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Oral Pathology > Pulpal, Periapical, and Periodontal Disease > Flashcards

Pulpal, Periapical, and Periodontal Disease Flashcards

1
Q

pulpitis

A

inflammation of the pulp

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2
Q

etiologies of pulpitis (4)

A
  1. mechanical damage
  2. thermal injury
  3. chemical irritation
  4. bacterial effects
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3
Q

MAIN difference between reversible and irreverisble pulpitis

A

reversible pulpitis - pain stops after a few minutes, only pain when stimulated

irreversible pulpitis - sharp, severe pain that lingers

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4
Q

What difficulty is presented with irreversible pulpitis?

A

difficult to localize pain to specific tooth

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5
Q

another name for pulp polyp

A

chronic hyperplastic pulpitis

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6
Q

demographics of pulp polyp

A

children and adolescents

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7
Q

clinical features of pulp polyp (3)

A
  1. asymptomatic
  2. granulomatous proliferation of pulpal tissue (pulp does not die, but becomes hyperplastic)
  3. large cavity and pulp exposed
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8
Q

acute apical periodontitis + chronic inflammation

A

periapical granuloma

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9
Q

acute apical periodontitis + pyogenic bacteria and suppuration (pus formation)

A

periapical abscess

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10
Q

acute apical periodontitis + activation of cell rests of Mallassez and cystic degeneration

A

periapical cyst

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11
Q

another name for parulis

A

gum boil

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12
Q

parulis (definition)

A

type of periapical abscess that occurs at the opening of the sinus tract near the apex of the tooth in the gums

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13
Q

if parulis is perforated, the pus is drained into the _______

A

oral cavity

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14
Q

periapical abscess usually drains to which side?

A

buccal

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15
Q

periapical abscess on maxillary lateral incisors usually drain

A

palatally (inclination)

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16
Q

periapical abscess near mandibular second and third molars usually drain

A

onto the skin surfus

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17
Q

clinical features of ludwig’s angina (4)

A
  1. massive neck swelling
  2. woody tongue
  3. bull neck
  4. dysphagia, dysphonia, respiratory embarassment, constiuttional symptoms
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18
Q

spaces involved in ludwig’s angina

A

affects sublingual, submandibular, and submental spaces

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19
Q

management of ludwig’s angina

A
  1. maintain airway
  2. resolve infection
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20
Q

clinical features of cavernous sinus thrombosis (6)

A
  1. perioral and periorbital edema
  2. ocular protrusion and fixation
  3. pupillary dilation, photophobia, loss of vision
  4. proptosis (buldging or protrusion of eye)
  5. chemosis (swelling of conjunctiva)
  6. ptosis (upper eyelid drooping over the eye)
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21
Q

cranial nerves involved in cavernous sinus thrombosis

A

III, IV, V1, V2, VI

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22
Q

management of cavernous sinus thrombosis

A
  1. incision and drainage
  2. IV antibiotics
  3. tooth extraction
  4. systemic corticosteroids

recognize what is going on and send PT to hospital!

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23
Q

prognosis of cavernous sinus thrombosis

A

high mortality (30%)

24
Q

infection space that contributes to cavernous sinus thrombosis

A
  1. lateral to sella turcica and medial to temporal bone
  2. dental infections count for 10% of cases
25
Q

highest risk area of face leading to cavernous sinus thrombosis

A

canine space infection

26
Q

what is osteomyelitis?

A

“bone marrow inflammation”

acute or chronic inflammatory process in the medullary space or cortical surfaces of bone that extend away from the intitial site of involvement

27
Q

Is osteomyelitis more common in the maxilla or mandible? why?

A

mandible (less vascular supply)

28
Q

signs and symptoms of acute suppurative osteomyelitis?

A

fever
pain
swelling
lyphadenopathy
lower lip paresthesia
drainage

29
Q

x-ray features of acute suppurative osteomyelitis (4)

A
  1. ill defined radiolucency (moth eaten appearance)
  2. widened PDL
  3. loss of lamina dura
  4. cortical duplication
30
Q

signs and symptoms of chronic suppurative osteomyelitis

A

swelling
pain
purulent discharge
sinus tracts
tooth loss
pathologic fracture
sequestration of non-vital one

31
Q

cortical duplication in proliferative periostitis

A

onion peel appearance

periosteal reaction to infection

32
Q

another name for alveolar osteitis

A

dry socket

33
Q

alveolar osteitis

A

premature fibrinolysis of post-extraction clot

34
Q

Risk factors for alveolar osteitis

A

smoking
oral contraceptives
poor surgical technique
excess use of vasoconstrictor

35
Q

management of alveolar osteitis

A

irrigation
analgesics
obtundent dressing

36
Q

most important thing to remember with the management of dry sockets

A

difficult to treat, try to prevent

37
Q

systemic factors of gingival inflammation

A

hormonal changes
stress
substance abuse
malnutrition
medication
diabetes
immune dysfunction
heavy-metal poisoning

38
Q

local factors of gingival inflammation

A

local trauma
tooth crowding
dental anomalies
tooth fracture
caries
gingival recession
high frenum attachment

39
Q

clinical features of gingivitis

A
  1. loss of stippling
  2. bleeding on probing
  3. increasing erythema and edema
  4. gingival hyperplasia
  5. pyogenic granuloma
40
Q

demographics of localized juvenile spongiotic gingival hyperplasia

A

adolescents

41
Q

clinical features of localized juvenile spongiotic gingival hyperplasia

A

small, bright red, hemorrhagic, velvety / papillary, sessile lesion

usually on maxillary gingiva

42
Q

management of localized juvenile spongiotic gingival hyperplasia

A

surgical incision

43
Q

causes of plasma cell gingivitis

A

allergic etiology (cinnamon gum, herbal toothpastes, breath mints)

use of “kath” in Yemen

44
Q

clinical features of plasma cell gingivitis

A

rapid onset of stomatodynia (intensified by toothpaste, hot or spicy foods)

45
Q

histopathological features of plasma cell gingivitis

A

intense plasmacytic infiltrate

46
Q

granulomatous gingivitis due to embedded foreign materials

A

foreign material embedded in CT (pumice, cement, luting agents, etc)

47
Q

prevention of granulomatous gingivitis due to embedded foreign material

A

cautious dental care (teeth polishing after 2 weeks of SRP)

48
Q

management of granulomatous gingivitis

A

identify foreign material
excise symptomatic tissue
graft healthy tissue

49
Q

medications frequently associated with gingival hyperplasia

A

Phenytoin
calcium channel blockers
cyclosporin

50
Q

clinical features of gingival hyperplasia

A

related to degree of inflammation

minimal = firm / pink / stippled
moderate = red / edematous
severe = friable, ulcerated

51
Q

management of gingival hyperplasia

A
  1. discontinue medication
  2. substitute medication
  3. aggressive preventative dental measures
  4. gingivioplasty to gingivectomy
52
Q

etiology of gingival fibromatosis

A

familial or idiopatic

53
Q

clinical features of gingival fibromatosis

A
  1. firm texture
  2. normal color
  3. multiple problems (cosmesis, retained decisuous teeth, abnormal occlusion, inadequate lip closure, dysphagia and dysphonia)
54
Q

management of gingival fibromatosis

A

mild cases respond to SRP

gingivectomy for advanced cases

55
Q

cause of Papillon-Lefevre syndrome

A

mutation and loss of function of the Cathepsin C gene (autosomal recessive trait)

56
Q

clinical features of Papillon-Lefevre syndrome

A

-Palmar and planter hyperkeratosis
-advanced periodontitis

57
Q

management of Papillon-Lefevre syndrome

A

cutaneous hyperkeratosis treated with vitamin A analogs and keratolytics

periodontal manifestations difficult to control

Oral Pathology (14 decks)

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