DH Radiology

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Author:
sthomp88
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48828
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DH Radiology
Updated:
2010-11-10 23:29:06
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Chapter thirty four
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Description:
pulpal and periapical lesions
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  1. an injury produced by an external force
    trauma
  2. trauma may affect what 3 things?
    • crowns of teeth
    • roots of teeth
    • alveolar bone
  3. Trauma may result in what 3 things?
    • fractures of teeth
    • fractures of bone
    • injuries (intrusion, extrusions, and avulsion)
  4. the breaking of a part that may affect the crowns and roots of teeth, or the bones of the maxilla and mandible
    fractures
  5. Which area do crown fractures most often involve?
    anterior teeth
  6. What do most crown fractures result from?
    accidental falls or motor vehicle accidents
  7. true or false. crown fractures may involve just the enamel or go all the way to the pulp.
    true
  8. What do radiographs allow views of considering crown fractures?
    evaluation of proximity of pulp chamber to fracture and examination of root
  9. Less common than crown fractures and usually can result from an accident or traumatic blow.
    Root fractures
  10. Where are root fractures most often found?
    Maxillary central incisors
  11. true or false. Root fractures may involve more than one root on multi-rooted teeth
    true
  12. How does a root fracture appear if the x-ray beam is parallel with the plane of the fracture?
    a sharp radiolucent line
  13. Why might root fractures be overlooked? And then be identified later on a radiograph?
    • If x-ray beam is not parallel with the fracture, adjacent areas of tooth structure might obscure the fracture sight and hide it
    • root fractures enlarge over time and might then be identified on a radiograph
  14. What type of fractures occur more often then fractures of any other bone of the face?
    jaw fractures (mandible)
  15. What are 3 main reasons for jaw fractures?
    • assaults
    • accidents
    • sport injuries
  16. What is the film of choice to evaluate mandibular fractures?
    panoramic radiograph
  17. How does a mandibular fracture appear on a radiograph?
    radiolucent line
  18. true or false. Maxillary fractures are hard to see on a radiograph
    true
  19. In addition to fractures, trauma may result in________________of teeth
    displacement
  20. What are 3 things that radiographs are used to evaluate with jaw injuries?
    • root or alveolar bone fractures
    • periodontal ligament damage
    • pulpal problems
  21. What are 2 types of luxation?
    • intrusion
    • extrusion
  22. the abnormal displacement of teeth
    luxation
  23. the abnormal displacement of teeth into the bone
    intrusion
  24. the abnormal displacement of teeth out of the bone
    extrusion
  25. What type of radiograph should be taken on luxated teeth?
    PA
  26. teeth that have been luxated should be examined for what 3 things?
    • root and adjacent alveolar bone fractures
    • damage to the periodontal ligament
    • pulpal problems
  27. The complete displacement of a tooth from the alveolar bone
    avulsion
  28. What do most avulsions result from?
    assault or accidental fall
  29. What are radiographs helpful to evaluate with avulsion?
    • socket area
    • region for splintered bone
  30. Name 2 types of radiographic changes caused by resorption
    • physiologic
    • pathologic
  31. a process that is seen with the normal shedding of primary teeth
    physiologic resporption
  32. a regressive alteration of tooth structure that is observed when a tooth is subjected to abnormal stimuli
    pathologic resorption
  33. What are 2 ways that resorption of teeth can be described by depending on the location of the process?
    • external
    • internal
  34. resorption that is seen along the periphery of root surfaces
    external resorption
  35. What 7 things is external resorption often associated with?
    • reimplanted teeth
    • abnormal mechanical forces
    • trauma
    • chronic inflammation
    • tumors or cysts
    • impacted teeth
    • idiopathic causes
  36. What area of the tooth does external resorption often affect?
    the apices (appears blunted)
  37. in external resorption the root length appears______________than normal
    shorter
  38. true or false. In external resorption, the lamina dura and bone appear normal
    true
  39. are there any signs or symptoms associated with external resorption?
    no
  40. can external resorption be detected clinically?
    no
  41. are teeth with external resorption mobile?
    no
  42. is there any effective treatment for external resorption?
    no
  43. Resorption that occurs within the crown or root and involves the pulp chamber, canals, and surrounding dentin
    internal resorption
  44. What are 3 precipitating factors believed to stimulate internal resorption?
    • trauma
    • pulp capping
    • pulp polyps
  45. What does internal resorption appear like on a radiograph?
    round-to-ovoid radiolucency seen in midcrown to midroot
  46. true or false. internal resorption is usually asymptomatic?
    true
  47. Can a root canal help a tooth with internal resorption?
    if it is not weakened
  48. When is extraction recommended for a tooth with internal resorption?
    if the tooth is weakened
  49. a diffuse calcification of the pulp chamber and pulp canals of teeth that results in a pulp cavity of decreased size (the bodies own root canal)
    pulpal sclerosis
  50. true or false. Pulpal sclerosis is associated with aging, has no clinical features, and is not clinically significant unless a root canal is indicated.
    all statements are true
  51. On a dental radiograph, a tooth with this condition appears not to have a pulp chamber or pulp canals, is nonvital and does not require treatment
    pulpal obliteration
  52. _______________________________can act as irritants to pulp and stimulate secondary dentin
    traumatic conditions
  53. What are 6 conditions that can act as irritants to pulp and cause pulpal obliteration
    • attrition
    • abrasion
    • caries
    • dental restorations
    • trauma
    • abnormal mechanical forces
  54. calcifications that are found in the pulp chamber or pulp canals of teeth, and the cause is unknown
    pulp stones
  55. How do pulp stones appear on a radiograph?
    round, ovoid, or cylindrical radiopacities
  56. true or false. Pulp stones vary in size, shape, and number and there is no treatment required
    both statements are true
  57. a lesion that is located around the apex (tip of the root) of a tooth and may appear either radiolucent or radiopaque
    periapical lesion
  58. What are 3 periapical radiolucencies?
    • granulomas
    • cysts
    • abscesses
  59. Can you diagnos periapical radiolucencies with radiographs alone? Why?
    no, because they all look the same, so you must diagnos based on clinical findings
  60. Why should we refer to granulomas, cysts, and abscesses as periapical radiolucencies?
    because it is impossible to distinguish between them based on their radiographic appearance
  61. a localized mass of chronically inflamed granulation tissue at the apex of a nonvital tooth, it results from pulpal death and necrosis
    periapical granuloma
  62. true or false. A periapical granuloma may give rise cyst or abscess
    true
  63. true or false. periapical granulomas may be asymptomatic but have a pervious history of sensitivity to hot and cold
    true
  64. What 2 treatments might be used for periapical granuloma?
    • Root canal
    • extraction with curettage of apical region
  65. How are periapical granulomas initially seen on a radiograph?
    as a widened perio ligament space at apex
  66. true or false. with time, the periapical granuloma widens to a round or ovoid radiolucency
    true
  67. is the lamina dura visible between the apex and lesion on a tooth with periapical granuloma?
    no
  68. a lesion that develops over a prolonged period of time; from cystic degeneration that takes place within a granuloma; it results from pulpal death and necrosis
    periapical cyst
  69. What are the most common of all tooth-related cysts and comprise of 50-70% of all cysts in the oral cavity?
    periapical cysts
  70. true or false. Periapical cysts are typically asypmtomatic
    true
  71. How are periapical cysts usually treated?
    • endodontic therapy
    • extraction as well as curettage of the apical region
  72. How do periapical cysts appear on a radiograph?
    round or ovoid radiolucency
  73. a localized collection of pus in the periapical region of a tooth that results from pulpal death
    periapical abscess
  74. what are 2 types of periapical abscesses?
    • acute
    • chronic
  75. features of a pus-producing process and inflammation, it may result from an acute inflammation of the pulp area or an area of chronic infection such as a periapical granuloma; it is painful, the pain may be intense and is sensative to pressure, percussion and heat
    acute periapical abscess
  76. features of a long-standing, low-grade, pus-producing process that may develop from an acute abscess or an acute abscess or a periapical granuloma; it is usually asymptomatic because the pus drains through the bone or periodontal ligament space
    chronic periapical abscess
  77. How does a chronic periapical abscess look clinically?
    a gumboil seen in the apical region of the tooth at the site of drainage
  78. How do you treat periapical abscess?
    • endodontic therapy
    • extraction
  79. in which type of periapical abscess is might radiographic change evident? But early radiographic changes include an increased widening of the periodontal ligament space
    acute periapical abscess
  80. How does a chronic periapical abscess appear on a radiograph?
    round or ovoid apical radiolucency with poorly defined margins, and lamina dura cannot be seen between the root apex and the radiolucent region
  81. Results from bacterial infections within the walls of periodontal tissues, may result from a preexisting periodontal condition, and deep scaling and debridement is recommended for this condition
    periodontal abscess
  82. What is the most common symptom of a periodontal abscess?
    pain
  83. What are 3 types of periapical radiopacities?
    • condensing osteitis
    • sclerotic bone
    • hypercementosis
  84. Can periapical radiopacities be diagnosed based on their radiographic appearance?
    yes, as well as clinical information and patient history
  85. a well-defined radiopacity that is seen below the apex of a nonvital tooth with a history of long-standing pulpitis, the opacity represents a proliferation of periapical bone that is a result of a low-grade inflammation or mild irritation and occurs in response to pulpal necrosis
    condensing osteitis (chronic focal sclerosing osteomyelitis)
  86. true or false. Condensing osteitis may vary in size and shape, and does not appear to be attached to the tooth root
    true
  87. What is the most common periapical radiopacity seen in adults?
    condesing osteitis or chronic focal sclerosing osteomyelitis
  88. Why is no treatment needed in the case of condensing osteitis?
    because teeth associated with this are nonvital, and this condition is believed to represent a physiologic reaction of bone inflammation
  89. what teeth is most frequently involved with condensing osteitis?
    mandibular first molar
  90. a well-defined radiopacity that is seen below the apices of vital, noncarious teeth, also known as osteosclerosis or idiopathic periapical osteosclerosis
    sclerotic bone
  91. true or fals. The cause of sclerotic bone is unknown
    true
  92. Is the lesion of a sclerotic bone attached to a tooth?
    no
  93. true or false. Sclerotic bone is asymptomatic and comes in various shapes and sizes
    both statements are true
  94. Excess deposition of cementum on root surfaces that results from supraeruption, inflammation or trauma or no cause
    hypercementosis
  95. How does hypercementosis appear on a radiograph?
    it is visible as an excess amount of cementum along all or part of the root surface; and the apical area appears enlarged and bulbous
  96. true or false. teeth affected by hypercementosis are vital and do not require treatment
    true

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