Chapter 2 Flashcards
1
Q
Abscess
A
A collection of purulent exudate that has accumulated in a contained space formed by the surrounding tissue
2
Q
Actinic
A
Relating to or exhibiting chemical changes produced by radiant energy, especially the visible and ultraviolet parts of the spectrum; relating to exposure to the ultraviolet rays of sunlight
3
Q
Acute
A
An injury or course of inflammation that is of short duration
4
Q
Angiogenesis
A
The formation and differentiation of blood vessels
5
Q
Atrophy
A
The decrease in size and function of a cell, tissue, organ, or whole body
6
Q
Biochemical mediators
A
Chemicals in the body that activate responses
7
Q
Central
A
Lesion is within bone
8
Q
Chemotaxis
A
The movement of white blood cells as directed by biochemcial mediators, to an area of injury
9
Q
Chronic
A
An injury or course of inflammation that is of long duration
10
Q
C-reactive protein
A
A nonspecific protein, produced in the liver, that becomes elevated during episodes of acute inflammation or infection
11
Q
Cyst
A
An abnormal sac or cavity lined by epithelium and surrounded by fibrous connective tissue
12
Q
Cytolysis
A
The dissolution or destruction of a cell.
13
Q
Demastication
A
When tooth wear is increased by chewing an abrasive surface
14
Q
Edema
A
tissue swelling
15
Q
Emigration
A
The passage of white blood cells through the walls of small blood vessels and into injured tissues
16
Q
Epithelialization
A
Process of renewal of new surface of epithelium
17
Q
Exudate
A
A body fluid with a high protein content that leaves the microcirculation during an inflammatory response that consists of serum that contains WBCs, fibrin, and other protein molecules
18
Q
Fibroblasts
A
The cells that form fibers as well as intercellular substance
19
Q
Fibroplasia
A
The formation of fibrous tissue as usually occurs in healing
20
Q
Fistula
A
An abnormal passage that leads from an abscess to the body surface
21
Q
Granulation tissue
A
The intial connective tissue formed in healing
22
Q
Granuloma
A
A lesion composed of a collection of macrophages usually surrounded by a rim of lymphocytes that is a form of chronic inflammation
23
Q
Hyperemia
A
Excess of blood within blood vessels
24
Q
Hyperplasia
A
An enlargement of a tissue or organ resulting from an increase in the number of cells; the result of increased cell divison
25
Hypertrophy
An enlargement of a tissue or oran resulting from an increase in the size of its individual cells, but not the number of cells
26
Inflammation
Allows the body to eliminate injurious agents, contain injuries, and heal defectss
27
Injury
An alteration in the environment that causes tissue damage
28
Keloid
The excessive scarring that mainly occurs in skin in some cases with healing
29
Leukocytosis
An increase in the number of white blood cells circulating in the blood
30
Leukopenia
A decrease in the number of white blood cells circulating in the blood
31
Local
A disease process that is confined to a limited location in the body that is not general or systemic
32
Lymphadenopathy
Adnormal enlargement of a lymph node or nodes
33
Macrophage
The second type of WBC to arrive at a site of injury that was originally a monocyte; it participates in phagocytosis during inflammation and continues to be active in the immune response
34
Margination
A process during inflammation in which WBCs tend to move to the periphery of the blood vessel as the site of injury
35
Microcirculation
The small blood vessels, including arterioles, capillaries, and venues of the vascular system
36
Myofibroblasts
Fibroblasts that have some of the characteristics of smooth muscle cells, such as the ability to contract
37
Necrosis
The pathologic death of one or more cells or a part of tissue, or an organ that results from irreversible damage to cells
38
Neutrophil
The first WBC to arrive at a site of injury; the primary cell involved in acute inflammation also called polymorphonuclear leukocyte
39
Opacification
Process of becoming opaque
40
Opsonization
The enhancement of phagocytosis by a process in which a pathogen is marked, with opsonins, for destruction by phagocytes
41
Pavementing
Adherence of WBCs to blood vessel walls during inflammation
42
Peripheral
That the lesion is within the gingival tissue or alveolar mucosa
43
Phagocytosis
The ingestion and digestion of particulate material by cells
44
Purulent exudate
Exudate containing or forming pus
45
Pyrogens
The fever-inducing substances produced from either WBCs or pathogenic microorganisms
46
Radicular
Pertaining to the root of a tooth
47
Regeneration
Process by which injured tissue is replaced with tissue identical to that present before the injury
48
Repair
The restoration of damaged or diseased tissue by cellular change and growth
49
Serous exudate
Exudate that has a watery consistency; resembles serum
50
Systemic
Pertaining to or affecting the body as a whole, as well as a disease process pertaining to or affecting the body as a whole
51
Transudate
The extravascular fluid component of blood that passes through the endotherlial cell walls of the microcirculation
52
WBCs
Cells within the blood and surrounding tissue, also called leukocytes, that are involved in the inflammatory and immune response
53
Traumatic injury
A disease process that results from injury that causes tissue damage
54
Waldeyer's ring
The ring of lymphatic tissue formed by the two palatine tonsils, the pharyngeal tonsil, the lingual tonsil, and intervening lymphoid tissue
55
What are the innate defenses?
```
Physical barrier
Mechanical barrier
Antibacterial barrier
Removal of foreign substances
Inflammation process
```
56
Localized signs of inflammation
```
Redness
Swelling
Heat
Pain
Loss of normal tissue function
```
57
Systemic signs of inflammation
Fever
Leukocytosis
Elevated CRP
Lymphadenopathy
58
White blood cells in the inflammatory response
White blood cells or leukocytes
Monocytes circulating in blood --> macrophages in tissue
Lymphocytes and plasma cells
Eosinophils and mast cell
59
These are seen in chronic inflammation and the immune response
Lymphocytes and plasma cells
60
These are seen in both inflammation and immune response
Eosinophils and mast cells
61
What is the function of Neutrophils?
Phagocytosis
62
Multilobed nucleus and granular cytoplasm that contains lysosomal enzymes
neutrophil
63
Constitues 60% to 70% of WBC population
neutrophil
64
What is the functions of macrophages?
Phagocytosis; play a role in immune system
65
Single round nucleus and do not have granular cytoplasm
Macrophages
66
Constitues 3% to 8% of WBC population
Macrophages
67
What biochemical mediators may be derived from?
Blood
Endotherlial cells
White blood cells and platelets
Pathogenic organisms as they injure the tissue
68
Three interrelated systems
Interaction takes place during activation, among their products, and within their various actions
69
What are the three interrelated systems associated with biochemical mediators
Kinin system
Clotting mechanism
Complement system
70
Kinin system
* Active in early phase of inflammation
* Dilation of blood vessels at the site of injury
* Permeability of local blood vessels
* Induces pain
71
Clotting mechanism
Clots blood and midates inflammation
72
Complement system
* Involves the production of a sequential cascade of plasma proteins
* Some components cause WBCs known as mast cells to release histamine
* Other components cause cell death, from chemotactic factors for WBCs and enhance phagocytosis
73
Other biochemical mediators released by the body
Prostaglandins
| Lysosomal enzymes
74
Prostaglandins
Cause increased vascular dilation and permeability, tissue pain and redness, and changed in connective tissue
75
Lysosomal enzymes (Released by body)
Act as chemotactic factors
| May cause damage to connective tissue and to the clot
76
Other biochemical mediators released by pathogenic microorganisms
Endotoxin
| Lysosomal enzyme
77
Endotoxin
* Produced by cell walls of gram-negative bacteria
| * Serves as chemotacitc factor; can activate complement, function as an antigen, and damage bone and tissue
78
Fever (systemic manifestations)
* Controlled by hypothalamus
* Pyrogens
* Hypothalamus increases body temperature by way of prostaglandins
79
Leukocytosis (systemic manifestations)
Increase to 10,000 to 30,000/mm^3 of blood
| It is the body's attempt to provide more cells for phagocytosis
80
increase in lymphocytes
viral infection
81
increase in neutrophils
bacterial infection
82
increase in eosinophils
allergic reaction
83
Used to monitor tissue healing
Elevated levels of C-reactive protein
84
Chronic inflammation
Cause by persistent injuries
| Repair cannot be completed until source of injury is removed
85
Cells involved in chronic inflammation
```
Macrophages
Lymphocytes
Plasma cells
Neutrophils
Monocytes
Fibroblasts
```
86
Formulation of granulomas
Microscopic groupings of macrophages surrounded by lymphocytes and plasma cells
Associated with foreign body reactions and some infections such as TB
87
Nonsteroidal antinflammatory drugs (NSAIDs)
```
Acetylsalicylic acid (aspirin)
Ibuprofen
```
88
Sterodial antinflammatory drugs
Prednisone
89
Scar tissue
Matured, fibrous connective tissue
| It is whiter and paler because of increased collagen and decreased vascularity
90
What are the types of repair for scar tissue
Primary intention
Secondary intention
Tertiary intention
91
Microscopic events 2 weeks after injury
Initial granulation tissue and its fibers have been remodeled
Matured, fibrous connective tissue is called scar tissue
It is whiter and paler because of increased collagen and decreased vascularity
92
Factors affecting amount of scar tissue
1. )Heredity
2. )Strength and flexibility needed in the tissue
3. )Tissue type
4. )Type of repair
- Healing by primary intention
- Healing by secondary intention
- Healing by tertiary intention
93
Healing by primary intention
Healing of an injury in which there is little loss of tissue
| The margins are close together and very little granulation tissue forms
94
Healing by secondary intention
The edges of the injury cannot be joined during healing
| A large clot forms, resulting in increased granulation tissue
95
Healing by tertiary intention
Delaying surgical tissue repair until infection is resolved
An injured area may become infected, especially with puncture wounds
In some situations, an infected injury is left open until infection is controlled
96
Osteoblasts create
New bone tissue
97
Factors delaying bone formation
```
Blood supply at site
Growth factors
Edema
Injury
Infection
Removal of osteoblast-producing tissues
Excessive or inadequate movement of bone tissue
```
98
Factors influencing repair of bone
Nutrition
Age
Tobacco use
99
Local factors that impair healing
```
Bacterial infection
Tissue destruction and necrosis
Hematoma
Excessive movement of injured tissue
Poor blood supply
```
100
Systemic factors that impair healing
Malnutrition
Immunosuppression
Genetic connective tissue disorders
Metabolic disorders
101
Injuries to Teeth
```
Attrition
-Bruxism
Abrasion
Abfraction
Erosion
-Bulimia
-Methamphetamine abuse
```
102
Attrition
Tooth-to-tooth wear
| May be observed in both primary and permanent dentition
103
Bruxism
```
Grinding and clenching teeth for nonfunctional purposes, such as:
Occlusal interferences
Stress
Tension
Seizure disorders
```
104
Signs and symptoms of bruxism
```
Wear facets
Abnormal rate of attrition
Hypertrophy of masticatory muscles
Increased muscle tone
Muscle tenderness
Muscle fatigue
Cheek biting
Pain in the temporomandibular (TM) joint area
Tooth mobility
Pulpal sensitivity to cold
```
105
Management of bruxism
Occlusal adjustments to eliminate occlusal interferences and fabrication of an acrylic splint
106
Abrasion
Pathologic wearing away of tooth structure that results from a repetitive mechanical habit
Most frequently seen as a notching on root surfaces with gingival recession
107
Abfraction
Cause: Microfracture of tooth structure in areas of concentration of stress
- May be related to fatigue, flexure, fracture, and deformation of tooth structure
- May occur in combination with abrasion
108
Appearance of abfraction
Typically appears as wedge-shaped lesions at the cervical areas of teeth
109
Preventive treatment of abfraction
Fabricating an acrylic splint
110
Erosion
Loss of tooth structure as a result of chemicals, without bacterial involvement
- Tooth structure may be lost around a restoration, making the restoration stand out, distinguishing it from abrasion or attrition
- Correlate location of erosion and abrasion with patient’s history
111
Potential causes of Erosion
```
Industrial factors
Intraorally applied cocaine hydrochloride drug abuse
Overuse of soft drinks
Baby bottle caries
Sucking on lemons
Chronic vomiting (Bulimia)
```
112
Bulimia
An eating disorder characterized by food binges followed by self-induced vomiting
- The patient with bulimia maintains a normal body weight but is secretive about eating habits
- May see electrolyte imbalance and/or malnutritionIrritation of oral mucosa and lipsTraumatic lesions on the backs of the fingers
113
Management of bulimia
- Fluoride rinse and toothpaste
- Rinse with water after purging
- Avoid brushing immediately after vomiting
- Use very soft toothbrush
- May require full-coverage restorative dental treatment
114
Methamphetamine abuse (Meth Mouth)
Rapid destruction of teeth as a result of:
- Methamphetamine acid content
- Decreased salivary flow
- Cravings for high-sugar beverages
- Lack of oral hygiene
115
Injuries to oral soft tissue
- Aspirin burns
- phenol burns
- electric burns
- other burns
- lesions associated with cocaine use
- lesions from self-induced injury
- Hematoma
- traumatic ulcer
- Frictional keratosis
- Linea alba
- Nictotinic stomatitis
- Tobacco pouch keratosis
- Traumatic neuroma
- Amalgam tattoo
- Melanosis
- Solar Cheilitis
- Mucocele
- Necrotizing sialometaplasia
- Sialolith
- Acute and chronic sialadenitis
116
Aspirin burn
Topical application is a common misuse of this product
- The tissue becomes necrotic and white
- The surface may slough off, leaving a painful ulcer
- The ulcer usually heals in 7 to 21 days
117
Phenol burn
Used in dentistry as a cavity-sterilizing agent and a cauterizing agent
Will cause whitening and sloughing of the area as a result of tissue destruction
118
Dental materials that can cause burns
```
Phenol
Sodium hypochlorite
Ferric sulfate
Formocresol
Eugenol
```
119
Electric burn
- May be seen in infants or young children who have chewed an electrical cord
- May be quite extensive, damaging oral tissue and even tooth buds
- May cause permanent disfigurement and scarring
- --Treatment
1. )Plastic surgery
2. )Oral surgery
3. )Orthodontic therapy
120
Thermal Burns
-Hot food burns:
From soup or cheese on pizza
-Products containing hydrogen peroxide or eugenol
121
Lesions associated with cocaine use
Lesions located at the midline of the hard palate may vary from ulcers to keratotic lesions to exophytic reactive lesions as a result of smoking crack cocaine
Necrotic ulcers of the tongue and epiglottis have been reported as a result of freebasing cocaine
122
Lesions from self-induced injuries
Chronic lip, cheek, or tongue biting
Trauma to the gingiva from a fingernail
Lesions may range from ulceration to epithelial hyperplasia and hyperkeratosis
123
Traumatic Ulcer
- Cheek, lip, or tongue biting
- Denture irritation
- Mucosal injury
- Overzealous brushing
- --Treatment
1. )Usually heals within 7 to 14 days unless the trauma persists
2. )May require a biopsy
124
Traumatic granuloma
-The result of persistent trauma
Appearance: Hard (indurated), raised lesion
Heals rapidly after biopsy
125
Hematoma
- Accumulation of blood within tissue as a result of trauma
- Appears as a red to purple to bluish-gray mass
- Frequently seen on labial or buccal mucosa
126
Frictional Keratosis
A form of hyperkeratosis
Cause: Chronic rubbing or friction against an oral mucosal surface; resembles a callus on skin
Appearance: Opaque white
127
Treatment of frictional keratosis
- Identify the traumatic cause of the lesion
- Eliminate the cause
* *Must be differentiated from idiopathic leukoplakia because leukoplakia may be premalignant
128
Linea Alba
- A white, raised line most commonly on the buccal mucosa at the occlusal plane
- May be the result of a teeth-clenching habit
- Sometimes the pattern of the teeth can be seen in the lesion
- Microscopic appearance: Epithelial hyperplasia and hyperkeratosis
- -No treatment necessary
129
Nicotine Stomatitis
- A benign lesion typically associated with pipe and/or cigar smoking; may also occur with cigarette smoking
- Initial appearance: Erythema
- Increased opacity as keratinization occurs
- Raised red areas occur at the openings of ducts of inflamed minor salivary glands
130
Smokeless Tobacco Keratosis (STK)
- A white lesion located where chewing tobacco is placed, most often in the mucobuccal fold
- Early lesions may have a granular or wrinkled appearance
- Long-standing lesions may be more opaquely white and have a corrugated surface
131
Tobacco Pouch Keratosis
Treatment:
- Tobacco cessation
- May require biopsy
- Long-term exposure to chewing tobacco has been associated with increased risk of squamous cell carcinoma
132
Amalgam tattoo
-A flat, bluish-gray lesion of the oral mucosa, caused by the introduction of amalgam into tissue
-May occur during placement or removal of an amalgam restoration or during an extraction
-May be seen in any location in the oral cavity, most commonly on the gingiva or alveolar ridge
-Amalgam particles may be seen on radiograph, aiding in diagnosis
-Patient history may help
-Must be differentiated from malignant melanoma
**Treatment:
None, providing melanoma has been ruled out
133
Melanosis
- Normal physiologic pigmentation of oral mucosa
- May be genetic
- May occur as a result of inflammation: -Postinflammatory melanosis
- If presenting as a macule, a biopsy may be warranted
- Labial melanotic macule on vermilion of lips
- Smoker’s melanosis
134
Solar Cheilitis (Actinic Cheilitis)
-A degeneration of the tissue of the lips, caused by exposure to the sun
-Appearance:
*Lips appear dry and cracked
*The vermilion appears pale pink and mottled
*The interface between lips and skin is indistinct
-Microscopically: Epithelium is thinner than normal; degenerative CT changes
-Smoking and alcohol use increase risk of squamous cell carcinoma
-Biopsy may be indicated for persistent scaling or ulceration
*Prevention
Avoid sun exposure
Use sun-blocking agents
135
Mucocele (Mucous Retention lesion)
- A lesion formed when a salivary gland duct is severed and the mucous salivary gland secretion spills into the adjacent connective tissue
* *Not a true cyst because it is not lined with epithelium
136
Mucous Retention Lesions: Mucocele, Mucous Cyst, or Mucous Retention Cyst
- Dilated salivary gland ducts that developed as a result of duct obstruction
* Treatment: Removal of affected minor salivary gland
137
Ranula
- A unilateral mucocele-like lesion that forms on the floor of the mouth
- Associated with the ducts of submandibular and sublingual glands
**Will only be found in the floor of the mouth
138
Sialolith
- A salivary gland stone
- May be found in both minor and major salivary glands
- Formed by precipitation of calcium salts around a central core
- May often be seen on radiographs
139
Treatment of Sialolith
Sometimes the calcification can be “milked” from the duct
| It may require surgical removal; this may damage the duct
140
Necrotizing Sialometaplasia
A benign condition of salivary glands
Moderately painful swelling and ulceration
Thought to result from blockage of blood supply to affected area, resulting in salivary gland necrosis
Salivary gland epithelium is replaced by squamous epithelium
The ulcer usually heals by secondary intention
Biopsy is needed to establish diagnosis
141
Acute and Chronic Sialadenitis
Painful swelling of the involved salivary gland caused by obstruction of the salivary gland duct
Diagnosis
May involve injection of a radiopaque dye into the gland, followed by a radiograph (sialogram)
Treatment
May require antibiotics
142
Lesions from Reactive Connective Tissue Hyperplasia
```
Pyogenic granuloma
Giant cell granuloma
Irritation fibroma
Denture-induced fibrous hyperplasia
Papillary hyperplasia of the palate
Gingival enlargement
Chronic hyperplastic pulpitis
```
143
Reactive Connective Tissue Hyperplasia
- Proliferating, exuberant granulation tissue and dense fibrous connective tissue resulting from overzealous repair
- May be a response to a single event or chronic low-grade injury
144
Pyogenic Granuloma
A proliferation of connective tissue containing numerous blood vessels and inflammatory cells occurring as a response to injury
The name is a misnomer; the lesion is neither pyogenic (pus forming) nor a true granuloma
145
Appearance of pyogenic granuloma
Ulcerated
Soft to palpation
Bleeds easily
Deep red to purple
Generally elevated, may be sessile or pedunculated
Most commonly observed on the gingiva, it may be seen on other intraoral areas
May vary in size from a few millimeters to several centimeters
Usually develops rapidly and then remains static
Most common in teenagers and young adults, but may occur at any age
If seen in a pregnant female, it is called a pregnancy tumor
146
TX of pyogenic granuloma
Surgically excised if it does not regress spontaneously
147
Pregnancy Tumor
Pyogenic granuloma seen in pregnant women
- The lesions are identical to those seen in men and nonpregnant women
- May be caused by hormonal changes and increased response to plaque
- They often regress after delivery
148
Peripheral Giant Cell Granuloma
- A lesion that contains many multinucleated giant cells, well-vascularized connective tissue, RBCs, and chronic inflammatory cells
- Reactive lesion
* *Clinical appearance resembles that of pyogenic granuloma
* *Treatment: Surgical excision
149
Peripheral Ossifying Fibroma
-Exophytic, usually well-demarcated sessile or pedunculated gingival lesion
-Clinically it appears to emanate from the interdental papilla
-Has been reported in both children and adults
Composed of cellular fibrous connective tissue
-Treatment consists of complete surgical excision with thorough scaling of the adjacent teeth
150
Fibroma, Irritation Fibroma, Traumatic Fibroma, and Focal Fibrous Hyperplasia
**The most common mass on the gingiva
| Caused by trauma
151
Appearance of Fibroma, Irritation Fibroma, Traumatic Fibroma, and Focal Fibrous Hyperplasia
Appearance: A broad-based, persistent exophytic lesion composed of dense, scarlike connective tissue with few blood vessels. Usually a small lesion, less than 1 cm in diameter
152
Denture-Induced Fibrous Hyperplasia
Cause: Ill-fitting denture
Location: In elongated folds of tissue adjacent to denture flange
Composed of dense, fibrous CT surfaced with stratified squamous epithelium
153
TX of Denture-Induced Fibrous Hyperplasia
Surgical removal
Relining of prosthesis
New denture
154
Inflammatory Papillary Hyperplasia of the Palate
Denture-induced hyperplasia
| Appearance: Palatal mucosa covered by multiple erythematous papillary projections; “cobblestone” appearance
155
TX of Inflammatory Papillary Hyperplasia of the Palate
Treatment: Surgical removal of hyperplastic papillary tissue before new denture construction
156
Gingival Enlargement
An increase in the bulk of free and attached gingiva, especially the interdental papillae
Gingival margins are rounded
Color may vary from normal pink to pale or erythematous depending on the degree of inflammation and vascularity
May be generalized or localized
157
Gingival enlargement is a reactive response to:
```
Local irritants
Hormonal changes
Drugs
Hereditary conditions
Idiopathic factors
Leukemia
```
158
TX of gingival enlargement
Gingivoplasty
Gingivectomy
Meticulous oral hygiene
159
Chronic Hyperplastic Pulpitis (Pulp Polyp)
- An excessive proliferation of chronically inflamed dental pulp tissue
- Occurs in teeth with large, open carious lesions often in primary and permanent molars
- Usually asymptomatic
- Granulation tissue with inflammatory cells, primarily lymphocytes and plasma cells
- Neutrophils may be present
- Generally surfaced by stratified squamous epithelium
160
TX of Chronic Hyperplastic Pulpitis (Pulp Polyp)
Endodontic therapy
| Extraction
161
Caries or trauma may result in:
Inflammation
Infection
Chronic hyperplastic pulpitis
Necrosis of the pulp
162
The inflammatory process begins
in pulp and then extends to the periapical area
| Accessory canals may lead to areas of inflammation on the lateral portion of the root
163
Periapical Abscess
- Acute periapical abscess: Purulent exudate surrounded by connective tissue containing neutrophils and lymphocytes
- Inflammation produces severe pain
- Tooth may slightly extrude from tooth socket
- May or may not test positive with electric pulp testing
164
TX of periapical abscess
May develop directly from inflammation in the pulp
More commonly develops in an area of previously existing chronic inflammation
Treatment
Drainage and endodontic therapy
Extraction
165
Fistula formed from Periapical abscess
- comes from Fistulous tract
- takes the Channel of least resistance
* *Presence of fistula warrants a radiographic evaluation
166
Periapical Granuloma
A localized mass of chronically inflamed granulation tissue that forms at the opening of the pulp canal, generally at the apex of a nonvital tooth root.
- Composed of granulation tissue containing lymphocytes, plasma cells, and macrophages
- May also contain neutrophils, areas of dense fibrous connective tissue, or epithelial rests of Malassez
167
Characteristics of Periapical granuloma
Chronic process
Most cases are asymptomatic
Tooth may be sensitive to pressure and percussion
Tooth may be slightly extruded from the socket
168
TX of periapical granuloma
1. )Endodontic therapy
| 2. )Extraction
169
Radicular cyst
* A true epithelium-lined cyst
- Associated with the root of a nonvital tooth
* ***The most commonly occurring cyst in the oral region
- A result of proliferation of the rests of Malassez
- Usually asymptomatic and discovered on radiograph
170
Radiographic appearance of radicular cyst
Radiolucent
Well circumscribed
Same as periapical granuloma
171
TX of radicular cyst
- Endodontic therapy
- Apicoectomy
- Extraction and curettage of periapical tissue
172
Residual Cyst
- Forms after tooth extraction and all or part of radicular cyst is left behind
* Treatment: Surgical removal
173
Root Resorption (RR)
External resorption: Nonreversible resorption of the tooth structure, beginning at the outside of the tooth
174
Causes of RR
1. )Inflammation
2. )Pressure
3. )Reimplantation (Tooth that has been knocked out but placed back in socket in an attempt to save tooth.)
4. )Idiopathic
175
Internal tooth or root resorption
Resorption often associated with an inflammatory response in the pulp or an idiopathic reason
Appearance
176
Clinical appearance of Internal RR
A pinkish area in the crown resulting from the vascular, inflamed connective tissue
Radiographically: Radiolucent
177
Treatment of internal or root resorption
- If the root is not perforated, calcium hydroxide is placed and endodontic treatment is performed in an attempt to save the tooth
- If the tooth is perforated, it must be removed
178
Focal Sclerosing Osteomyelitis (Condensing Osteitis)
- A change in the bone near the apices of teeth
- Thought to be a reaction to low-grade infection
- Generally asymptomatic
- If painful, may be associated with pulpal inflammatory disease
- Radiopaque
- Borders may be diffuse or well defined
- Commonly associated with the mandibular first molar
179
TX of Focal Sclerosing Osteomyelitis (Condensing Osteitis)
No treatment usually necessary
| Biopsy to rule out other radiopaque lesions such as osteoma, complex odontoma, or ossifying fibroma
180
Alveolar Osteitis (“Dry Socket”)
- A postoperative complication following tooth removal in which the blood clot is lost before healing can take place, leaving raw, exposed nerve endings
- Most often occurring in mandibular third molar areas
- Patient may complain of pain, bad odor, and bad taste
181
Risk Factors for Alveolar Osteitis (“Dry Socket”)
Dissolution of the clot at the surgical site
Traumatic extraction
Presence of infection before extraction
Tobacco smoking after extraction
182
TX for Alveolar Osteitis (“Dry Socket”)
Gentle irrigation
| Daily application of Dry Socket Paste containing eucalyptol until symptoms are relieved
