Spread Of Infection

Question 1

The inflammation of pulp tissue which can be reversible or irreversible

Answer 1

Pulpitis

Question 2

Infection spread into periapical tissue causes…

Answer 2

Periapical periodontitis

Question 3

Accumulation of pus within the PDL

Answer 3

Periodontal abscess

Question 4

Inflammation of the surrounding tissue around a partially erupted wisdom tooth

Answer 4

Pericoronitis

Question 5

Odontogenic infection within the confines of the jaw

Answer 5

Osteomyelitis

Question 6

What would you diagnose if:

Toxins from carious bacteria stimulate an acute inflammatory reaction within pulp tissue

Answer 6

Reversible pulpitis

Question 7

What would you diagnose if:

Bacterial colonisation of the pulp occurred which could lead to pulp necrosis if untreated

Answer 7

Irreversible pulpitis

Question 8

How would you treat irreversible pulpitis?

Answer 8

Root canal treatment

Question 9

What would you diagnose if:

Toxins from carious bacteria move into PDL space, triggering acute inflammation.

Answer 9

Periapical periodontitis

Question 10

How can toxins from bacteria move from the pulp into PDL space to cause periapical periodontitis?

Answer 10

Through lateral canals off pulp chamber

Question 11

What does acute inflammatory reaction of the PDL stimulate?

Answer 11

A build up of hydrostatic pressure and subsequent build up of fluid

Question 12

What triggers osteoclastic bone resorption?

Answer 12

Hydrostatic pressure and fluid pressure on the adjacent bone

Question 13

What leads to bone loss around the apex of a tooth?

Answer 13

Osteoclastic bone resorption

Question 14

how would periapical periodontitis appear on a radiograph?

Answer 14

As a periapical radiolucency and loss of lamina dura

Question 15

What would be the next step in treatment of periapical periodontitis id endodontic treatment fails?

Answer 15

Extraction of the tooth

Question 16

The final stage of periodontitis, generally non-painful condition that presents in the apical portion of the apical canal around the apex of a tooth, causing long-lasting inflammation.

Answer 16

Chronic periapical periodontitis

Question 17

What Odontogenic infection is associated with periapical cyst formation?

Answer 17

Chronic periapical periodontitis

Question 18

What is a very rare, but possible extra oral swelling as a result of chronic periapical periodontitis?

Answer 18

Oral cutaneous fistula

Question 19

How does swelling relating to periapical periodontitis usually initially present?

Answer 19

Intra-orally

Question 20

In odontogenic infection from maxillary teeth, where could intra-oral swelling present?

Answer 20

Buccal or palatal

Question 21

What blade would you use to incise and drain pus?

Answer 21

Number 11 blade

Question 22

What will “follow the path of least resistance”?

Answer 22

Pus

Question 23

Where are apices of most teeth close to?

Answer 23

The buccal cortex

Question 24

What are the more common intra-oral swellings and why?

Answer 24

Buccal swellings because the apices of most teeth are closer to the buccal cortex than the lingual/palatal cortex

Question 25

What are the three ways that you could treat intra-oral swellings?

Answer 25

1. Extrication and sterilisation of the pulp 2. Extraction 3. Excise and drain puss

Question 26

What are the 4 potential paths of infection spread fro maxillary 6’s and 7’s?

Answer 26

- palatal swelling - buccal swelling - facial swelling - maxillary Sinusitis

Question 27

What is the most likely presentation of swelling if the muscle attachments are higher than the tooth root?

Answer 27

Intra-oral swelling

Question 28

What is the most likely presentation of swelling if the muscle attachments are lower than the tooth root?

Answer 28

Extra-oral swelling

Question 29

What special investigation result would indicate periapical inflammatory process?

Answer 29

If a tooth is tender to percussion (TTP)

Question 30

What is the reason you would do culture and sensitivity testing for a patient with suspected abscess?

Answer 30

It would give you an idea of what bacteria is involved in the infection and also indicate what antibiotic is most appropriate for treatment

Question 31

What type of bacteria is mostly involved in the formation of an abscess?

Answer 31

Anaerobic

Question 32

what antibiotic would be the primary choice for treatment of a periapical abscess?

Answer 32

Metronidazole

Question 33

How would a canine space infection present and why?

Answer 33

Would present as an infra-orbital swelling. This is because the canine roots are long and pass the muscle attachments of facial expression.

Question 34

Where do buccal space infection most commonly originate from?

Answer 34

Odontogenic infection in maxillary molars

Question 35

What facial plane infection is a rare but possible result of odontogenic infection of a maxillary 8?

Answer 35

Infratemporal space infection

Question 36

why is there a particular need for infratemporal space infection to be recognised and treated early?

Answer 36

Because, if allows to progress, infection will do so posteriorly towards the pterygoid plexus of veins. This plexus connects with the cavernous sinus.

Question 37

Swelling of tissues as a consequence of acute inflammatory oedema OR Transient swelling caused by the build-up of oedema fluid in tissues.

Answer 37

Cellulitis

Question 38

If an infected mandibular molar root is closer to the buccal cortex, what would be the likely presentation of swelling?

Answer 38

Intra-oral buccal swelling

Question 39

If an infected mandibular molar root is closer to the buccal/inferior cortex, what would be the likely presentation of swelling?

Answer 39

Infection spread under mylohyoid, presenting as an extra-oral submandibular space swelling in the neck

Question 40

If an infected mandibular molar root is closer to the lingual cortex, what would be the likely presentation of swelling?

Answer 40

Either: Submental swelling OR Sublingual swelling

Question 41

If an infected mandibular molar root is closer to the lingual cortex, and infection spreads to the anterior belly of digastric muscles, what would be the likely presentation of swelling?

Answer 41

Submental swelling

Question 42

If an infected mandibular molar root is closer to the lingual cortex, and infection spreads above the mylohyoid, what would be the likely presentation of swelling?

Answer 42

Sublingual swelling

Question 43

What does cervical facial planes refer to?

Answer 43

Spaces that connect the head, neck and mediastinum

Question 44

If infection spreads to prevertebral spaces in the neck, what could be the sequelae of this?

Answer 44

Infection of whole mediastinum ( mediastinitis)

Question 45

If infection spreads to retropharyngeal space in the neck, what could be the sequelae of this?

Answer 45

Secondary infection of posterior mediastinum

Question 46

As a dentist, what would you do if a patient came in presenting with a large extra-oral swelling?

Answer 46

Refer to secondary care immediately

Question 47

What are the main bacteria associated with Ludwig’s angina?

Answer 47

Streptococcus and staphylococcus

Question 48

what life-threatening condition involves swelling of submandibular, sublingual and submental spaces?

Answer 48

Ludwig’s angina