disease of the pulp + periodontium

Question 1

Describe the process of pulp hyperaemia and how it may progress

Answer 1

When a tooth gets decay or trauma, there is increased blood supply to the pulp chamber
From there the pulp may recover, or develop into acute pulpitis
This may develop into acute apical periodontitis or chronic pulpitis

Question 2

What are the clinical features of acute pulpitis?

Answer 2

Constant severe pain
Reacts to thermal stimuli
Poorly localised pain
Referral of pain
No (or minimal) response to analgesics

Question 3

Define acute apical periodontitis

Answer 3

It is the spread of infection from within the pulp chamber to the apex of the tooth

Question 4

How can acute apical periodontitis be diagnosed?

Answer 4

Tenderness to percussion
Non-vital tooth
Slight increase in mobility
Radiographs showing loss of clarity of lamina dura and radiucency shadow

Question 5

What causes traumatic periodontitis?

Answer 5

Parafunction, such as tooth clenching or grinding

Question 6

Describe the treatment for traumatic periodontitis

Answer 6

Occlusal adjustment and therapy for parafunction

Question 7

What is an apical cyst?

Answer 7

It is a fluid-lined cavity that develops from a long-term chronic apical infection

Question 8

What is the most common pus-producing infection?

Answer 8

The acute apical abscess

Question 9

What are some possible causes of an acute apical abscess?

Answer 9

Periodontal abscess, pericoronitis, and sialadenitis

Question 10

Describe the clinical features of an acute apical abscess

Answer 10

Severe unremitting pain
Acute tenderness in function and on percussion
No swelling
Redness
Heat

Question 11

What are the 5 cardinal signs of inflammation?

Answer 11

Heat
Redness
Swelling
Pain
Loss of function

Question 12

What happens once an acute apical abscess perforates through bone?

Answer 12

Pain often remits
Swelling, redness, and heat in the soft tissues becomes apparent
Tenderness to percussion reduces as pus escapes into the soft tissues

Question 13

What factors determine the site of swelling in an acute apical abscess?

Answer 13

Position of the tooth in the arch
Root length
Muscle attachments
Potential spaces in proximity to the lesion

Question 14

What is the treatment for irreversible pulpitis?

Answer 14

Root canal treatment or extraction

Question 15

Define periapical granuloma

Answer 15

A mass of chronically inflamed granulation tissue located at the apex of a tooth, consisting of plasma cells, lymphocytes, histiocytes, fibroblasts, and capillaries

Question 16

Differentiate between a periapical granuloma and a true granuloma

Answer 16

A periapical granuloma is not a true granuloma because it lacks granulomatous inflammation, which is characterized by the presence of epithelium, histiocytes mixed with lymphocytes, and giant cells

Question 17

List the steps of formation of an apical (radicular) cyst

Answer 17

1. Caries, trauma, periodontal disease
2. Death of dental pulp
3. Apical bone inflammation
4. Dental granuloma
5. Stimulation of epithelial rests of Malassez
6. Epithelial proliferation,
7. Periapical cyst formation.