Shared Flashcard Set

Details

Pulpal Pathology
Oral pathology
58
Dentistry
Professional
10/16/2013

Additional Dentistry Flashcards

 


 

Cards

Term
3 Periapical inflammatory disorders
Definition
Periapical granuloma, apical periodontal cyst ("periapical cyst") periapical abscess
Term
Etiology of pulpitis
Definition

Reactive/inflammatory

External stimulus: mechanical, thermal, chemical, microorganisms

Inflammation (mast cells release, decrease nutrient flow, cellular damage)

Term
2 types of pulpitis
Definition
Irreversible & reversible
Term
Histo of reversible pulpitis
Definition
Hyperemia, edema
Term
Histo of irreversible pulpitis
Definition
Hyperemia, edema, fibrosis, chronic inflammation, +/- abscess (vide infra)
Term
Another name for pulp polyps
Definition
Chronic hyperplastic pulpitis
Term
Characteristics of pulp polyps
Definition
Recently erupted tooth w/ open apices; mass of red tissue (pyogenic granuloma-like) emanating from exposed pulp
Term
Stages of typical progression for diseased tooth
Definition
1. Healthy tooth = asymptomatic, 2. mild-moderate caries, 3. severe pulpal insult, 4. Leads to non-vital ("necrotis") pulp, 5. Acute pain resolves (if untreated), 6. over time, mediators of inflammation may stimulate proliferation of residual epithelial cells in jaws
Term
Periapircal granuloma etiology
Definition
Non-vital tooth, chronically inflamed granulation tissue at apex, not a cyst
Term
Demographics of periapical granuloma
Definition
Very common, more common than periapical cyst
Term
Radiology of periapical granuloma
Definition
Unilocular radiolucency, apex or lateral root, +/- root resorption, can't distinguish radiographically from periapical cyst, most periapical radiolucencies = periapical granuloma
Term
Treatment of periapical granuloma
Definition
Extraction vs. RCT
Term
Histo of periapical granuloma
Definition
Granulation tissue; chronic inflammatory cell infiltrate, CT, NO epithelial lining, not "granulomatous inflammation"
Term
Cyst definition
Definition
Epithelial-lined pathologic cavity
Term
Etiology of cyst
Definition
Isolated epithelial cells in tissue stim to divide, forms continuous sheet of epi cells (lining), enlarges slowly, destroying neighboring normal tissue, result = hole in bone lined by epi, on x-ray = black (radiolucency)
Term
Etiology of periapical (radicular) cyst/apical periodontal cyst
Definition
Non-vital tooth (caries, trauma); epithelial rests of Malassez (PDL)
Term
Demographics of Apical periodontal cyst
Definition

Most common jaw cyst

Uncommon in primary dentition

Term
Radiology of radicular cyst
Definition

Unilocular radiolucency, apex or lateral root, contiguous w/ LD of involved tooth

Can't distinguish radiographically from periapical granuloma

+/- root resorption

Term
Histo of radicular cyst
Definition
Non-keratinized epi lining, chronic inflammatory cells + fibrovascular CT
Term
Treatment of Radicular cyst
Definition

Extraction + curettage of socket vs. RCT

Persistent lesions following RCT require root end surgery

Term
Periapical granuloma review
Definition

NON-VITAL tooth

Erupted tooth

Unilocular radiolucency

Term
Periapical cyst = radicular cyst review
Definition

NON-VITAL tooth

Erupted tooth

Unilocular radiolucency

presence of epi/cyst lining = only difference

Term
etiology of residual cyst
Definition
If tooth w/ periapical cyst at apex removed but cyst not removed
Term
Treatment for residual cyst
Definition
Conservative surgical enucleation (open into bone defect and remove any soft tissue by scraping w/ a curette)
Term
Types of osteomyelitis
Definition
Acute osteomyelitis, diffuse sclerosing osteomyelitis, proliferative periostitis, chronic supportive osteomyelitis
Term
Definition of osteomyelitis
Definition
Acute or chronic inflammation of bone (medullary space or cortical bone)
Term
etiology of osteomyelitis
Definition
Bacteremia (most cases), bone fracture, dental infection, surgery, spread from adjacent tissue (diabetic gangrene)
Term
Pathogenesis (mandible) of osteomyelitis
Definition
Common site: limited blood supply and presence of tooth (pulpal/perio infection)
Term
Additional contributing factors of osteomyelitis
Definition
Decreased vascularity of bone (radiation tx, osteopetrosis); immunocomp states (diabetes, alcholism); chronic systemic diseases (collagen vascular diseases)
Term
Clinical of osteomyelitis
Definition
General (tooth mobility, altered sensation); acute (fever, malaise, leukocytosis); chronic (+/- drainage, bone sclerosis)
Term
Clinical features of osteomyelitis
Definition

Esp males (75%+), esp. mandible

 

Term
Definition of sequestrum
Definition
Fragment of necrotic bone that has separated from the adjacent vital bone
Term
involucrum definition
Definition
Fragment of necrotic bone surrounded by new vital bone
Term
Diagnostic tests for osteomyelitis Radiographs:
Definition
varies depending on type; esp CT, +/- sequestrum, +/- periosteal reaction, irregular radiolucency, +/- increased radiopacity
Term
Diagnostic tests for osteomyelitis (everything else)
Definition
Bone scan (radioactively-labeled WBC/gallium scans - increased signal); histologic examination of tissue, microbilogic culture of affected bone (esp if acute)
Term
Treatment for osteomyelitis
Definition
Resolve any source of infection; long-term antibiotic treatment (depending on type); +/- surgical debridement (remove sequestrae); +/- decortication (remove dense cortical bone, allow granulation tissue); +/- hyperbaric oxygen (debate as to effectiveness)
Term
Classification of osteomyelitis
Definition

Can be based on microbiologic etiology:

- Pyogenic osteomyelitis

- Tuberculous osteomyelitis

- Less common: herpes zoster

Term
Classification of osteomyelitis in dentistry usually based on...
Definition
Acute, chronic, +/- sclerosis
Term
Etiology of acute osteomyelitis
Definition
Most cases are infectious in nature
Term
Clinical acute osteomyelitis
Definition
Usually less than one month duraction, pain, +/- lymphadenopathy and other features of acute inflammation; +/- purulent exudate
Term
Radiographics of acute osteomyelitis
Definition
Often no radiographic change, since ~60% of bone must be demineralized to see radiographic change; some cases may see bone changes esp CT
Term
Definition of chronic supportive osteomyelitis
Definition
Suppuration: formation or discharge of pus
Term
Etiology of chronic suppurative osteomyelitis
Definition
Progression from acute osteomyelitis or long term low grade inflammatory process which never went through acute phase
Term
Clinical of chronic supportive osteomyelitis
Definition
Mild to moderate pain, purulent discharge, swelling, esp. mandibular molar area
Term
Etiology of chronic osteomyelitis w/ proliferative periostitis
Definition
Usually associated w/ an abscessed mandibular molar (esp. in children) or post extraction
Term
Clinical of chronic osteomyelitis w/ proliferative periostitis
Definition
Asymptomatic to mildly tender bony hard swelling with normal appearing overlying mucosa
Term
Radiographics of chronic osteomyelitis w/ proliferative periostitis
Definition

Prominent periosteal reaction; trabeculae of bone perpendicular to long axis of bone (expanded cortex on occlusal view) = "Onion-skinning"

+/- Moth eaten appearance

Term
Etiology of diffuse sclerosing osteomyelitis
Definition
Inflammatory reaction of organism of low virulence; chronic periodontal disease is common portal of entry
Term
Clinical and radiographic of diffuse sclerosing osteomyelitis
Definition
Asymptomatic, crestal portion of tooth-bearing areas of mandible
Term
Histology of chronic osteomyelitis
Definition

Chronically inflamed and reactive fibrous CT filling the intertrabecular spaces

Nonvital bone exhibits loss of osteocytes from lacunae; peripheral bone resorption; bacterial colonization; +/- surrounding inflammatory infiltrate

Term
Etiology of condensing osteitis
Definition
Reaction of bone to LOW GRADE CHRONIC pulpal inflammation
Term
Another name for condensing osteitis
Definition
Focal sclerosing osteitis
Term
Clinical of condensing osteitis
Definition
VERY COMMON, Tooth VITAL (large restoration, caries); tooth may subsequently become non-vital (after bone sclerosis has occurred)
Term
Another name for idiopathic osteosclerosis
Definition
dense bone island
Term
Definition of idiopathic osteosclerosis
Definition

Area of increased density within medullary area of bone of jaws of unknown etiology

Like "tori" on inside of jaw bone

Term
Clinical of idiopathic osteosclerosis
Definition
VERY COMMON, focal area of increased bone density (radiopacity); not associated w/ root of inflamed tooth; NB: Difference re"condensing osteitis"
Term
Definition of Dry socket (alveolar osteitis)
Definition
Failure to maintain clot after extraction; esp surgical; esp mandible
Term
Etiology of dry socket
Definition
Increased risk for dry socket if: BCP, alcohol, smoker, debilitated, vomiting
Supporting users have an ad free experience!