Lecture 4 - Sequelae of Pulpal Disease Flashcards
(23 cards)
All the different kinds of inflammation of the pulp
1 - Reversible Pulpitis
2 - Irreversible Pulpitis
3 - Pulpal Necrosis (dead, no blood supply, discolored)
4 - Acute Pulpitis (adolescent)
5 - Chronic Pulpitis (old, previous restorations)
6 - Chronic Hyperplastic Pulpitis (pulp polyp, rampant caries in kids)
Potential sequellae of bacterial pulpitis flowchart order?
Chronic –> Chronic apical periodontitis –> Periapical granuloma –> Periapical cyst
Acute –> Periapical Abscess –> Osteomyelitis –> 1. Chronic osteomyelitis OR 2. Cellulitis OR 3. Garre osteomyelitis
Periapical Granuloma
Occur at apex of NON-vital tooth (mass of inflamed granulation tissue), often ASYMPTOMATIC
Periapical Cyst
Inflammatory cyst (rests of malassez) on apex of NON-vital tooth, asymptomatic, need biopsy (see lumen to differentiate from granuloma)
Definition of cyst and 3 components?
Pathologic cavity located in soft tissue or bone lined by epithelium
- Wall (CT with granulation tissue with inflammed cells)
- Epithelial Lining
- Lumen
Periapical Abscess
Accumulation of acute inflammatory cells at apex of non-vital tooth, symptomatic or asymptomatic
Contains lots of neutrophils (pus)
Name the 5 drainage pathways of an acute periapical infection
- Surface of the gingiva (parulis/gum boil)
- Palate (palatal abscess)
- Maxillary sinus
- Soft tissue spaces (cellulitis)
- Floor of mouth (Ludwig’s Angina)
Parulis/gum boil…
From acute periapical inflammation. It is an intraoral opening of a sinus tract that leaks pus
Abscess…
Localized collection of pus, that needs to be drained
Cutaneous Sinus tract…
Abscess that drains extra-orally, through skin
What is the Oroantral Fistula? What does it connect?
A result of communication between two anatomic cavities (from trauma) - oral cavity and maxillary sinus
Sinus tract vs Fistula
Sinus tract - from within to exterior
- Parulis at end of a sinus tract
Fistula - connects two cavities
Cellulitis results from what?
The inability of an abscess to drain into the oral cavity or the surface of the skin. It is the spread of inflammation across the fascial planes of soft tissue.
What often occurs second to cellulitis? What does this result in?
Trismus, difficulty opening mouth
Ludwig’s Angina…
Aggressive cellulitis/swelling of the neck regions - can obstruct airways
Cavernous Sinus Thrombosis can result in __________ due to ___________. This results in the formation of _____________________ which is associated with spread of infection from ____________
Retrograde spread of infection from middle third of face
Valveless venous system
A blood clot in cavernous sinus
Maxillary teeth
What all is located in the Cavernous Sinus?
Internal Carotid Artery
CN III (Occulomotor)
CN IV (Trochlear)
CN V1 (Opthalmic)
CN V2 (Maxillary)
CN VI (Abducens)
Actinomycosis can be described as
Bacterial infection (NOT FUNGUS), Suppurative with sulfur granules often called Lumpy jaw disease. 55% cervico-facial, 25% adbomino-pelvic, 15% pulmonary
What is another name for Chronic Focal Sclerosing Osteomyelitis?
Condensing Osteitis - localized area of bone associated with apices of teeth with pulpal diseases in kids’ molars and premolars
Osteomyelitis
Chronic or acute, bacterial infection of bone
Sequestrum
Segment of necrotic bone that undergoes exfoliation
Involucrum
Non-vital bone encased in vital bone
Another name for chronic osteomyelitis with proliferative periostitis? What is it?
Garre Osteomyelitis, seen in young adults, where vital bone react and result in cortical expansion
