The Disease of Pulp and Periodontium Flashcards
What are the clinical features of pulp hyperaemia?
- pain lasting for seconds
- pain stimulated by hot/cold or sweet foods
- pain resolves after stimulus
- caries approaching pulp but tooth can still be restored without treating pulp
What are the clinical features of acute pulpitis?
- constant severe pain
- reacts to thermal stimuli
- poorly localised pain
- referral of pain
- no (or minimal) response to analgesics
- open symptoms less severe
How do we diagnose acute pulpitis?
- history
- visual examination
- negative tenderness to percussion
- pulp testing isn’t helpful
- radiographs
- diagnostic LA
How does acute apical periodontitis present on a radiograph?
- loss of clarity of lamina dura
- radiolucency shadow
- delay in changes at the apex of the tooth
- widening of apical periodontal space
Is acute apical periodontitis TTP?
YES very much so
What are the clinical features of acute apical periodontitis?
- TTP
- tooth is non-vital
- increased mobility
- radiographic shows
What causes traumatic periodontitis?
Parafunction (tooth clenching or grinding)
How might a parafunctional habit show on radiographs?
Widening of PDL space
What organisms are involved in dental abscesses?
Anaerobes play an important part
What are the symptoms of an acute apical abscess?
- severe unremitting pain
- acute tenderness in function
- acute tenderness on percussion
NO swelling, redness or heat yet
What occurs once an acute apical abscess perforates through the bone?
- pain often remits
- swelling, redness and heat in the soft tissue become apparent
- as swelling increases pain returns
- usually initial reduction in tenderness to percussion of the tooth as pus escapes into the soft tissues
What does the site of swelling of an acute apical abscess depend on?
- the position of the tooth in the arch
- root length
- muscle attachments
- potential spaces in proximity to lesion
How are acute apical abscesses treated?
- Provide drainage
- Occasionally require antibiotics
What local factors would suggest a patient may require antibiotics to treat an acute apical abscess?
- toxicity
- airway compromisation
- dysphagia
- trismus
- lymphadenitis
- location
What is a periapical granuloma? (chronic apical periodontitis)
Mass of chronically inflamed granulation tissue at apex of tooth
- plasma cells, lymphocytes, histiocytes with fibroblasts and capillaries
