Pulpal, Periapical, and Periodontal Disease Flashcards
1
Q
Abscess
A
- Confined pocket of puss
- collects in tissues, organs or spaces inside the body
2
Q
Cyst
A
- Closed sac
- distinct membrane
- develops abnormally in cavity or structure of body
3
Q
Granuloma
A
- Mass or nodule of chronically inflamed tissue
- associated w/infective process
4
Q
Primary Dentin
A
- Dentin formed before crown completion
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
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
6
Q
What is the timeline for pulpal and periodical disease?
A
- Caries, Trauma, Periodontitis
- Death of Dental Pulp
- Apical Bone inflammation
- Dental Granulation formation
- Stimulation of epithelial rest of Malassez
- Epithelial Proliferation
- Periapical Cyst formation
7
Q
How does Dentin show up radiographically?
Secondary & Tertiary Dentin
A
- accelerated closure of pulp chamber and canal
- obliterated pulpal space
8
Q
how long do Alterations in dentin take after trauma?
A
As early as 3 months
9
Q
What separates primary and secondary dentin?
A
- line of demarcation
- bending of tubules
10
Q
Tertiary Dentin
A
- localized to pulpal end of odontoblastic processes
11
Q
Calcific Metamorphosis
A
- hard tissue deposited in root canal space
- yellow discoloration of clinical crown
12
Q
Calcific Metamorphosis
A
- hard tissue deposited in root canal space
- yellow discoloration of clinical crown
13
Q
Pulpal Calcifications
A
- prevalence increases with age
- associated w/chronic pulpitis
14
Q
Types of Pulpal Calcifications?
A
- Denticles
- Pulp Stones
- Diffuse Linear Calcifications
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
- neutrophils predominate
- Chronic Inflammatory cells dominate host response
- stimulate fibroblasts and microvasculature
- Early stages:
- 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:
- Involve Canine space
- Protrusion and fixation eyeball
- proptosis, chemises, ptosis
