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23 Endodontics > 5 - Periradicular (Periapical) Pathosis > Flashcards

5 - Periradicular (Periapical) Pathosis Flashcards

(56 cards)

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1
Q

what are the periradicular conditions

A
  1. Normal
  2. Symptomatic apical periodontitis
  3. Asymptomatic apical periodontitis
  4. Condensing Osteitis
  5. Acute Apical Abscess
  6. Chronic Apical Abscess (Supurative apical periodontitis)
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2
Q

what is shown in normal PA tissues

A
  1. No radiolucencies in periradicular tissues
  2. No sensitivity to percussion
  3. No swelling or sinus tracts
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3
Q

is systomatic apical periodontitis associated with vital pulp or a necrotic pulp?

A

EITHER!

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4
Q

etiology of symptomatic apical periodontitis

A
  1. inflammatory mediators (from inflamed pulp)
  2. microbial toxins (from nectrotic pulp)
  3. hyper-occlusion
  4. post endo: mechanical and/or chemical irritants
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5
Q

inflammatory mediators are from what type of pulp

A

inflamed pulp

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6
Q

microbial toxins are from what type of pulp

A

nectrotic pulp

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7
Q

signs and symptoms of apical perio

A
  1. spontaneous pain
  2. radiograph appearance varies
  3. PAIN TO CHEWING
  4. PAIN TO PERCUSSION
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8
Q

what diagnosis

A

systemic apical periodontitis

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9
Q

what is the most diagnostic symptom of symptomatic apical periodontitis

A

sensitivity to touch/chewing

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10
Q

how do you verify sensitivity to touch/chewing

A

doing a percussion test

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11
Q

what is the percussion test

A
  1. first w/ finger
  2. if not sensitive, use mirror handle
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12
Q

how to treat symptomatic apical periodontitis

A

remove the cause!

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13
Q

what is symptomatic irreversible pulpitis w/ symptomatic apical periodontitis

A
  1. vital pulp
  2. LINGERING PAIN TO COLD
  3. SENSITIVITY TO PERCUSSION
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14
Q

what is SIPSAP

A

symptomatic irreversible pulpitis w/ symptomatic apical periodontitis

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15
Q

what is pulpal necrosis with SAP

A
  1. no response to cold
  2. sensitive to percussion
  3. no swelling, no sinus tracts
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16
Q

etiology of asymptomatic apical periodontitis

A
  1. bacteria from pulpal necrosis
  2. asymptomatic lesion
  3. no pain to percussion
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17
Q

what does asymptomatic apical periodontitis xray look like

A

range from small to large radiolucency

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18
Q

treatment of asymptomatic apical perio

A

endodontic therapy or extraction

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19
Q

what is the most diagnostic sign of asymptomatic apical periodontitis

A

radiolucency at apex. there are no other symptoms

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20
Q

etiology of condensing osteitis

A

low grade, long standing irritants from pulp

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21
Q

what does xray of condensing osteitis look like

A

radiopaque area at apex of tooth

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22
Q

do you do root canal on condensing osteitis

A

depends.

if you do pulp test and normal, you do not do root canal. if pulp is not normal, then you root canal.

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23
Q

histology of condensing osteitis

Study These Flashcards
A
  1. increase in trabeclular bone density
  2. less cellular
  3. chronic inflammatory infiltrate
  4. can be associated with either vital inflamed pulps of necrotic pulps
24
Q

what is a normal pulp that has condensing osteitis in radiograph called

25
is acute apical abscess localized or diffuse
either
26
acute apical abscess is associated with what pulp
necrotic pulp
27
acute apical abscess affects what spaces
FACIAL spaces and is called cellulitis
28
is cellulitis a symptom or diagnosis
symptom
29
signs and symptoms of acute apical abscess
1. Spontaneous pain 2. Pain to percussion/palpation 3. SWELLING (MUST) 4. Systemic manifestations 5. Variable radiographic appearance
30
what diagnosis
acute apical abscess
31
what is a recrudescent abscess or phoenix abscess? this is a type of what
exacerbation of previous chronic lesion with large radiolucency type of acute apical abscess
32
what is the most diagnostic sign of AAA
swelling
33
treatment of AAA
1. release pressure: drainage 2. systemic support: antibiotics 3. remove cause: endodontic therapy
34
what is chronic apical abscess (CAA)
1. associated w/ nectrotic pulps 2. abscess that drains to surface 3. draining sinus tract
35
is chronic apical absecess symptomatic or asymptomatic
usually asymptomatic
36
does chronic apical abscess have variable radiograph appearance
yes
37
chronic apical abscess is also called what
suppurative apical perio
38
CAA can drain how
1. into oral mucosa (most common) 2. occasionally extra oral) 3. gingival sulcus (can look like perio pocket)
39
why trace sinus tract w/ gutta percha point
- determine origin of drainage - sometimes not possible if sinus not closed take a radiograph with gp cone in place
40
what is the most diagnostic sign/symptom for chronic apical abcess
presence of sinus tract
41
what are histological diagnoses for PA lesions that can only determine from biopsy
granuloma, cyst, abscess
42
what is this
granuloma
43
what is a granuloma
1. Granulomatous tissue 2. Mast cells, macrophages, lymphocytes , plasma cells, and occasional PMN'S 3. Multinucleated giant cells, foam cells, cholesterol clefts and epithelium are often found very vascular with collagen fibers
44
what is cyst
Apical or radicular cyst Central cavity filled with EOSINOPHILIC FLUID and is lined by STRATIFIED SQAMOUS EPI In turn this lesion is surrounded by granulomatous tissue ( A CYST WITHIN A GRANULOMA )
45
cyst is filled with ___ and lined by ___
filled: eosinophil fluid lined: stratified sqamous
46
cyst is surrounded by what tissue
granulomatous tissue (cyst within a granulmoa)
47
where does epithelium for cysts come from
cell rests of malassez
48
what is an area of liquefaction necrosis
acute abscess
49
what is in acute abscesses
Disintegrating PMN's Purulent exudate Debris and dead cells All surrounded by granulomatous tissue (abscess within a granuloma)
50
acute abscess is surrounded by what
granulomatous tissue (abscess within a granuloma)
51
histology of chronic abscess
Lymphocytes, plasma cells, and macrophages
52
T/F: If the damaged tissues and microbial products are removed periapical tissues return to their original arquitecture
TRUE
53
what repair is done in periapical tissue repair
osseous, cementum, and PDL
54
how long does it take to get PA repair
6 months to over 1 year
55
you should always make how many diagnoses
two (one for pulp and one for periradicular tissue)
56
what is this
cyst

23 Endodontics (12 decks)

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