Pulpal, Periapical, and Periodontal Disease Flashcards

1
Q

Abscess

A
  • Confined pocket of puss
  • collects in tissues, organs or spaces inside the body
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2
Q

Cyst

A
  • Closed sac
  • distinct membrane
  • develops abnormally in cavity or structure of body
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3
Q

Granuloma

A
  • Mass or nodule of chronically inflamed tissue
  • associated w/infective process
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4
Q

Primary Dentin

A
  • Dentin formed before crown completion
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5
Q

Secondary Dentin

A
  • After primary dentin
  • leads to smaller pulp chambers and canals
  • Deposition not uniform
  • associated w/calcification related disease
    • arthritis
    • gout
    • kidney. stones
    • gall stones
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6
Q

Causes of Secondary Dentin

A
  • Early formation associated with progeria (accelerated aging)
  • Significant traumatic injury
    • early obliteration of pulp chamber and canal =calcific metamorphosis
    • leads to yellow discoloration of crown
  • Physiologic secondary dentin
    • result of aging
    • functional forces of occlusion promote deposition
    • begin in apical areas and spread coronally
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6
Q

What is the timeline for pulpal and periodical disease?

A
  1. Caries, Trauma, Periodontitis
  2. Death of Dental Pulp
  3. Apical Bone inflammation
  4. Dental Granulation formation
  5. Stimulation of epithelial rest of Malassez
  6. Epithelial Proliferation
  7. Periapical Cyst formation
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7
Q

How does Dentin show up radiographically?

Secondary & Tertiary Dentin

A
  • accelerated closure of pulp chamber and canal
  • obliterated pulpal space
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8
Q

how long do Alterations in dentin take after trauma?

A

As early as 3 months

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9
Q

What separates primary and secondary dentin?

A
  • line of demarcation
    • bending of tubules
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10
Q

Tertiary Dentin

A
  • localized to pulpal end of odontoblastic processes
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11
Q

Calcific Metamorphosis

A
  • hard tissue deposited in root canal space
  • yellow discoloration of clinical crown
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12
Q

Calcific Metamorphosis

A
  • hard tissue deposited in root canal space
  • yellow discoloration of clinical crown
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13
Q

Pulpal Calcifications

A
  • prevalence increases with age
  • associated w/chronic pulpitis
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14
Q

Types of Pulpal Calcifications?

A
  • Denticles
  • Pulp Stones
  • Diffuse Linear Calcifications
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15
Q

Pulpitis

A
  • Inflammation of the Pulp
16
Q

What does pulpits cause?

A
  • increased fluid pressure
    • adjacent to affected dentin
    • increases interstitial pressure
      • →causes increased flow of fluid back into capillaries of adjacent uninflamed tissue and increased drainage
17
Q

What are the causes of Pulpitis:

A
  • Mechanical Damage
  • Thermal Injury
  • Chemical Irritation
  • Bacterial effects
18
Q

Chronic Hyperplastic Pulpitis

A
  • aka Pulp polyp
  • Teeth w/large chamber
    • molars
  • Mostly children
  • Pink to red nodule
    • in pulp chamber
  • inflammatory hyperplasia
19
Q

Periapical Granuloma

A
  • Aka Apical Periodontitis
  • inflamed granulation tissue at apex of non-vital tooth
  • Formation of apical inflammatory lesion:
    • Early stages:
      • neutrophils predominate
        • release prostaglandins→activate osteoclasts
      • radiographic alterations absent
        • acute apical periodontitis
    • Chronic Inflammatory cells dominate host response
      • stimulate fibroblasts and microvasculature
  • Phoenix Abscess
20
Q

Acute Apical Periodontitis

A
  • constant dull, throbbing pain
  • pain on biting and percussion
    • periodical granuloma-asymptomatic
  • represent 75% of apical inflammatory lesions
  • 50% fail to respond to conservative endo
21
Q

Periapical Cyst

A
  • aka Radicular Cyst
  • True epithelium-lined cyst in response to inflammation
  • Source of epithelium
    • Rest of malassez
  • No Symptoms
  • Radiograph:
    • loss of lamina dura
  • Root Resorption-Common
  • Cyst Development-Common
22
Q

What are the variants of Periapical Cysts

A
  • Periapical Pocket cyst
  • Periapical True cysts
  • Lateral Radicular Cyst
  • Residual Periapical Cyst
23
Q

Periapical Pocket Cysts

A
  • Incomplete epithelial lining
  • apical portion of tooth extends into cyst lumen
24
Q

Periapical True Cysts

A
  • Complete Epithelium-lined
  • bag like structure
  • adjacent to tooth apex
25
Q

Lateral Radicular Cyst

A
  • appear along lateral aspect of root
  • mimic radiograph of lateral periodontal cyst
26
Q

Residual Periapical Cyst

A
  • Inflammatory cyst
  • post extraction
27
Q

Periapical Abscess

A
  • Acute Apical Periodontitis
    • earliest stage of all forms of periodical inflammatory disease
    • symptomatic and asymptomatic presentations
  • Radiograph:
    • Thickened PDL
    • ill defined radiolucency
    • or both
  • Parulis (gum boil)
  • Dental abscesses drain via cutaneous sinus
    • perforate buccally-thinner bone
  • Drain through lingual cortical plate
    • Maxillary Lateral incisors
    • palatal roots of maxillary molars
    • mandibular 2nd and 3rd molars\
  • Can spread through bloodstream=systemic symptoms
    • fever
    • lymphadenopathy
    • malaise
28
Q

Cellulitis

A
  • Abscess that doesn’t drain through surface of skin or into oral cavity
    • spread diffusely through fascial planes of soft tissue
  • Types:
    • Ludwigs Angina
    • Cavernous Sinus Thrombosis
29
Q

Ludwig’s Angina

A
  • aggressive and rapid spreading cellulitis
  • involves:
    • sublingual
    • submandibular
    • submental spaces
  • Acute infection from lower molar teeth-70%
    • extend to lateral pharyngeal space→retropharyngeal space
    • spread to mediastinum
      • serious consequences
      • massive swelling of neck-→clavicle
  • Woody Tongue
    • sublingual space
    • compromised airway
  • Bull neck
    • submandibular space
  • Restricted neck movement
30
Q

Cavernous Sinus Thrombosis

A
  • edematous periorbital enlargement
    • involve:
      • eyelids
      • conjunctiva
  • Involve Canine space
  • Protrusion and fixation eyeball
  • proptosis, chemises, ptosis