Perio Ii Dental Abscess Ch 11

Front 1

What is a type of infection orginating from the tooth or periodontium?

Back 1

A Dental Abscess

Front 2

What "symptoms" usually accompany an abscess?

Back 2

Pain & Swelling

*The classification of an abscess is based on its location.*

Front 3

What is defined as an acute infection characterized by localized painful edema at the GM or interdental papilla?

Back 3

Gingival Abscess.

Front 4

Are there any signs of periodontitis in the mouth when a gingival abscess is present? What usually is the cause of a gingival abscess?

Back 4

NO
Usually caused by a foreign object lodged in the gingival crevice: popcorn Kernel, fish bone, seeds.

Front 5

How quickly can a gingival abscess develop?

Back 5

24-48 hours

*Lesion is usually smooth but can have a smelly (purulent) exudate. Often will rupture on its own.*

Front 6

What is usually the casue of a periodontal abscess?

Back 6

Bacteria in the periodontal tissues.

*Usually occurs with pre-existing advanced periodontitis.*

Front 7

What is the most common type of abscess involving the periodontium?

Back 7

Periodontal Abcess.

Front 8

What is a periodontal abscess usually related to? (what condition)

Back 8

Incomplete Calculus Removal

Front 9

What are some conditions (4) that may "cause" a perio abscess?

Back 9

1) Perio Surgery
2) Perio Maintenance Therapy
3) Systemic Antibiotics
4) Recurrent Disease.

Front 10

How are conditions like tooth perforation, tooth fracture or foreign body impaction related to periodontal abscesses?

Back 10

They aren't related!

Front 11

What is the chief complaing with a perio abscess?

Back 11

"Pressure in my gums."

Front 12

Where does a perio abscess usually present?

Back 12

On the lateral aspect of the root.
Usually is a shiny, swollen discolored mass on the gingiva/mucosa.

**It won't be on the GM-> more likely a gingival abscess then.**

Front 13

The microbiology of the gingival or perio abscess usually resembles….

Back 13

the microbiota of chronic periodontitis lesions.

Front 14

What is the primary bactera, including shape, for gingival/perio abscess?

Back 14

Gram - anerobic rods

(P Gingivalis is prevelent)

Front 15

Is AA usually found in the exudate of gingival/perio abscess?

Back 15

NO!

Front 16

When would a Chronic eriodontal abscess occur?

Back 16

If the abscess isn't resolved or treated.

*It forms after the spreading infection has achieved spontaneous drainage, host response or therapy.*
*A Chronic Periodontal Abscess doesn't usually display overt symptoms like an acute perio abscess once homeostasis has been reached.*

Front 17

If an Chronic Perio abscess is present on the lateral aspect of the tooth, how will the area present radiographically?

Back 17

Radiolucent

Front 18

How does an abscess present radiographically if its on the facial or lingual aspect?

Back 18

You won't see it on Rads.

Front 19

True or False? An acute periodontal abscess may occur in the site of a chronic periodontal lesion or abscess.

Back 19

True!

*It may be due to the increasing number of bacteria or the presence of more virulent bacteria over time.*

Front 20

Acute abscess may occur in the site of a __________ abscess.

Back 20

chronic

Front 21

Where is a common place for a periodontal abscess to occur?

Back 21

In furcations of teeth

Front 22

What is another name for Pericoronitis?

Back 22

Pericoronal Abscess.

*It usually involves the gingiva adjacent to a partially erupted tooth-->often the MN molars with children/adults as well as 3rd molars.*

Front 23

What is another name for the gingival flap over the erupting tooth?

Back 23

Operculum?

Front 24

How does the operculum usually appear over an erupting tooth?

Back 24

Red or edematous-->Its usually due to food & debris collecting underneath it or due to occlusal trauma.

Front 25

What happens to the operculum once the tooth is fully erupted?

Back 25

It disappears.

Front 26

A PT may have trouble completely opening their jaw if they have periocoronitis. What is this condition called?

Back 26

Trismus

Front 27

How might the infection from pericoronitis spread in the body?

Back 27

It may spread to the oralpharyngeal area to the base of the tongue and into the surrounding lymph nodes.

Front 28

Is the bactera found in pericoronitis similar to other gingival or periodontal abscesses?

Back 28

Yes!
The microbes are Gram- anerobes

Front 29

What might the Tx of pericoronitis involve?

Back 29

The lesiosn may be incised & drained/cureted.
Usually the operculum is removed.

Front 30

What is another term of endodontic abscess?

Back 30

Pulpal Abscess

Front 31

What are pulpal abscess's usually associated with?

Back 31

Deep caries, trauma or tooth fracture.

*They can be asymptomatiac. They can occur in any type of PT regardless of age, perio status, overall systemic health or oral hygiene quality.*

Front 32

Pulpal Abscess can be ___________ post root canal therapy.

Back 32

Recurrent

Front 33

Because pulpal abscess's can be asymptomatic where might they be identifible only on ____________.

Back 33

Radiographs.

Front 34

At time pulpal abscess's can be extremely painful with swelling. Are they associated with a specific age group, perio status, systemic health conditions or oral hygiene quality?

Back 34

No!

Front 35

When examining and diagnosing a PT presenting with an abscess, what should the exam always include? (4 things)

Back 35

1) Rads
2) Check Health History & circumstantial history
3) Clinical Examination (including pocket measurements & access)
4) Vitality testing (cold testing or electric pulp test.)

Front 36

When diagnosing a type of abscess for Tx, how can an endodontic or pulpal abscess be distinguised from another type of abscess?

Back 36

Endodontic abscess occurs at the apex of a necrotic tooth & heals following root canal therapy.

Front 37

Is it possible when diagnosing that it could be a combined lesion?

Back 37

Yes! The endo/perio lesion with a non vital tooth & a deep perio pocket.

Front 38

Review Chart 11-1 Pg 174 of our text

Back 38

You really should review Chart 11-1 Pg 174!

Don't argue with me!

Front 39

What is the typical Tx of an abscess?

Back 39

Perform an incision and drain the pocket.
You'll need to use anesthesia then open the pocket with a probe or curet to drain the pus.

Eeeeewwww!

Front 40

Describe the tissue in the Tx of an abscess.

Back 40

Tissue is extremely sensitive & fragile!

Front 41

What needs to be done after draining of the abscess?

Back 41

Remove all plaque & calc from the root surface to aid in healing.

Front 42

What should be done with abscess having severe swelling & inflammation?

Back 42

Postpone mechanical instrumentation & Tx until after antibiotic therapy to avoid damaging healthy tissue.

Front 43

What should post-opp include in Tx of an abscess?

Back 43

Rinsing w/warm salt water every 2 hours for 24 hours (especially after incision & drainage)

Front 44

What do periapical lesions require to be completely resolved?

Back 44

Endodontic therapy.

Front 45

If you are presented with a picture and asked what this lesion is and you don't know, but you can select 2 lesions…what do you pick?

Back 45

Periapical Granuloma & Radicular Cyst!

**I had to put this question in as I couldn't remember it from our final in 1st year Spring Oral Path**

Front 46

What is a radicular cyst associated with?

Back 46

A non-vital tooth

Front 47

What is the most commonly occuring odontogenic cyst?

Back 47

Radicular Cyst!
It can recur!