ENDO - Periapical Pathology Flashcards
(40 cards)
what comes before radiographic examination? (3)
- patient history
- clinical examination
- review prior imaging
2 features of normal periapical tissues
PDL space - even width black line around the tooth
Lamina dura - continuous white line around the root
what does the PDL space appear as?
radiolucent black line around the tooth
what does the lamina dura appear as?
radiopaque white line around the root
Describe the Trabeculae in the Mandible and Maxilla
Mandible - thick and horizontal
Maxilla - finer and predominant pattern
Describe the Periapical Tissues of Developing Teeth.
Apical Papilla - radiolucency
Lamina Dura - intact
root is funnel shaped
be able to see if there is any superimposition of the: radiolucent shadows
maxillary antrum - black lines above
nasopalatine foramen - line between the upper centrals
mental foramina - holes on both side of the jaw under the 5
oral air space
mental fossa - shadowing between alveolar ridge and mental ridge
submandibular fossa - shadowing submandibular
inferior alveolar canal
submandibular fossa
be able to see if there is any superimposition of the: radio-opaque shadows
mylohyoid ridge - the ridge right at lower back
external oblique ridge - superior to mylohyoid ridge
zygomatic buttress - u shaped, above the 6
soft tissues of the nose/lip
how can you easily find the zygomatic buttress on a radiograph? (3)
radio-opaque
U shaped
usually over the upper 6
How does Periapical Inflam Pathology usually come about?
bacterial invasion of root canal system
+
pulp necrosis
Describe Steps of Periapical Inflam Pathology (8)
- bacterial ingress via caries, cracks, marginal gaps
- reversible pulpitis
- irreversible pulpitis
- pulp necrosis
- root canal infection
- bacterial and necrotic pulpal product leak out apical foramen
- periapical periodontitis
= bone resorption - granulation tissue or cysts
How do Granulated Tissues or Cysts Appear on Radiographs?
radiolucency around the apex
As well as Bone Resorption, can Bone Formation Occur?
yes
Define Osteitis and what it looks like radiographically.
inflammation of the bone due to infection, trauma or disorder
radiograph - diffused opaqueness
Define Periodontitis
inflammation of the supporting tissue of the teeth, leading to permanent tissue destruction
Be able to know the difference between Apical, Periapical and Peri-Radicular
What are the 5 Signs of Inflammation? RCTFD
Heat = Cador
Pain = Dolor
Redness = Rubor
Loss of Function = Function Laesa
Swelling = Tumour
is it possible to differentiate between abscess, granuloma or cyst?
no
abscess - acute
granuloma and cysts - chronic
Describe how Acute Inflammation presents on a Radiograph and how it Progresses. (3 stages)
Initial
- widening of PDL
- lamina dura intact
Spread
- periapical radiolucency
- loss of apical lamina dura
Further
- bone loss at apex
- described as rarefying osteitis
Define Rarefying
radiolucency
What is the Clinical Diagnosis of an Abscess.
- pus
- takes 10 days for radiographic appearance to catch up
What can An Abscess be Mistaken as?
rarefying osteitis
Describe how Chronic Inflammation presents on a Radiograph (2 stages)
Initial
- sclerosing osteitis - dense bone around the apex
Later
- apical bone is resorbed
- dense bone around area of destruction
- periapcial granuloma or radicular cyst
What is Sclerosing Osteitis AKA? (2)
Condensing or Focal Sclerosing Osteitis
