DHY221-OralPathology.ppt

Elsevier items and derived items ? 2009 by Saunders, an imprint of Elsevier Inc Microscopic Events and Clinical Signs of Inflammation (Cont.) Inflammatory Periapical Lesions Periapical Abscess Dental or Periapical Granuloma Radicular Cyst (Periapical Cyst) Resorption of Teeth Focal Sclerosing Osteomyelitis Alveolar Osteitis (“Dry Socket”) Inflammatory Periapical Lesions (cont.) (pg. 63) Caries or trauma may result in Inflammation Infection Chronic hyperplastic pulpitis Necrosis of the pulp The inflammatory process begins in pulp and then extends to the periapical area. Accessory canals may lead to areas of inflammation on the lateral portion of the root. Periapical Abscess (pgs. 38, 63) Purulent exudate surrounded by connective tissue containing neutrophils and lymphocytes Inflammation produces severe pain. May develop directly from inflammation in the pulp More commonly develops in an area of previously existing chronic inflammation Periapical Abscess (cont.) Periapical Abscess (cont.) The pus may cause a fistula to form. The tooth may be extruded. If the acute abscess forms directly from pulpal inflammation There may be no radiographic changes except for a slight thickening of the apical periodontal ligament space. If the abscess forms in a preexisting area of periapical chronic inflammation A distinct radiographic lucency may be seen at the apex. Periapical Abscess Treatment May require incision and drainage of the abscess Endodontics or extraction Dental or Periapical Granuloma (pgs. 63-64) A localized mass of chronically inflamed granula that forms at the opening of the pulp canal, generally at the apex of a nonvital tooth root Granulation tissue with lymphocytes, plasma cells and macrophages – neutrophils may be present Usually asymptomatic May be sensitive to pressure or percussion Dental or Periapical Granuloma (cont.) Dental or Periapical Granuloma (cont.) The tooth may be slightly extruded from the socket. Radiographic May vary from slight thickening of