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BDS4 Oral Surgery > The diseases of the pulp and periodontium > Flashcards

The diseases of the pulp and periodontium Flashcards

1
Q

What can caries result in

A
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2
Q

Clinical features of pulp hyperaemia

A
  • sharp 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 (reversible pulpitis)
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3
Q

Clinical features of acute pulpitis

A
  • constant severe pain
  • reacts to thermal stimuli
  • poorly localised pain
  • referral of pain
  • no/minimal response to analgesics (can’t get into pulp chamber)
  • open sumptoms less severe
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4
Q

would acute pulpitis show as positive or negative to TTP and why

A

Negative (usually) as PDL is not inflamed

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5
Q

How could you diagnose acute pulpitis

A
  • History - constant severe pain, reacts to thermal stimuli, poorly localised pain, referral of pain, no/minimal response to analgesics
  • Visual examination
  • negative TTP
  • pulp testing equivocal
  • radiographs - big cavity maybe but that’s all
  • ‘Diagnostic LA’ - numb up and see if pain goes away
  • removal of restorations
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6
Q

is pulp hyperaemia reversible or irreversible

A

reversible

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7
Q

Is acute pulpitis reversible or irreversible

A

irreversible

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8
Q

What is the diagnosis:
- can pinpoint exactly where pain is
- very TTP
- tooth is non-vital
- slight increase in mobility
- radiographs: loss of clarity of lamina dura, possible radioleucent shadow from old lesion, delay in changes at the apex of the tooth

A

acute periodontits

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9
Q

What causes traumatic periodontitis

A

parafunction (tooth clenching or grinding)

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10
Q

in traumatic periodontitis would teeth have vitality?

A

yes

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11
Q

how would you diagnose traumatic periodontitis

A
  • clinical examination of occlusion (functional positioning, posturing)
  • TTP
  • normal vitality
  • radiographs may show generalised widening of PDL space
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12
Q

how would you treat traumatic periodontitis

A
  • occlusal adjustment
  • therapy for parafunction
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13
Q

what is the most common pus producing infection

A

acute apical abscess

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14
Q

what infections produce pus

A
  • acute apical abscess
  • periodontal abscess
  • peridoronitis
  • sialadenitis (infection of glands)
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15
Q

scientific word for pus

A

suppuration

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16
Q

what orgainisms are in a dental abscess

A
  • polymicrobial
  • anaerobes play a part

unusual infections:
- staphylococcal lymphadenitis of childhood
- cervico-facial actinomycosis

17
Q

initial symptoms of acute apical abscess

A
  • severe unremitting pain
  • acute tenderness in function
  • acute tenderness on percussion

before it perforates through bone

18
Q

what are the differences between acute apical periodontitis and acute apical abscess

A

get answer

19
Q

what are the 5 cardinal signs of inflammation

A
  1. heat
  2. redness
  3. swelling
  4. pain
  5. loss of function
20
Q

what are the symptoms once an acute apical abscess perforates through bone

A
  • pain often remits (unless it’s in the palate) (release of pressure)
  • swelling, redness and heat (in the soft tissues) become increasingly apparent
  • as swelling increases, pain returns
  • there is an initial reduction in TTP of the tooth as pus escapes into the soft tissues
21
Q

when do 3rd molars erupt into the mouth

A

18-24yrs

22
Q

when does crown calcification begin in a 3rd molar

A

7-10 years old

Upper: 7-9yrs; Lower: 8-10yrs

23
Q

when is root calcification complete for 3rd molars

A

18-25yrs

24
Q

what is it called when an organ (tooth) fails to erupt

A

agenesis

25
Q

What does impacted mean

A

blocked (partial or full)

26
Q

incidence of impacted lower 3rd molars

A

36-59%

27
Q

nerves at risk during 3rd molar surgery

A
  • inferior alveolar nerve
  • lingual nerve
  • nerve to mylohyoid
  • long buccal nerve
28
Q

anatomy of where the lingual and inferior alveolar nerve lies at 3rd molar

A
29
Q

what does the IAN supply and what is it a branch of

A
  • mandibular division of trigeminal nerve
  • supplies all mandibular teeth on that side, skin of lower lip and chin on that side
30
Q

what is the lingual nerve a branch of and what does it supply

A
  • mandibular division of the trigeminal nerve
  • supplies anterior 2/3 dorsal and ventral mucosa of tongue
  • also gives off a branch which supplies lingual gingiva of mouth
31
Q

where does the lingual nerve lie

A
  • superior attachment of mylohyoid muscle and mean vertical distance from the crest of the lingual plate is 8.32mm while mean horizontal distance is 3.45mm
32
Q

what is the location of the lingual nerve

A

close relationship to the lingual plate in mandibular and retromolar area

33
Q

What are the NICE guidelines on whether or not to extract wisdom teeth

A

Discouraged removal unless there is pathology

34
Q

What are the FDS, RCS 2020 guidelines on whether to extract wisdom teeth

A
  • by not removing we’re just postponing inevitable surgery which can make tx more difficult at the time
  • could affect 7
  • complicaitons if older pt

more holistic and agreed by pt

35
Q

Indications for extraction

A
  • infections
  • cysts
  • tumours
  • external resorption of 7 or 8

BDS4 Oral Surgery (10 decks)

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