Unit 3

Question 1

Definition of Pulpitis

Answer 1

Response of dental pulp to injury, with the pulp attempting to remove cellular debris, limit tissue damage, or eliminate invading organisms

Question 2

Describe the clinical presentation of Pulpitis

Answer 2

• 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.

Question 3

Describe reversible pulpits.

Answer 3

Reversible: mild/moderate, short duration of pain due to cold, sweet, or sour

Question 4

Describe Irreversible Pulpitis.

Answer 4

Irreversible: sharp, severe, continues after stimulus. Low electronic response to stimulus.

Question 5

Describe the histology of pulpits

Answer 5

does not always match the symptoms but reversible may demonstrate tissue with hyperemia and edema.

Question 6

Define what a Periapical granuloma is

Answer 6

A mass of granulated tissue causing inflammation at the apex of the tooth. granulated tissue itself is inflamed.

Question 7

What is the cause of a Periapical Granuloma?

Answer 7

Mass of chronically or subacutely inflamed granulated tissue at the apex of a toot

Question 8

A Periapical Granuloma is considered a True cyst T/F?

Answer 8

True

Question 9

What are a Periapical Granuloma clinical signs?

Answer 9

Chronic lesions are usually asymptomatic.

Discovered by routine XR

Question 10

What is the histological presentation of a Periapical granuloma?

Answer 10

*not a true granulomatous inflammation microscopically

Inflamed Granulation tissue surrounded by fibrous connective tissue.

Question 11

A common differential diagnosis of periapical granulomas?

Answer 11

periapical cysts

Question 12

What is a periapical cyst?

Answer 12

Epithelium at the apex of a tooth that is stimulated by inflammation.

Question 13

What is the cause of a periapical cyst?

Answer 13

The Rests of Malassez is the epithelial source.

It can also arise from cervical or sinus epithelium.

Question 14

What is a periapical abscess?

Answer 14

An accumulation of inflammatory cells at the apex of a tooth.

Question 15

Describe the clinical condition of a periapical abscess?

Answer 15

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.

Question 16

How does the Hystology of a periapical abscess present?

Answer 16

A sea of PMNs within exudate.

Question 17

What is Periapical Cellulitis?

Answer 17

The dangerous spread of abscesses through facial planes of soft tissue. These accesses have the inability to drain to the surface.

Question 18

How does Periapical Cellulitis present?

Answer 18

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.

Question 19

Which Periapical Cellulitis is most dangerous. How is it treated?

Answer 19

Cavernous sinus thrombosis: Incision & Drainage and high dose antibiotics. Patients can die from this

Question 20

What is Pulpal Calcification?

Answer 20

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…)

Question 21

How many people are affected by plural calcification

Answer 21

8-90% of people

More common with males as they age

Question 22

Pulpal calcification can also be associated with?

Answer 22

Dentin dysplasia I and II

Tumoral calcinosis

Ehlers Danlos Syndrome

Question 23

There are 3 types of Pulpal calcification to recognize

Answer 23

Denticles
Pulp stones ​
Diffuse linear Calcifications