion

36
Q

What is cellulitis?

A

infection that spreads through soft tissue via vascular channels or through direct autolysis of tissue

37
Q

Tissue associated with cellulitis is _______ and ______ to palpation.

A

swollen and hard (indurated)

38
Q

Cellulitis can progress to ________ formation, which is considered second phase.

A

abscess

39
Q

What is clinically recognizable about second phase cellulitis (abscess)?

A

Pus production

-badly infected tissue can become walled off and the acute inflammatory process is stimulated with migration of PMNs

40
Q

Second phase cellulitis is characterized by a ________ lesion; the first phase of cellulitis is indurated and swollen.

A

Fluctuant and erythematous

41
Q

Is second phase cellulitis vascular or avascular?

A

avascular (oxygen levels are low)

42
Q

Abscesses will not resolve without drainage. What are the two natural drainage routes?

A
  1. External (intraoral or extraoral fistula)

2. Internal (in the tissue spaces leading to potentially serious infections**)

43
Q

True or False: Cellulitis and Dental Abscesses are mono-microbial.

A

False: polymicrobial ~4-6 species

44
Q

Are there more anaerobes or aerobes in cellulitis?

A

anaerobes (2 or 3) to aerobes 1

45
Q

Which bacterial species are most prevalent in cellulitis?

A

streptococci and prevotella

46
Q

The presence of ______ in cellulitis usually results in more severe symptoms.

A

fusobacterium

47
Q

Treatment of cellulitis involves: temporary management with _______, quick resolution via _________ of the source, or ______ of the tooth followed by ________ if it is well-established.

A

antibiotics
removal of the source of infection
extraction with antibiotics

48
Q

If toot extraction or root canal therapy does not work for an abscess, _________ and ______ is required for resolution.

A

surgical incision

drainage

49
Q

What are the two first line antibiotic choices for abscesses?

A

penicillin (most often- narrow spectrum)

clindamycin (alternate-unnecessarily broad spectrum)

50
Q

What are three common bone infections?

A
  1. Alveolar Osteitis (dry socket)
  2. Osteomyelitis of the Jaw
  3. Medication Induced Osteonecrosis of the Jaw (MRONJ)
51
Q

What is alveolar osteitis and how does it occur?

A

dry sockets

  • delayed healing of extraction site, premature breakdown of fibrin clots that exposes bone
  • biofilm formation on the bone surface
  • painful, swollen, red, and mal-odor
52
Q

How are dry sockets treated?

A

Systemic antibiotics do not work

-gentle debridement and medicated dressing

53
Q

How does osteomyelitis of the jaw present?

A

radiolucent area of bone that may be surrounded by an involucrum (white line), pain, swelling, and possible pus

54
Q

How do you treat osteomyelitis of the jaw?

A

surgical debridement

longterm antibiotic therapy

55
Q

How does MRONJ present itself?

A

as exposed bone that does not heal with swelling, pain, redness, ulceration, and pus

56
Q

What are two predisposing factors of MRONJ?

A
  1. immunosuppressive cancer treatement

2. high-dose IV bone antiresorptive agents (bisphosph)

57
Q

True or False: MRONJ is fairly common in cancer patients and occurs in approximately 30% of cases.

A

False: it is rare, less than 2%

58
Q

Why does MRONJ occur?

A

antiresorptive agents prevent osteoclasts from remodeling bones (becomes non-shedding) while the bone surface also has decreased vascularity. Biofilms form on the exposed bone surface after dental procedure.

59
Q

True or False: MRONJ occurs in adults and children.

A

False. Not reported in children

60
Q

MRONJ has mixed species bacterial and ______ biofilms.

A

yeast

61
Q

How do you treat MRONJ?

A
  1. Insist on a “drug holiday” from the anti-resorptive drug
  2. Systemic antibiotics
  3. Remove biofilm by debridement
62
Q

List the diseases from least to most severe:

apical periodontitis, bone infections, abscess, acute apical abscess, cellulitis, pulpitis

A 
Least to Most:
Pulpitis
apical periodontitis
acute apical abscess
cellulitis
abscess
bone infections

AU 15- Oral Micro (11 decks)

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