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ORAL PATHOLOGY! > Exam 4-Pulpitis/Periapical-Lecture1 > Flashcards

Exam 4-Pulpitis/Periapical-Lecture1 Flashcards

1
Q

Pulpitis is simply inflammation involving the dental pulp, BUT it can also only be ________ of the blood vessels!

A

dilation

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2
Q

What are the two causes of pulpitis?

A

caries and trauma

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3
Q

What are the 3 classifications of pulpitis?

A

1.Reversible 2.Irreversible 3.Chronic Hyperplastic

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4
Q

What is the MAIN (not only) indicator of REVERSIBLE pulpitis? (The CLASSIC indicator)

A

PAIN on COLD stimulation (hot also works, but not as often)

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5
Q

What is the duration of pain in reversible pulpitis?

A

pain fades away RAPIDLY after the stimulus is removed

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6
Q

The pain in reversible pulpitis can be intermittent, and sometimes not ________

A

reproducible

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7
Q

How does the radiograph present in pulpitis?

A

Radiograph is NORMAL

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8
Q

What are the two treatments for reversible pulpitis?

A

1.remove the cause (traumatic occlusion) 2. TIME

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9
Q

What is the classic stimulus and pain duration for IRREVERSIBLE pulpitis?

A

Hot and LINGERING pain (minutes) after removal of stimulus

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10
Q

Is the degree of pain a differentiating factor for irreversible pulpitis?

A

Nope, it can vary from mild to excruciating

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11
Q

What are three indicators for irreversible pulpitis?

A

1.temperature 2.chewing pressure 3.percussion

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12
Q

What can sometimes trigger “spontaneous” pain in irreversible pulpitis?

A

lying down

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13
Q

What is the most common indicator of irreversible pulpitis on a radiograph?

A

slight widening of the PDL

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14
Q

What are the 2 treatments for irreversible pulpitis?

A

extraction or endo

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15
Q

What is another name for chronic hyperplastic pulpitis?

A

a pulp polyp

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16
Q

What is the term for when the pulp grows out from inside the tooth to produce a red soft tissue mass in the crown area?

A

Chronic Hyperplastic Pulipitis

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17
Q

What are the two treatments for chronic hyperplastic pulpitis?

A

extraction and endo

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18
Q

What is the term for death of the pulp tissue due to overwhelming inflammation in a confined environment?

A

Pulp Necrosis

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19
Q

Why is a tooth discolored in pulp necrosis? Breakdown of the red blood cells in the dentinal tubules into a brown pigment (_________) produces tooth discoloration

A

hemosiderin

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20
Q

Are there symptoms of pain in pulp necrosis?

A

Yes, there can be! No pain through intense pain

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21
Q

Does percussion testing have an affect on a pulp necrosis tooth?

A

Yes, it can be sensitive to percussion

22
Q

Pulp necrosis: Radiographs typically show _______ of the periodontal ligament area or destruction of bone in the _______ region

A

thickening…..periapical

23
Q

GREATER THAN ____% of all lesions found at the periapical region of a tooth are the result of pulpal inflammation (pulpitis) that PROGRESSES to pulp necrosis

A

95%

24
Q

With periapical pathology, The tooth, when tested, will prove to be _______

A

non-vital

25
Q

With periapical pathology, what kind of response is there to hot and cold stimuli?

A

NONE

26
Q

With periapical pathology, what kind of response to electric pulp testing procedures?

A

NONE

27
Q

With periapical pathology, tenderness to what actions may still be present??

A

Tenderness to percussion and mastication

28
Q

With periapical pathology, earliest radiographic change is a widening of the ____________ at the root apex area

A

periodontal ligament space

29
Q

With periapical pathology, Longer duration lesions produce _________, usually _______, radiolucent defect in the
alveolar bone at the root apex

A

circumscribed, symmetric

30
Q

With periapical pathology, what are the 3 standard lesions for your differential diagnosis? What is a 4th, outlier that has distinct characteristics?

A

1.Periapical Granuloma 2.Apical periodontal cyst 3.Periapical Abscess….4.Periapical Scar (outlier, very unique characteristics)

31
Q

What are three possible sequelae to a localized periapical lesion?

A

1.Sinus tract 2.OsteoMyelitis 3.Cellulitis

32
Q

What is another name for a periapical granuloma?

A

Chronic Apical Periodontitis

33
Q

What is the MOST COMMON periapical pathosis?

A

Periapical Granuloma (aka chronic apical periodontitis)

34
Q

periapical granuloma: Accumulation of inflammatory tissue at the periapex in response to noxious products of WHAT condition?

A

pulp necrosis

35
Q

In a pericaplical granuloma, its important to remember that it is _______ inflammation, not ______!!

A

CHRONIC….acute

36
Q

Are periapical granuloma’s typically symptomatic?

A

Nope, typically asymptomatic (not sensitive to percussion)

37
Q

Are teeth with a periapical granuloma typically mobile?

A

Nope, typically immobile

38
Q

A periaplical granuloma will present on a radiograph as symmetrical and well defined…what is characteristic about the borders of the lesion? What anatomic structure has been lost here?

A

“punched out” there is no cortical bone around the lesion…LAMINA DURA has been lost at the root tip

39
Q

Root ________ can be seen with a periapical granuloma.

A

resorption

40
Q

What was the rule of thumb used for differentiating a periapical granuloma from a apical periodontal cyst?

A

If it is bigger than a nickel on the radiograph, its probably a cyst

41
Q

What are the three types of treatment for a periapical granuloma?

A

1.Conventional endo tx 2.surgical endo tx 3.extraction

42
Q

What are the alternative names for an apical periodontal cyst?

A

Periapical Cyst or Radicular Cyst

43
Q

An apical periodontal cyst is inflammatory stimulation of epithelial remnants of _____________ results in epithelial proliferation and cyst formation

A

Hertwig’s epithelial root sheath

44
Q

Does an apical periodontal cyst typically have symptoms or mobility?

A

typically asymptomatic and usually not mobile

45
Q

In an apical periodontal cyst _________ of the affected or adjacent teeth can occur

A

displacement

46
Q

An apical periodontal cyst usually do not produce clinically noticeable enlargement of the _________

A

alveolar bone

47
Q

apical periodontal cyst: The border of the cyst usually tells if there is active inflammation or it is done…which feature is most common?

A

punched out border is most common (so active inflammation)

48
Q

An apical periodontal cyst is basically radiographically identical to a ________

A

Periapical Granuloma (Variable size
May show static behavior or very slow growth
Symmetrical Well defined
Punched out border most often
Loss of lamina dura in the area of the lesion is usually present Root resorption can be seen)

49
Q

What are the three radiographic variations of an apical periodontal cyst?

A

1.Classic (at root tip) 2.LATERAL Apical Periodontal Cyst 3.RESIDUAL apical periodontal cyst

50
Q

What are the treatment options for an apical periodontal cyst?

A

1.conventional endo 2.surgical endo 3.extraction

ORAL PATHOLOGY! (40 decks)

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