The Pulp and Periodontium Diseases

Question 1

what is the pathway of disease after a tooth has been infected with caries

Answer 1

pulp hyperaemia
acute pulpitis - chronic
acute apical periodontitis
acute apical abscess - chronic sinus
chronic apical infection
apical cysts
infected apical radicular cyst

Question 2

what are the clinical features of hyperaemia

Answer 2

pain lasting for seconds
stimulated by hot/cold or sweet foods
resolves after stimulus
caries approaching pulp but tooth can still be restored without treating pulp

Question 3

what are the clinical features of acute pulpitis

Answer 3

constant severe pain
reacts to thermal stimuli
poorly localised pain
referral of pain
no response to analgesics
often symptoms less severe

Question 4

what helps aid your diagnosis of acute pulpitis

Answer 4

history
visual examination
no TTP
pulp testing is equivocal
radiographs
diagnostic local anaesthetic (numbs sore area)
removal of restorations

Question 5

what gives you a diagnosis of acute apical periodontitis

Answer 5

TTP
non-vital tooth
slight increase in mobility
loss of clarity of lamina dura
radiolucent shadow
delay in changes at apex of tooth
widened apical periodontal space

Question 6

what is the cause of traumatic periodontitis

Answer 6

parafunction

Question 7

what is included in the diagnosis of traumatic periodontitis

Answer 7

clinical examination of occlusion
TTP
vital tooth
radiographs show general widening of PDL

Question 8

how do you treat traumatic periodontitis

Answer 8

occlusal adjustment
therapy for parafunction

Question 9

what are the types of pus producing infections

Answer 9

acute apical abscess
periodontal abscess
pericoronitis
sialadenitis

Question 10

what organisms are included in abscesses

Answer 10

polymicrobial
anaerobes

Question 11

what are the symptoms of abscesses before it perforates bone

Answer 11

severe unremitting pain
acute tenderness in function
acute tenderness on percussion

Question 12

what are the symptoms of abscesses after perforating through bone

Answer 12

pain remits
swelling, redness and heat apparent
pain returns with swelling
initial reduction in TTP

Question 13

what does the site of a swelling depend on

Answer 13

position of tooth in arch
root length
muscle attachments
spaces in proximity to lesion

Question 14

what is the treatment for abscesses

Answer 14

drainage
determine antibiotic need

Question 15

what is the need for antibiotics determined by

Answer 15

severity
absence of adequate drainage
patients medical condition

Question 16

what local factors would signify that the patient needs antibiotics

Answer 16

toxicity
airway compromised
dysphagia
trismus
lymphadenitis
location

Question 17

what systemic factors would signify that the patient needs antibiotics

Answer 17

immunocompromised
diabetes
extremes of age

Question 18

what are the 5 cardinal signs of inflammation

Answer 18

heat
redness
swelling
pain
loss of function

Question 19

what is reversible pulpitis

Answer 19

level of inflammation in which returning to a normal state is possible if stimuli removed

Question 20

what are the signs for reversible pulpitis

Answer 20

mild-moderate tooth pain when stimulated
no pain without stimulus
subsides within seconds
no mobility
no TTP

Question 21

what is irreversible pulpitis

Answer 21

higher level of inflammation where pulp damaged beyond point of recovery
sharp throbbing severe pain upon stimulation
spontaneous
need RCT

Question 22

what is a periapical granuloma

Answer 22

mass of chronically inflamed granulation tissue at apex of tooth
not a true granuloma because not granulomatous inflammation

Question 23

when are apical radicular cysts seen

Answer 23

when tooth is non vital

Question 24

what is an apical radicular cyst

Answer 24

apical bone inflammation forming dental granuloma. this stimulates the epithelial rests of malassez giving epithelial proliferation and periapical cyst formation