Swellings Flashcards
what are the differential diagnosis for a patient who has swelling and apical pathology is present
periapical periodontitis, perio-endo lesion, periodontal abscess, periapical abscess, periapical cyst
what are the differential diagnosis for a patient who has swelling and apical pathology is not present
salivary gland obstruction/infection, pericoronitis, fractured jaw, fractured tooth, malignancy, bony diseases, tumour, tori
what are the symptoms of acute apical abscess
localised pain, pain increases on chewing/touching tooth, quick onset of swelling and pain, possible mobility
what is the immediate management of acute apical abscess
establish drainage, extirpate/XLA +/- incision of fluctuant swellings, analgesia, antimicrobials, consider relieving occlusion
what is the long term management of acute apical abscess
review, RCT or XLA
what are the symptoms of pericoronitis
localised pain to partially erupted tooth, swelling of gingiva which can progress to facial swelling, limited mouth opening, bad taste and smell
what is the immediate management of peicoronitis
debride area, irrigate with saline, assess need to antimicrobials, consider adjustment of opposing tooth
what is the long term management of pericoronitis
consider XLA for 2 or more episodes or 1 severe episode, XLA of opposing tooth
what are the symptoms of perio-endo abscess
generalised periodontitis with localised pain, swelling, deep pocketing to root apex
what is the immediate treatment for perio-endo abscess
debride pockets, irrigate, chemical plaque control, establish drainage - extirpate/XLA +/- incision, antibiotics
what is the long term management of perio-endo abscess
review OH, based on whether the cause is primary endo/perio carry out endodontic/periodontal therapy initially, followed up by the other one
what are the symptoms of salivary gland obstruction/infection
pain in major salivary gland, swelling, history of dehydration, history of xerostomia
what is the immediate management of salivary gland obstruction/infection
analgesia, advise patient to increase fluid intake, use warm compress on gland, massage gland, encourage salivary slow, consult GMP to consider changing medication, referral
what is the long term management of salivary gland obstruction/infection
saliva substitutes, high caries risk prevention protocol
what are the symptoms of periodontal abscess
pain/tenderness of gingiva, increased mobility, gingival swelling, suppuration from gingiva, systemic symptoms inlude pyrexia, lymphadenopathy and malaise
what is the immediate management of peridontal abscess
supra and sub-gingival debridement of pockets, antibiotics, consider extraction
what is the long term management of periodontal abscess
review OH, periodontal treatment, consider extraction
what is a radicular cyst
apical to non-vital tooth, egg-shell crackling of bone, commonly upper centrals
what is the treatment of radicular cysts
root canal or extraction
what is a residual cyst
following extraction of tooth with radicular cysts, cyst remains and becomes residual cyst
what is the treatment of a residual cyst
no treatment and monitor or enucleation
what is a dentigerous cyst
cyst that develops around CEJ of teeth and prevents their eruption
what is the treatment of dentigerous cyst
surgical removal or uncover the tooth
what is a mucocele
due to trauma to minor salivary gland, usually lower lip
what is the treatment of a mucocele
monitor or enucleation
what is a ranula
cyst formed from major salivary gland (submandibular or sublingual)
what is the treatment for a ranula
marsupialisation
what is a salivary gland stone/obstruction
cause pain and swelling, diagnosis with clinical signs and symptoms physical exam
what is the treatment for salivary gland stone/obstruction
depends on size and location: no treatment, surgical removal, basket retrieval, lithotripsy
