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44 Cards in this Set

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  • Back
Periapical Granuloma:
What is another name for it?

Decription?
Chronic Apical Periodontitis.

Chronically inflammed granulation tissue at apex of non-vital tooth.
Periapical Granuloma:
Tooth mobility?
Painful?
Tooth vitality?
No tooth mobility.

Usually no pain (unless with acute exacerbation).

Tooth is non-vital.
Periapical Granuloma:
Radiolucent or radioopaque?
What is it similar to?
Apically Radiolucent.

Cannot destinguish radiographically from a periapical cyst.
Periapical Granuloma:
Treatment?
Extraction or root canal.
Periapical Cyst:
What are two other names for it?
1. Radicular Cyst
2. Apical Periodontal Cyst
Periapical Cyst:
What is a cyst?
A pathologic cavity lined by epithelium.
Periapical Cyst:
What is a residual cyst?
Not synonymous. Cyst that follows extraction.
Periapical Cyst:
Pain?
Tooth mobility?
Vital tooth?
No pain unless acutely exacerbated.

May have mobility of adjacent teeth.

Tooth is non-vital (Unlike lateral periodontal cyst).
Periapical Cyst:
Similar to what condition radiographically?
Periapical granuloma (Chronic apical periodontitis).
Periapical Abscess:
Define.
Vital or non-vital?
Accumulation of acute inflammatory cells at the apex of a non-vital tooth.
Periapical Abscess:
Acute or chronic?
Symptomatic?
Acute.

Yes...pain, sensitivity, and possible systemic symptoms.
Periapical Abscess:
PDL appearance?
PDL may appear thickened and/or an ill-defined radiolucency.
Periapical Abscess:
What may it lead to?
Osteomyelitis
Cellulitis
Cutaneous sinus tract
Parulis
Parulis:
Define.
Appearance?
A mass of subacutely inflamed granulation tissue at the opening of the intraoral sinus tract.

Red (or yellow if pus filled) tumescence, usually on buccal gingiva of children/young adults.
Parulis:
Cause?

Treatment?
Usually from the inflammation of a periodontal or apical abscess.

Treatment of the underlying cause usually fixes the parulis. If not, surgical excision.
Cellulitis:
Define.
A diffuse inflammation of soft tissues, not circumscribed or confined, but which in contradistinction to an abscess, tends to spread through tissue spaces and along fascial planes.
Cellulitis:
What are the 2 most important forms?
1. Ludwig's angina
2. Cavernous sinus thrombosis
Ludwig's angina:
Clinical features?

Treatment?
Swelling in floor of mouth and mandibular area, protrusion of tongue, enlargement of neck, fever, chills.

Maintain airway
Antibiotic therapy
Surgical drainage
Cavernous Sinus Thrombosis:
Clinical features?

Treatment?
Swelling around eye, nose and forehead, protrusion of eyeball, lacrimation, photophobia, V1 and V2 pain, fever, chills. Can lead to brain abscess.

Extraction of tooth.
Drainage.
High dose antibiotics.
Corticosteroids & perhaps anti-coagulants.
Osteomyelitis:
Define.
Acute or chronic inflammatory process in medullary spaces or cortical surfaces of bone that extends away from the initial site of involvement. Usually bacterial.
Osteomyelitis:
Predispositions?
Chronic systemic diseases
Immunocompromised status
Decreased bone vascularity
Osteomyelitis:
Predisposing factors?
Alcohol & tobacco abuse
IV drug use
Diabetes
Malaria
Anemia
Malnutrition
Malignancy
AIDS

Radiation
Osteopetrosis
Osteitis deformans
etc.
Acute Osteomyelitis:
Male or Female?
Maxilla or Mandible?
Male
Mandible
Acute Osteomyelitis:
Radiographic evidence?

Treatment?
May be unremarkable early on.
Ill-defined radiolucency.

Antibiotics and drainage.
Chronic Osteomyelitis:
Causes?
Clinical features?
May arise de novo or from acute osteomyelitis.

Swelling, pain, sinus formation, purulent discharge, sequestrum formation, tooth loss or pathologic fracture.
Chronic Osteomyelitis:
Radiographs?
Patchy, ragged, ill-defined radiolucency-->"moth-eaten"
Chronic Osteomyelitis:
Treatment?
High dose IV antibiotics.
Surgical intervention.
Hyperbaric O2--lost vascularity...how to deliver antibiotics?
Diffuse Sclerosing Osteomyelitis:
Clinical features?

Name the 3 categories.
Pain, inflammation, gnathic periosteal heperplasia, sclerosis and lucency.

1. Diffuse sclerosing osteomyelitis
2. Tendoperiostitis
3. SAPHO syndrome
Diffuse Sclerosing Osteomyelitis:
Define.
Infectious process that is DIRECTLY responsible for the bony sclerosis.
Diffuse Sclerosing Osteomyelitis:
Maxilla or mandible?
Adult or children?
Pain?
Mandible.

Adults.

Pain and swelling are not common.
Diffuse Sclerosing Osteomyelitis:
Radiographs?
Increase radiodensity develops around sites of chronic infection.

May be multifocal or fill entire quadrant.
Diffuse Sclerosing Osteomyelitis:
Treatment?
Removal of source of infection...often will allow for remodeling of bone.
Chronic Tendoperiostitis:
Define.
Reactive hyperplasia of bone caused by chronic overuse of the muscles of mastication.
Chronic Tendoperiostitis:
Clinical features?
Recurrent pain, swelling of the cheek and trismus.
No evidence of infection.
Usually affects the angle of the mandible.
Chronic Tendoperiostitis:
Radiographs?
Radiolucencies in areas of radiodensity around the angle of the mandible.
SAPHO:
What does it stand for?
Synovitis
Acne
Pustulosis
Hyperostosis
Osteitis
Condensing Osteitis:
Another name?
Define.
Focal Sclerosing Osteomyelitis.

Localized areas of bone sclerosis associated with the apices of teeth with pulpitis or pulpal necrosis.
Condensing Osteitis:
What age?
Area of mouth?
Enlargement of jaw?
Children and young adults.

Mandibular pm/molar region.

NO.
Condensing Osteitis:
Radiographs?
Localized, uniform zone of radiodensity adjacent to the apex of tooth that exhibits a thickened PDL or apical inflammatory lesion.

*Early lesions may appear radiolucent toward apex with a radiodensity to the periphery.*
Condensing Osteitis:
What is the residual area of condensing osteitis that remains after extraction or root canal called?
A bone scar.
Osteomyelitis with Proliferative Periostitis:
2 other names?
1. Periostitis Ossificans
2. Garre's Osteomyelitis
Osteomyelitis with Proliferative Periostitis:
Define.
A periosteal reaction to inflammation (usually to a carious tooth), forming several rows of reactive, vital bone causing bone expansion.
Osteomyelitis with Proliferative Periostitis:
Clinical features?
Mean age is 13.
Onion skin radiograph.
Non-painful swelling.
Alveolar Osteitis:
2 other names?
1. Dry socket
2. Fibrinolytic alveolitis