Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 4, Sem 2 > Week 8 Sharma- Endo-Perio > Flashcards

Week 8 Sharma- Endo-Perio Flashcards

1
Q

What are the pathways of communication for endo perio lesions?

A
  • Apical foramen
  • Accessory canals
  • Dentinal tubules (deficient cementum, excess root planing & debridement)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 3 types of endo-perio lesions?

A
  • Primary endo/secondary perio lesion (endo lesion can seep through apex or accessory canals and form perio lesion)
  • Primary perio/secondary endo lesion (pulp becomes infected from deep perio pocket)
  • True combined lesion (hard to tell what happens first- caries and pocket formation present)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are anatomical predisposing factors for endo/perio lesions?

A
  • Lingual grooves
  • Root / tooth fractures
  • Root anomalies
  • Intermediate bifurcation ridges
  • Cervical enamel projections
  • Trauma-induced root resorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the 2017 endo-perio lesions classifications (classification to use for diagnosis)?

A
  • Endo-perio lesion with root damage (root fracture or cracking, perforation, ERR)
  • Endo-perio lesion without root damage
    • EPL in periodontitis pt (grade 1-3)
    • EPL in non-periodontitis pt (grade 1-3)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is hopeless EPL associated with?

A

Trauma or iatrogenic factors (perforation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is poor or favourable prognosis of EPL associated with?

A

EPL’s associated with endo and periodontal lesions and depends on extent of perio involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are effects of pulpal diseases on periodontium?

A
  • As long as pulp remains vital, significantly inflamed pulp exerts little or no effect on periodontium.
  • Necrosis of pulp results in bone resorption and apical radiolucency in the furcation or along the root.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When is hemisection or root resection often carried out?

A
  • Perforation
  • Fractured file during endo
  • Furcation involvement
  • Extensive BL around one root
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 3 grades for E/P lesions in periodontitis and non-periodontitis patients?

A
  • Grade 1: narrow deep perio pocket in 1 tooth surface
  • Grade 2: wide deep perio pocket in 1 tooth surface
  • Grade 3: deep perio pockets in >1 tooth surface
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some endodontic procedures that can affect periodontium?

A
  • Pulp extirpation
  • Cleaning and shaping of root canal
    • Debris pushed into PDL
    • Extension of files, reamers or filling materials
    • Perforation of floor of pulpal chamber
  • Vertical root fracture during obturation or post placement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are periodontal procedures affecting pulp?

A
  • Deep curettage- can damage apical vessels
  • Scaling and debridement can remove cementum leading to open dentinal tubules and possibly lateral canals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are characteristics of primary endo lesion?

A

Necrotic pulp with chronic apical periodontitis & sinus tract draining through PDL or gingival sulcus

  • Not a true endo-perio lesion
  • Radiograph reveals isolated periodontal problems around an individual tooth
  • Usually no associated generalised periodontal disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do investigations reveal for primary endo lesions

A
  • Negative pulp vitality
  • Tracing tract often reveals origin is at apex of tooth. May also go to mid root when lateral canal is involved
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the treatment for primary endo lesion?

A
  • Conventional RCT
  • Sinus usually heals after RCT and no root debridement needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is prognosis for primary endo lesion?

A
  • Excellent prognosis
  • Radiographic and clinical healing is rapid
  • Complete healing usually in 3-6 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are characteristics of primary perio lesion?

A
  • Can sometimes mimic endo problem, clinically & radiographically
  • Minimal or no pain in perio disease (dull pain)
  • If painful, there may be coronal fracture that extends into PDL
  • Perio pocket may reach apex of involved tooth
17
Q

What are clinical test findings for primary perio lesions?

A
  • Pulp testing of teeth are WNL
  • Deep pocket present
18
Q

What are treatments for primary perio lesions?

A
  • Periodontal therapy
  • RCT isn’t indicated unless pulp vitality changes
  • Re-evaluation must be performed periodically after therapy to check for possible retrograde endo problems
19
Q

What is the prognosis of primary perio lesions?

A
  • Entirely dependent on perio therapy
  • Most teeth with periodontitis resulting in AL to apex do NOT have favorable prognosis
20
Q

What are primary endodontic lesions with primary periodontal involvement + clinical test results?

A

Primary endodontic lesion with an independent periodontal lesion

  • Pulp vitality -ve
  • Perio pockets present do not extend up to periapical lesion
21
Q

What is tx for primary endo lesion with primary periodontal involvement?

A
  • Good, conservative endo
  • Perio debridement
22
Q

What is prognosis of primary endo lesion with primary periodontal involvement?

A
  • Endo component prognosis is excellent. Regeneration of attachment apparatus is limited by perio prognosis
  • If RCT alone, limited healing is expected bc periodontal component of lesion is not treated adequately
23
Q

What is primary perio lesion with secondary endodontic involvement?

A
  • When periodontal involvement extends to apex of tooth, retroinfection of pulp tissue may occur.
  • Pt sometimes has severe pain
  • Infection of pulp can follow path through lateral canal
  • Dentinal abrasions and root debridement can also contribute to death of pulp
24
Q

What are results of clinical tests for primary perio lesions with secondary endo involvement?

A
  • Pt often has generalized periodontitis
  • Pulp vitality test results can sometimes be mixed
  • When pulp is inflamed, application of cold produces an immediate response
25
Q

What is tx for primary perio lesions with secondary endo involvement

A
  • Conservative RCT
  • Perio therapy should be initiated and can proceed in conjunction with the endo
26
Q

What is prognosis of primary perio lesion with secondary endo involvement?

A
  • Prognosis is dependent on perio therapy
  • Healing response of periapical lesion is not predictable bc of perio communication
  • Favourable endo prognosis is obtained only when tooth is in closed and protected environment
  • Failures also occur when a perio problem develops in a tooth with anatomical issues like fused roots in posterior teeth
27
Q

What are true combined lesions?

A

Lesion is formed with pulpal and perio pathosis develop independently and unite

  • Usually have significant perio involvement
  • Similar to secondary endo involvement on pre-existing primary perio lesions
28
Q

What is differential diagnosis for true combined lesions?

A

Vertical root fracture

29
Q

What are clinical test results for true combined lesions?

A
  • Negative pulp test
  • Tooth will have deep perio probing depths at multiple sites
  • Radiographs by placing perio probe, multiple GP point or silver points into sulcus and tracing them to apex
30
Q

What is tx for true combined lesion?

A
  • Perio therapy can be initiated before, during or immediately after endo tx
  • Number of advanced perio and endo clinical approaches may be required- hemi-section or root resection, apicoectomy.
31
Q

What is prognosis for true combined lesions?

A
  • Dependent on perio therapy
  • Greater the perio involvement, poorer the prognosis
32
Q

What are alternative treatment modalities when traditional endo and perio treatments are insufficient?

A
  • Root amputation (mx molars w/ untreatable perio BL)
  • Hemi-section (md molars)

Year 4, Sem 2 (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions