Pathology #03 - Inflammatory Jaw Lesions

Front 1

What is CHRONIC HYPERPLASTIC PULPITIS?

Back 1

Unique pattern of pulpal inflammation where the pulp tissue reacts to injury by undergoing hyperplasia

Front 2

What is the etiology of PULP POLYP?

Back 2

- open chronic pulpitis
- ample blood supply
- increased regenerative capacities of young pulpal tissue

Front 3

PULP POLYPS are generally found in which teeth?

Back 3

Molars of children/ young adults

Front 4

What is the treatment for PULP POLYP?

Back 4

- endodontic therapy
- extraction

Front 5

Occurence of PULPAL CALCIFICATIONS increases with what two factors?

Back 5

- aging
- trauma/caries

Front 6

What are PULP STONES?

Back 6

Spherical calcifications formed within the coronal portions of the pulp.

Front 7

Prominent PULPAL CALCIFICATIONS have been associated with what two conditions?

Back 7

- Dentin Dysplasia Type II
- Ehlers Danlos Syndrome

Front 8

What is the treatment for PULPAL CALCIFICATIONS?

Back 8

No treatment required

Front 9

What is a PERIAPICAL ABCESS?

Back 9

accumulation of acute inflammatory cells at the apex of a non-vital tooth

Front 10

What is the etiology of a PERIAPICAL ABCESS?

Back 10

- often associated with a non-vital tooth
- may be symptomatic or asymptomatic
- spreads along path of least resitance

Front 11

What is a PARULIS?

Back 11

- gum boil
- an intraoral opening of a sinus tract that often presents as an erythematous mass of subacutely inflamed granulation tissue

Front 12

What is the treatment for a PERIAPICAL ABCESS?

Back 12

- drainage
- elimination of the focus of infection: reduction of occlusion, analgesic and Abx, endodontic therapy

Front 13

What is a PERIAPICAL GRANULOMA?

Back 13

a mass of chronically inflamed granulation tissue at the apex of a nonvital tooth

Front 14

PERIAPICAL GRANULOMA can arise from which two conditions?

Back 14

- initial periapical pathosis
- progression of a periapical abcess

Front 15

What are the radiographic features of PERIAPICAL GRANULOMA?

Back 15

- radiolucency with loss of apical lamina dura
- well circumscribed or ill defined
- root resorption may occur

Front 16

What is a complication of PERIAPICAL GRANULOMA?

Back 16

may transform into a periapical cyst

Front 17

What is a PERIAPICAL CYST?

Back 17

Inflammation stimulates epithelium at the apex of a nonvital tooth to form a true epithelium lined cyst

Front 18

What are the two etiological sources of PERIAPICAL CYSTS?

Back 18

- source of epithelium
- source of inflammation

Front 19

What are the epithelial sources of PERIAPICAL CYST?

Back 19

- usually rest of Malassez
- crevicular epithelium
- sinus lining
- epithelial lining of fistula tract

Front 20

What are the inflammatory sources of PERIAPICAL CYST?

Back 20

- peridontal disease
- pulpal necrosis with spread through lateral foramen

Front 21

What is a complication with PERIAPICAL CYST?

Back 21

Rarely squamous cell carcinoma has been reported within them.

Front 22

What is a FIBROUS PERIAPICAL SCAR?

Back 22

Defect created by the periapical lesion is filled with dense fibrous tissue instead of bone (when facial and lingual cortical plates have been lost)

Front 23

What is OSTEOMYELITIS?

Back 23

Acute or Chronic inflammatory process in the medullary spaces or cortical surfaces of bone that extend away from the initial site of involvement.

Front 24

What majority of OSTEOMYELITIS cases are caused by what?

Back 24

Bacterial infection.

Front 25

What is ACUTE SUPPURATIVE OSTEOMYELITIS?

Back 25

Acute inflammation process spreads through the medullary spaces of the bone. There is insufficient time for the body to react to the presence of the inflammatory infiltrate.

Front 26

What conditions pre-dispose people to OSTEOMYELITIS?

Back 26

- chronic systemic diseases
- immunocompromised status
- disorders associated with decreased vascularity of bone

Front 27

Most cases of ACUTE SUPP. OSTEOMYELITIS arise after what two events?

Back 27

- odontogenic infections
- traumatic fracture of the jaws

Front 28

Which two bacteria are most frequently involved in cases of OSTEOMYELITIS?

Back 28

Staphylococci
Streptococci

Front 29

What are the signs and symptoms of ACUTE SUPP. OSTEOMYELITIS?

Back 29

- pain
- fever
- lymphadenopathy
- leukocytosis
- significant sensitivity
- soft tissue swelling
- less than 1 MONTH duration

Front 30

Define SEQUESTRUM"

Back 30

drainage or exfoliation of a fragment of necrotic bone

Front 31

Define INVOLUCRUM:

Back 31

When a fragment of necrotic bone becomes surrounded by vital bone

Front 32

What are the radiographic features of ACUTE SUPP. OSTEOMYELITIS?

Back 32

- significant resorption of trabecular bone
- diffusely blotchy area
- motted with indistinct margins
- islands of residual bone (sequestra)

Front 33

What is the treatment of ACUTE SUPP. OSTEOMYELITIS?

Back 33

- surgical intervention to establish drainage and remove sequestra
- use of antibiotics
-

Front 34

What is CHRONIC SUPP. OSTEOMYELITIS?

Back 34

Defensive response leads to the production of granulation tissue which subsequently forms dense scar in attempt to wall off the infected area. Encircled dead space acts as a reservoir for bacteria, and antibiotics can't reach the site. Begins to evolve 1 month after spread of infection.

Front 35

What are the two etiological patterns of CHRONIC SUPP. OSTEOMYELITIS?

Back 35

- sequela of acute osteomyelitis
- low grade inflammatory reaction that never went through an acute phase

Front 36

Which area is affected more frequently in cases of OSTEOMYELITIS?

Back 36

Mandible

Front 37

What are the radiographic features of CHRONIC OSTEOMYELITIS?

Back 37

patchy, ragged, ill-defined radiolucency often with central radiopaque sequestra

Front 38

What is the treatment for CHRONIC SUPP. OSTEOMYELITIS?

Back 38

- removal of all infected and necrotic tissue mandatory
- antibiotics but IV in high doses
- hyperbaric oxygen in difficult cases to stimulate vascularization, collagen synth and osteogenesis
- weakened jaw bones must be immobilized

Front 39

What is DIFFUSE SCLEROSING OSTEOMYELITIS?

Back 39

obvious infection process directly is responsible for sclerosis of bone
- increased radiodensity develops around sites of chronic infection such as periodontisis, pericoronitis, and apical inflammatory disease.

Front 40

What is CONDENSING OSTEITIS?

Back 40

A focal bony reaaction to low-grade inflammatory stimulus, seen at the apex of a tooth with long-standing pulpitis or pulpal necrosis

Front 41

CONDENSING OSTEITIS occurs most frequently in...

Back 41

- children and young adults
- at apices of Mn premolars and molars

Front 42

What are the radiographic features of CONDENSING OSTEITIS?

Back 42

localized, uniform zone of increased radiodensity adjacent to the apex of a tooth that exhibits a thickened pariodontal ligament space or apical inflammatory lesion.

Front 43

What is the treatment for CONDENSING OSTEITIS?

Back 43

- resolution of odontogenic infection, endo or extraction

Front 44

What is a BONE SCAR?

Back 44

residual area of condensing osteitis which remains after resolution of inflammatory focus

Front 45

What is OSTEOMYELITICS WITH PROLIFERATIVE PERIOSTITIS?

Back 45

Periosteal reaction to presence of inflammation

Front 46

What is the most common cause of GARRE's OSTEOMYELITIS?

Back 46

dental caries associated with periapical inflammatory disease

Front 47

An open apex in CHRONIC HYPERPLASTIC PULPITIS can help reduce what?

Back 47

Pulpal necrosis

Front 48

What things have been associated with increased frequency of OSTEOMYELITITS?

Back 48

- tobacco use
- alcohol abuse
- IV drug abuse
- diabetes mellitus
- malnutrition
- AIDS
- Radiation

Front 49

Define "BONE SCAR":

Back 49

Residual area of condensing osteitis which remains after resolution of inflammatory focus

Front 50

How long does bone remodelling normally take after OSTEOMYELITIS?

Back 50

6-12 months

Front 51

Identify the inflammatory lesions:

Back 51

CHRONIC HYPERPLASTIC PULPITIS (pulp polyp)

Front 52

Identify the inflammatory lesions:

Back 52

CHRONIC HYPERPLASTIC PULPITIS (pulp polyp)

Front 53

Identify the inflammatory lesions:

Back 53

CHRONIC HYPERPLASTIC PULPITIS (pulp polyp)

Front 54

Identify the inflammatory lesions:

Back 54

CHRONIC HYPERPLASTIC PULPITIS (pulp polyp)

Front 55

Identify the inflammatory lesions:

Back 55

CHRONIC HYPERPLASTIC PULPITIS (pulp polyp)

Front 56

Identify the inflammatory lesions:

Back 56

PULP STONES

Front 57

Identify the inflammatory lesions:

Back 57

PULP STONES

Front 58

Identify the inflammatory lesions:

Back 58

PULP STONES

Front 59

Identify the inflammatory lesions:

Back 59

PULP STONES

Front 60

Identify the inflammatory lesions:

Back 60

PARULIS

Front 61

Identify the inflammatory lesions:

Back 61

PARULIS

Front 62

Identify the inflammatory lesions:

Back 62

PARULIS

Front 63

Identify the inflammatory lesions:

Back 63

PARULIS

Front 64

Identify the inflammatory lesions:

Back 64

PARULIS

Front 65

Identify the inflammatory lesions:

Back 65

PARULIS

Front 66

Identify the inflammatory lesions:

Back 66

PARULIS

Front 67

Identify the inflammatory lesions:

Back 67

PARULIS

Front 68

Identify the inflammatory lesions:

Back 68

PERIAPICAL GRANULOMA

Front 69

Identify the inflammatory lesions:

Back 69

PERIAPICAL GRANULOMA

Front 70

Identify the inflammatory lesions:

Back 70

PERIAPICAL GRANULOMA

Front 71

Identify the inflammatory lesions:

Back 71

PERIAPICAL GRANULOMA

Front 72

Identify the inflammatory lesions:

Back 72

PERIAPICAL GRANULOMA

Front 73

Identify the inflammatory lesions:

Back 73

PERIAPICAL GRANULOMA

Front 74

Identify the inflammatory lesions:

Back 74

PERIAPICAL GRANULOMA

Front 75

Identify the inflammatory lesions:

Back 75

PERIAPICAL GRANULOMA

Front 76

Identify the inflammatory lesions:

Back 76

PERIAPICAL GRANULOMA

Front 77

Identify the inflammatory lesions:

Back 77

PERIAPICAL GRANULOMA

Front 78

Identify the inflammatory lesions:

Back 78

CONDENSING OSTEITIS

Front 79

Identify the inflammatory lesions:

Back 79

CONDENSING OSTEITIS

Front 80

Identify the inflammatory lesions:

Back 80

CONDENSING OSTEITIS

Front 81

Identify the inflammatory lesions:

Back 81

CONDENSING OSTEITIS

Front 82

Identify the inflammatory lesions:

Back 82

CONDENSING OSTEITIS

Front 83

Identify the inflammatory lesions:

Back 83

BONE SCAR