Unit 3 Flashcards
Definition of Pulpitis
Response of dental pulp to injury, with the pulp attempting to remove cellular debris, limit tissue damage, or eliminate invading organisms
Describe the clinical presentation of Pulpitis
- Inflammatory reaction can increase pulpal injury or lead to necrosis.
- increased fluid pressure, with flow of fluid back into capillaries of adjacent uninflamed tissue and increased drainage.
- Localized abscesses can heal via reparative dentin.
- severe localized damage can spread apically and produce pulpal necrosis.
Describe reversible pulpits.
Reversible: mild/moderate, short duration of pain due to cold, sweet, or sour
Describe Irreversible Pulpitis.
Irreversible: sharp, severe, continues after stimulus. Low electronic response to stimulus.
Describe the histology of pulpits
does not always match the symptoms but reversible may demonstrate tissue with hyperemia and edema.
Define what a Periapical granuloma is
A mass of granulated tissue causing inflammation at the apex of the tooth. granulated tissue itself is inflamed.
What is the cause of a Periapical Granuloma?
Mass of chronically or subacutely inflamed granulated tissue at the apex of a toot
A Periapical Granuloma is considered a True cyst T/F?
True
What are a Periapical Granuloma clinical signs?
Chronic lesions are usually asymptomatic.
Discovered by routine XR
What is the histological presentation of a Periapical granuloma?
*not a true granulomatous inflammation microscopically
Inflamed Granulation tissue surrounded by fibrous connective tissue.
A common differential diagnosis of periapical granulomas?
periapical cysts
What is a periapical cyst?
Epithelium at the apex of a tooth that is stimulated by inflammation.
What is the cause of a periapical cyst?
The Rests of Malassez is the epithelial source.
It can also arise from cervical or sinus epithelium.
What is a periapical abscess?
An accumulation of inflammatory cells at the apex of a tooth.
Describe the clinical condition of a periapical abscess?
Can be symptomatic or asymptomatic
-The presence a Parulis: A gingival boil filled with puss from a draining abscess, Detected on a XR as a thickened PDL + ill-defined radiolucency.
How does the Hystology of a periapical abscess present?
A sea of PMNs within exudate.
What is Periapical Cellulitis?
The dangerous spread of abscesses through facial planes of soft tissue. These accesses have the inability to drain to the surface.
How does Periapical Cellulitis present?
Swollen, red and Tender
Ludwig’s Angina: Infection has spread from the lower molars to one or more sublingual, submandibular, submental or even to the mediastinum spaces.
Woody Tongue: Elevation, and enlargement of the tongue, may compromise airway. In this case the infection can spread to the contralateral side. The submandibular space can be infected leading to enlargement and tenderness of the neck right above the hyoid bone.
Cavernous sinus thrombosis: Infection of the maxillary sinus perforates the maxillary bone into the canine space. Infection of eyelid and conjunctiva result.
Which Periapical Cellulitis is most dangerous. How is it treated?
Cavernous sinus thrombosis: Incision & Drainage and high dose antibiotics. Patients can die from this
What is Pulpal Calcification?
Begins when secondary denton is laid down. Starts in the coronal area and progresses downward. Aging may be the cause.
Tertiary Dentin is localized haphazardly arranged dentin that is in response to a focal injury (caries, attrition, etc…)
How many people are affected by plural calcification
8-90% of people
More common with males as they age
Pulpal calcification can also be associated with?
Dentin dysplasia I and II
Tumoral calcinosis
Ehlers Danlos Syndrome
There are 3 types of Pulpal calcification to recognize
Denticles
Pulp stones
Diffuse linear Calcifications
