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201 > Benedict- periapical pathology, odontogenic infections, cysts > Flashcards

Benedict- periapical pathology, odontogenic infections, cysts Flashcards

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1
Q

What is pulpitis

A

Inflammation of the pulp, secondary to environmental effects.

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2
Q

pulpitis aetiology (4)

A
  1. Bacterial/caries
  2. Thermal
  3. Chemical
  4. Mechanical
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3
Q

Describe bacterial aetiology of pulpitis

A
  • most common cause
  • Caries/mechanical loss of hard tissues
  • Movement of pioneer bacteria into dentinal tubules
  • Inflammatory response of pulpal tissues
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4
Q

Describe thermal aetiology of pulpitis

A
  • Iatrogenic (clinician induced) induction of heat
  • Cavity & crown preps, polishing
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5
Q

Describe chemical aetiology of pulpitis

A
  • Irritants penetrating through exposed dentine
  • Access to dentinal tubules
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6
Q

Describe mechanical aetiology of pulpitis

A

Crown/root fracture/root planing
- Access of bacteria into dentinal tubules
Luxation/trauma
- Disturbed blood supply and secondary inflammatory response

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7
Q

Describe the pulpal response of pulpitis

A
  • Inflammatory mediators released
  • Recruitment of immune cells
  • Pressure & damage to structures
  • Necrosis
  • Aspiration of odontoblast nuclei
  • movement of fluid within tubules
  • Sclerosis of tubules
  • Repairative dentine
  • Fibrosis
  • Dystrophic calcification
  • Inflammation
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8
Q

What happens at the periapical region with pulpitis?

A

Inflammatory cytokines and bacterial byproducts cause periapical periodontitis

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9
Q

What is periapical periodontitis

A

inflammation of periapical tissues- can be acute or chronic

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10
Q

What type of virus is a human herpesvirus

A

DNA virus- humans are the only natural resevoirs

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11
Q

How long can herpesvirus reside within their host

A

life with periods of latency and reactivation

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12
Q

Describe HSV1

A

-orofacial and ocular
- transmitted through saliva, shedding of perioral lesions

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13
Q

Describe HSV2

A

-genital, skin below waist
- transmitted through sexual contact

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14
Q

What are the similarities between HSV1 and HSV2

A
  • similar structurally
  • clinical lesions are identical
  • antibodies directed to one cross-reacts against the other
  • antibodies of one decreases chance of infection by the other
  • If breakthrough infection: much less severe
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15
Q

How does herpesvirus reoccur

A

virus remains latent in trigeminal ganglion, uses axons of sensory neurons to travel back and forth to the peripheral skin/mucosa

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16
Q

What is a symptomatic presentation of HSV in a young person?

A

primary herpetic gingivostomatitis (chills, fever, oral blisters, vesicles, small red lesions, englarged gingiva with punched out erosions)

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17
Q

What is a symptomatic presentation of HSV in an older person/adult?

A

pharyngotonsillitis (sore throat, malaise, ulcerations that may coalesce)

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18
Q

What can cause reactivation of HSV

A
  • Old age
  • UV
  • Stress
  • Pregnancy
  • Allergy
  • Trauma
  • Menstruation
  • Malignancy
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19
Q

Describe herpes labialis

A
  • most common presentation
  • 30% of those who have had primary infection
  • vermillion of lip
  • pain, burning, itching, tingling, erythema
  • multiple small erythematous papules that form fluid filled vesicles
  • rupture and crust in 2 days, heal 7-10 days
  • Mechanical rupture may spread virus
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20
Q

Describe recurrent intraoral herpes

A
  • Rare
  • Immunocompromised
  • always in keratinised mucosa bound to bone
  • heals 7-10 days
  • persist and spread until treated w antiviral
  • larger and more extensive
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21
Q

Describe primary and secondary HHV3 (varicella zoster) infection and transmission

A

primary: chickenpox
secondary: herpes zoster (shingles)
transmission: air droplets and direct contact

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22
Q

Describe chickenpox

A
  • 5-9
  • most cases symptomatic
  • 10-21 day incubation
  • erythema-vesicle-pustule-hardened crust
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23
Q

Describe shingles (herpes zoster)

A
  • reactivation (10-20% chance)
  • predisposition: immunocompromised, cytotoxic drugs, radiation, old age, alcohol abuse, dental manipulation
  • along nerve trunk distribution
  • unilateral
  • painful
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24
Q

Describe HHV4 (epstein barr)

Study These Flashcards
A

children: fingers, toys, objects (asymptomatic)
young adults: intimate contact (symptomatic)

25
What are some other associations with epstein barr virus
- lymphomas - nasopharyngeal carcinoma - hairy leukoplakia
26
What is the cause of coxackievirus and how does it spread
- summer-early autumn - crowding and poor hygiene - oral-faecal route but also saliva and air droplets - epidemic every 2-3 years
27
What are the presentations and symptoms of coxackievirus
hand foot and mouth: flu like:sore throat, fever, erythema, vesicle rupture, and ulcer on hand foot and mouth herpangina: flu like: sore throat, fever, posterior oral lesions-ulcerated vesicles
28
Describe papovavirus
- papillomas - 16 & 18 associated with squamous cell carcinoma - projections
29
Describe candidosis
- most common oral infection - candida albicans - commencal (opportunistic) - Rate of carriage increases with age - yeasts (commensal) and hyphae (virulent and pathogenic)
30
What are some predisposing factors for candidosis
Natural - infancy, pregnancy Mechanical - trauma, occlusion, laceration, dentures Iatrogenic - radiotherapy, drugs, corticosterioids disease - diabetes, iron deficiency, HIV
31
What are some clinical presentations of oral candidosis
- acute pseudomembranous candidosis - acute erythematous candidosis - chronic erythematous candidosis - chronic hyperplastic candidosis - angular chelitis
32
describe acute pseudomembranous candidosis
- thrush - creamy white plaque, removable - wiping away leaves raw, bleeding - buccal mucosa, tongue, palate - symptomatic-discomfort and burning
33
What is acute pseudomembranous and eryethematous candidosis caused by
long term use of broad spectrum antibiotics
34
describe acute eryethematous candidosis
- antibiotic sore mouth - uncommon - eryethematous area on dorsum of tongue, palate, buccal
35
How to test for acute eryethematous candidosis
swab to see if there is candida hyphae
36
Describe chronic atrophic candidosis
- Denture sore mouth - ill fitting dentures - OH may be poor - well demarcated erythema with petechiae and edema on palate - may be papillary hyperplasia in midline palate and angular chelitis
37
Describe angular chelitis
- infection of corner of mouth - often ass. with other candidal infection - often candida and staph aureus - may be underlying nutritional deficiency - erythema and/or ulcer
38
Describe median rhomboid glossitis
- uncommon - smooth looking dorsum lesion - usually responds to antifungals - elliptical lesion devoid of papillae
39
Describe chronic hyperplastic candidosis
- uncommon - candida associated leukoplakia - not removable - may be speckled white/red - may be tobacco or trauma related - premalignant lesion?
40
Describe diagnosis of candidal infections
labtests - direct smear exam - culture - biopsy
41
Describe management of candidal infections
remove predisposing factor - denture - diet - steroid - dry mouth - smoking - systemic condition antifungal therapy
42
What is a cyst
pathological cavity lined by epithelium
43
What are odontogenic cysts of inflammatory origin
- Radicular cyst - inflammatory collateral cysts
44
What are odontogenic and non-odontogenic developmental cysts
- dentigerous cyst - odontogenic keratocyst - gingival cysts - nasopalatine duct cyst
45
Describe a radicular (periapical) cyst
- most common jaw cyst - results from tooth losing vitality (pulpitis) - inflammatory cytokines and breakdown products travelling to periapical region - cyst at root apices
46
Describe an inflammatory collateral cyst
- paradental cyst - relate to inflammation of pericoronitis (not pulpitis) - lateral surface of tooth
47
What is periapical granuloma?
granulation tissue formed after apical bone resorption due to infection
48
How is a radicular cyst formed
- rests of malassez in PDL proliferate - degeneration within proliferating epithelium - fill with fluid - bone further resorbed
49
Describe management of radicular cysts
- Endodontic treatment (root canal or surgery) - Extraction Benign and do not recur
50
Describe paradental cysts
Cyst of inflammatory origin occuring on lateral/distal aspect of partially erupted mandibular third molars with a history of pericoronitis
51
Describe dentigerous cyst
- Cyst that encloses the crown of an unerupted tooth and is attached to the tooth at the ACJ - Occurs due to accumulation of fluid between reduced enamel epithelium and crown
52
Describe eruption cyst
- similar to dentigerous but in soft tissue - bluish tissue - spontaneous resolution
53
Describe gingival cysts of infants
- common, occur on maxillary alveolar ridge and palate of infants - small, multiple keratin-filled papules - spontaneously resolve
54
Describe odontogenic keratocysts
- Developmental jaw cyst - may grow to a large size - tendency to recur
55
Describe nasopalatine duct cyst
- uncommon developmental cyst in incisive canal - presents as ant. maxilla swelling
56
Describe Odontoma
- developmental defect - teenagers - failed eruption (prev. routine xray) - composed of dental tissues
57
Describe the two types of odontoma
complex - irregular mass of dentine, enamel, cementum compound - small tooth-like structures
58
Describe ameloblastoma
benign tumor of odontogenic epithelium - usually in post. mandible - may grow to large size - infiltrative growth pattern

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