Pulpal and PA pathology lucencies

Question 1

Pulpal Interpretation factors

Answer 1

Size
Secondary dentin
Pulp stones, Pulpal sclerosis
Internal/External resorption

Question 2

Answer 2

enlarged pulp chamber, young pt

Question 3

Answer 3

enlarged pulp chambers, young pts

Question 4

Answer 4

Small Pulp Chamber/Secondary Dentin Formation: Older Patient

Question 5

compare with contralateral tooth

Answer 5

Enlarged Pulp Chamber/Root Canal: Non-vital tooth #7.
Compare with contralateral tooth.

Question 6

Answer 6

Secondary Dentin Formation/Pulpal Recession –
Distal Pulp Horn of First Molar

Question 7

Answer 7

pulp stones

Question 8

Answer 8

pulp stones

Question 9

Answer 9

pulpal sclerosis

Question 10

Answer 10

internal root resorption

Question 11

Answer 11

internal root resorb

Question 12

Answer 12

External Root Resorption

Question 13

Answer 13

External Root Resorption from tumor

Question 14

Answer 14

External Root Resorption from impacted mesiodens that is resorbing

Question 15

large horns/chamber issues

Answer 15

potential for carious exposure

Question 16

Answer 16

ext root resorb, due to inflammatory process, may req endo

Question 17

Answer 17

secondary dentin formation can make pulp chamber app as if its gone

Question 18

Potential Superimposition of Normal
Anatomic Structures

Answer 18

Nasopalatine foramen
Lateral fossa
Mental foramen

Question 19

8/9 luceny, pathologic?

Answer 19

no, NP canal

Question 20

Answer 20

lateral fossa

Question 21

internal root resorb

Answer 21

internal would be seen in canal system as aneurysm

Question 22

int root resorb tx

Answer 22

endo

Question 23

ext root resorb

Answer 23

not due to pulpal inflamm, ext pressure resorbing tooth (ortho, tumor, etc.)

Question 24

Answer 24

mental foramen

Question 25

Answer 25

Open apices in young patient simulates periapical lesion.

Question 26

lamina dura importance

Answer 26

follow around the root to ensure lucency is not pathologic but instead anatomic

Question 27

Periapical Radiolucencies

Answer 27

Periapical Abscess Periapical Granuloma Periapical Cyst Residual/Recurrent Cyst Periapical Cemento-Osseous Dysplasia Fibrous Healing Defect

Question 28

Acute Pulpal/Periapical Diseases

Answer 28

Reversible/irreversible pulpitis Acute apical abscess

Question 29

reversiable pulpitis/early irreversable radio

Answer 29

may be none, use clinical findings

Question 30

Apical Abscess Radiographic Findings at Apex

Answer 30

**in sequential order** 1. PDL space thickening 1. Discontinuity of lamina dura 1. Periapical radiolucency

Question 31

1st molar path

Answer 31

Periodontal ligament space widening at mesial apex of first molar.

Question 32

Answer 32

discontinuous LD on 1st molar

Question 33

what could this be in an acute case

Answer 33

abcess

Question 34

Chronic Periapical Inflammatory Lesions

Answer 34

Chronic apical abscess Periapical granuloma Periapical cyst Periapical rarefying osteitis (umbrella term)

Question 35

can we dif abcesses, granulomas and cyst radiographically?

Answer 35

no

Question 36

chronic apical abcess radio

Answer 36

small luceny surrounded by sclerotic bone

Question 37

apical diagnosis

Answer 37

CAA

Question 38

Answer 38

CAA

Question 39

PA granuloma radio

Answer 39

variable: well or ill defined margins, thin sclerotic border or not

Question 40

PA cyst may develop from

Answer 40

granuloma

Question 41

PA cyst radio

Answer 41

well defined often with thin sclerotic border (corticated)

Question 42

Answer 42

PA cyst

Question 43

granuloma vs cyst differentiation by size?

Answer 43

not done, but the larger the more likely it is a cyst

Question 44

Residual Cyst vs. Recurrent Cyst

Answer 44

residual: remain after tooth has been extracted/lost recurrent: removed tooth with no cyst, later on a cyst develops in this area due to remanent epithelium

Question 45

CAA divisions

Answer 45

those with and without DST (draining fistula with parulis)

Question 46

CAA, what is seen D?

Answer 46

DST

Question 47

Answer 47

Gutta Percha Point to Identify Source of Draining Fistula

Question 48

Periapical Halo Formation

Answer 48

corticated border around apex of the tooth, none of it will contact part of the tooth due to the tooth developing abcess in which fluid penetrated into sinus>periosteum stimulated to form layer of bone

Question 49

Answer 49

PA halo formation

Question 50

apical scars

Answer 50

occurs with tx of PA pathologies, may be small luceny associated with PT teeth

Question 51

apical scar diagnosis

Answer 51

would need prior radiographs to confirm, luceny would not change overtime

Question 52

fibrous healing defect

Answer 52

large PA lesion destroying B/L cortexes: not able tp reform bone very radiolucent, no sclerotic border, no change over time

Question 53

Answer 53

fibrous healing defect

Question 54

PERIAPICAL CEMENTO-OSSEOUS DYSPLASIA

Answer 54

three stages, beings as lucency then filled in with opacities early stage can resemble inflam lesion due to lucencies no tx required

Question 55

Answer 55

PA cemento-osseous dyplasia

Question 56

metastic carcinoma at apices

Answer 56

irregular, ill defined borders with isolated trabeculae