Chapter 3

Question 1

What are the three forms of pulpitis?

Answer 1

Reversible, irreverisble, and chronic hyperplastic pulpitis

Question 2

What is the Sequelae of Periapical Pathology?

Answer 2

Sinus tract, osteomyelitis, cellulitis, condensing osteitis.

Question 3

What are the differentials of a periapical radiolucency?

Answer 3

Periapical granuloma, apical periodontal cyst, periapical abscess, and periapical scar.

Question 4

What is the most common periapical pathosis?

Answer 4

Periapical granuloma.

Question 5

What is a periapical granuloma?

Answer 5

Mass of inflamed granulation tissue at the apex of a nonvital tooth.

Question 6

What is a phoenix abscess?

Answer 6

Secondary acute inflammatory changes within a periapical granuloma.

Question 7

What is this condition?

Answer 7

Chronic hyperplastic pulpitis

Question 8

What type of periapical defect is occuring?

Answer 8

Periapical granuloma. Notice the inflammatory cells and CT tissue present.

Question 9

What type of periapical defect is associated with a corticated rim?

Answer 9

Apical periodontal cyst.

Question 10

What are the three patterns of a apical periodontal cyst? Describe them.

Answer 10

Classic pattern: lesion surrounds root tip

Lateral apical periodontal cyst: Found on the side of the root

Residual apical periodontal cyst: cyst remains after tooth has been extracted

Question 11

What is the cause of an apical periodontal cyst?

Answer 11

Inflammatory stimulation of epithelium in the area. (rests of malassez)

Question 12

What are the two other common names for an apical periodontal cyst?

Answer 12

Periapical cyst and radicular cyst

Question 13

What is the term for an accumulation of acute inflammatory cells at the apex of a non vital tooth?

Answer 13

Periapical abscess

Question 14

What is the term for a periapical lesion that is filled with dense collagenous tissue and occurs most frequently when the buccal and lingual cortical plates have been lost?

Answer 14

Periapical scar.

Question 15

What is an epulis granulomatosa?

Answer 15

Mass gorwing out of an extraction site. Thnk of two things, either granulation tissue or metastatic cancer.

Question 16

What is chronic hyperplastic pulpitis?

Answer 16

Pulp that is coming up out of the tooth.

Question 17

What is a sinus tract?

Answer 17

Periapical abscess with pus formation. Penetrates cortical plate and enters soft tissues

Question 18

What is an intraoral sinus tract?

Answer 18

Also called parulis or gum boil. Marks the exit point of the sinus tract on the oral mucosa.

Question 19

What are the two types of intraoral sinus tract?

Answer 19

A hole with surrounding redness and an enlarged nodular mass.

Question 20

What is a cutaneous sinus tract?

Answer 20

When a dental abscess channels through skin and drains via cutaneous skin.

Question 21

What are the two types of cellulitis associated with dental infections?

Answer 21

Ludwig’s angina and cavernous sinus thrombosis.

Question 22

What is osteomyelitis?

Answer 22

Acute or chronic inflammation of the bone.

Question 23

What is the difference betweem bone sequestra and involucrum

Answer 23

Sequestra is when a piece of the bone fragments off. Involucrum is when necrotic bone becomes surrounded by new vital bone.

Question 24

What is Ludwig’s Angina?

Answer 24

Cellulitis of the submandibular region. Huge issue as it can extend around throat and close off air way potentially leading to death.

Question 25

What are the 4 treatment steps of Ludwig’s Angina?

Answer 25

1- Maintenance of the airway. 2- Incision and drainage. 3- Antibiotic therapy. 4- Elimination of original focus of infection.

Question 26

What is cavernous sinus thrombosis?

Answer 26

Infection that typically arises from abscess of a maxillary anterior or premolar tooth. Canine most common source of infection. Swelling will typically present along the lateral boarder of the nose.

Question 27

What is the treatment for cavernous sinus thrombosis?

Answer 27

Surgical drainage and high-dose antibiotics

Question 28

What is condensing osteitis?

Answer 28

Localized area of bone sclerosis associated with apices of teeth with pulpitis. The association of inflammation is critical for diagnosis because it is radiographically identical to idiopathic osteosclerosis

Question 29

What is the difference between ideopathic osteosclerosis and condensing osteomyelitis?

Answer 29

Ideopathic osteosclerosis, the radiolucency will not be associated with the tooth and will usually be asympotomatic, not needing to be treated.

Question 30

What is the condition associated with this histology?

Answer 30

Periapical scar.

Question 31

What is the likely diagnosis?

Answer 31

Periapical scar. Notice both the cortical plates are lost.

Question 32

What is the condition associated with this histology?

Answer 32

Periapical cyst. Notice cyst lined by epithelium. Spider web look.

Question 33

What type of condition is associated with this histology?

Answer 33

Periapical abscess. Notice the large amount of neutrophils.

Question 34

What is this?

Answer 34

Cutaneous tract

Question 35

What is this?

Answer 35

Intraoral sinus tract (gum boil/parulis)

Question 36

What would be your likely diagnosis?

Answer 36

Ludwig’s angina

Question 37

What is the likely diagnosis?

Answer 37

Cavernous sinus thrombosis

Question 38

What is the likely diagnosis?

Answer 38

Condensing osteitis. Bone condensing around apices.

Question 39

What is the likely diagnosis?

Answer 39

Bone scar.