Endo-Systematic Flashcards
Endodontic Infections
- ____ of____ with oral bacteria
- ¡Commonly linked to ___/____bacteria
- ____,_____
- ___
- _____ ____
- ____ ___ ___
- __ __ __ ___ (____)
- ____ infections
- ¡among the ____ infections seen by dentists
- ¡Pulp is very___ to___
Endodontic Infections
¡Infection of pulp with oral bacteria
¡
¡Commonly linked to caries/periodontal bacteria
endogenous,polymicrobial
§pulp
§periapical area
§orofacial soft tissues
§bone of the jaw (osteomyelitis)
§
¡acute infections
¡
¡among the commonest infections seen by dentists
¡
¡Pulp is very sensitive to inflammation
Pulpal Infection Routes
¡caries
¡fractured tooth
¡microleakage from restorations
¡
¡dentinal tubules
¡lateral and accessory canals (periodontal disease)
¡anachoresis
Pulpitis through an Open Cavity
¡Due to ___ ___ exposure to the ___ and ___
Pulp can be exposed by
___
___
____
¡High numbers of bacteria introduced directly into ___ ___
¡Inflammatory response can __ __ ___ to the pulp
__ ___ plus ___ of ____ lead to rapid ___ and ____ of tissue
¡
What kind of bacteria?¡_____________
¡
____
____
¡
¡Due to direct pulpal exposure to the mouth and saliva
§decay
§trauma
§Instrumentation
§
¡High numbers of bacteria introduced directly into sterile tissue
¡
¡Inflammatory response can cut off circulation to the pulp
¡
¡Bacterial challenge plus loss of circulation lead to rapid disintegration and liquefaction of tissue
¡
¡Mixed, mainly anaerobic infection
¡
¡Polymicrobial, endogenous!
¡
Pulpitis via Caries -Dentinal tubules
_____ and certain ____ dominate in advancing carious lesion
¡Bacterial penetration of tubules is ___, but ___ and other___ ___ diffuse quickly
¡Damage to ___ and ___ ___ ___
§may be ___ if the bacteria have not ___ __ ___
¡Bacterial invasion by ___ and ___, then ___ oral species
¡large numbers of ____
____ develop and ____
¡result is gradual ___ and ____ of pulp tissue
¡Lactobacilli and certain streptococci dominate in advancing carious lesion
¡Bacterial penetration of tubules is slow, but acids and other toxic products diffuse quickly
¡Damage to odontoblasts and local pulp tissue
§may be transient if the bacteria have not infected the pulp
¡Bacterial invasion by lactobacilli and streptococci, then other oral species
¡large numbers of PMN’s
¡microabscesses develop and enlarge
¡result is gradual death and liquefaction of pulp tissue
Pulpitis through the Apical Foramen, Periodontium
¡from a ___ ___ in communication with a ___ ___ ___(____-___ lesion)
¡from an adjacent ____ ____
_____ spread (_____)
¡Pulpitis from other ____ a risk factor*
¡from a lateral canal in communication with a deep periodontal pocket (perio-endo lesion)
¡from an adjacent periapical lesion
¡hematological spread (anachoresis)
¡Pulpitis from other stimuli a risk factor*
Microflora Associated with Endodontic Pulp Infection
¡Primary infections –____ infection; mostly gram-____ ____ ( O2) bacteria belonging to the genera, ____ ____ ___(____, ____, anaerobes, __________ complex)
¡
¡Secondary infections- ___ ___ ___; usually ___ or ___ ___ than primary infections, and are often gram-___ organisms and ___ – ____ ____
Microflora Associated with Endodontic Pulp Infection
¡Primary infections –pulp infection; mostly gram-negative anaerobic bacteria belonging to the genera, Porphyromonas, Prevotella, Fusobacterium, Treponema, Peptostreptococcus, Eubacterium, and Campylobacter (Endogenous, polymicrobial, anaerobes, orange and red complex)
¡
¡Secondary infections- failing root canal; usually singular or less diverse than primary infections, and are often gram-positive organisms and fungi – Enterococcus faecalis
Enterococcus faecalis
____organism
¡Common ___ ____ in ___ infections
¡___ to common treatments for root canals
- ___
- ___ resistant
- ___ resistant
- ▪___ ___
¡Strong association with __ __ __
¡Enteric organism
¡Common opportunistic pathogen in pulp infections
¡Resistant to common treatments for root canals
§Biofilms
§Antibiotic resistant
§Acid/Base resistant
▪Calcium hydroxide
¡Strong association with failing root canals
Pulpitis: Possible Complications
___ and _____ infection
___ of ___ to ___ ___ __
¡Abscess and peri-apical infection
¡
¡Spread of infection to local soft tissue
Microbiology of Dentoalveolar Abscesses
_____ infections
______
(O2) important
___ ____bacteria
___ ___bacteria
¡Endogenous infections
¡Polymicrobial
¡anaerobes important
§black pigmented bacteria
§non-pigmented bacteria
Black Pigmented Bacteria
_____
- ____
- _____
§
____
§P. ____
§P. ____
§P. ____—most prevalent
¡Porphyromonas
§P. gingivalis
§P. endodontalis
§
¡Prevotella
§P. melaninogenicus
§P. intermedia
§P. nigrescens—most prevalent
Strep. milleri group
Very common for them to be in these abscesses as well
Sites of Spread from a Dental Abscess
___ ____ is probably the better outcome because at least it is draining to the surface
If it doesn’t drain you may end up with ____
- Infection moves to ___ __ of the ___ and ___
You will have ___ ___ ____ around site of infection
Teeth, circulatory system and soft tissue of the face are highways that the bacteria can move thru
Depending on which tooth is infected and where infection trying to drain things can go down or they can go up
If they get into soft tissue of face or neck that is an _____
Neck: that can cut off your___
Draining fistula is probably the better outcome because at least it is draining to the surface
If it doesn’t drain you may end up with cellulitis
Infection moves to soft tissue of face and neck
You will have heat tender swelling around site of infection
Teeth, circulatory system and soft tissue of the face are highways that the bacteria can move thru
Depending on which tooth is infected and where infection trying to drain things can go down or they can go up
If they get into soft tissue of face or neck that is an EMERGENCY
Neck: that can cut off your airway
Ludwigs Angina
¡Spreading infection of ___ and ___ ___, ___ infection
¡Cellulitis of ___ ___, little ___
___ swelling-____ may become compromised
¡90% of cases associated with ____ ____-____ flora
___/____, eliminate primary source of infection
¡Spreading infection of sublingual and submandibular space, acute infection
¡
¡Cellulitis of facial tissue, little pus
¡
¡Brawny swelling-airway may become compromised
¡
¡90% of cases associated with dental source-endogenous flora
¡
¡Amoxicillin/Metronidazole, eliminate primary source of infection
¡
Actinomycosis
¡“___ ____”
¡_____ region is most common site
¡usually ___ with history of ___ ___, ___ developing, ___ painful
___ ____ seen in lesion biopsy
____ _____—most frequent isolate
___ ____ required due to formation of ___ ____ around the lesions
___ ___antibiotic treatment—___ or ____
¡“Lumpy jaw”
¡
¡cervicofacial region is most common site
¡usually chronic with history of tooth extraction, slow developing, not painful
¡
¡sulfur granules seen in lesion biopsy
¡
¡Actinomyces israelii—most frequent isolate
¡
¡surgical drainage required due to formation of fibrous walls around the lesions
¡
¡long-term antibiotic treatment—penicillin or erythromycin
Oral Bacteria and Endogenous Infections
Brain abscess
Sinuses could get infected
Oral infections are most common in head and neck because that is closest to where the bacteria are
But they can also spread elsewhere in the body from the blood stream
Oral Bacteria and Endogenous Infections
Brain abscess
Sinuses could get infected
Oral infections are most common in head and neck because that is closest to where the bacteria are
But they can also spread elsewhere in the body from the blood stream
