OPATH MIDTERM EXAMS

DENTAL CARIES

Once erupted, tooth is exposed to function

LACTOBACILLI

Gram-positive, nonspore forming rods that grow best under microaerophilic condition

ORAL ACTINOMYCES

Gram-positive, filamentous organisms that include A. naeslundii and A. viscosus which are facultative anaerobes and A. israelii and A. odontolyticus which are strict anaerobes

VEILLONELLA

One of the gram-negative cocci commonly found in plaque

ORAL STREPTOCOCCI

S. Mutans - a streptococcus that prevailed in many human carious lesions. These bacteria are catalase negative, gram-positive cocci forming short to medium chains

Race

Investigations indicate that the blacks have fewer carious lesions than the whites

ACIDOGENIC TYPE

capable of producing acid (attack inorganic)

ACIDOPHILIC TYPE

do not produce acid but can withstand acidic environment

PROTEOLYTIC TYPE

attack the protein (organic) portion of the tooth

PROTECTIVE TYPE

has a filament that attaches to tooth surfaces for better attachment of plaque

ACIDOGENIC THEORY

Miller, Black, Williams

theory: caries is caused by acids produced by microorganisms of the mouth

PROTEOLYTIC THEORY

Bernhard Gottlieb

the organic or protein elements are the initial pathways of invasion by microorganisms

PROTEOLYSISCHELATION THEORY

Schatz

Both the inorganic and organic are destroyed simultaneously

CLINICAL APPEARANCE

During initial stage, caries appears opaque and white

It becomes pigmented and discolored as light brown to black

As it progresses, the enamel is completely destroyed producing a visible defect or cavity

LINEAR ENAMEL CARIES

An atypical form of dental caries that has been observed in the primary dentition of children in Latin America and Asian countries

RAMPANT CARIES

a condition which is characterized by sudden, rapid and almost uncontrollable destruction of teeth, affecting surfaces of teeth that are relatively caries free

Acute caries

- (+) pain

Frequently in children and young adults, presumably because the dentinal tubules are open and show no sclerosis

Chronic Caries

- - pain

ARRESTED CARIES

Caries which becomes static and does not show any tendency for further progression

RADIATION CARIES

Seen in patients undergoing therapeutic radiation to the head and neck

It starts as a diffuse area of demineralization encircling the entire crown of the tooth at the cervical portion and proceeds further to result in amputation of the crown at the gingival margin

Oblong cavities

run parallel to the dentinal tubule

Transverse clefts

run perpendicular to the dentinal tubule

ATTRITION

Loss by wear of surface of tooth or restoration caused by tooth-to-tooth contact during mastication or parafunction

EROSION

Progressive loss of hard dental tissue by chemical processes not involving bacterial action

ABRASION

Loss of wear of dental tissue caused by abrasion by foreign substance

ABFRACTION

Occlusal stresses

RESORPTION

It is the elimination of tissues and the eliminated part goes back to the circulation

ROOT RESORPTION

Breakdown or destruction and subsequent loss of the root structure of a tooth

EXTERNAL ROOT RESORPTION

Resorption that involves the root surface but may involve the crown of unerupted tooth

INTERNAL ROOT RESORPTION

Resorption that occurs within the pulp chamber or canal involving the surrounding dentin

INTERNAL-EXTERNAL RESORPTION

Did not know where it started

RESORBING ODONTOCLAST

Scalloped areas in the dentin containing odontoblasts lining the periphery of the now altered pulp

ODONTOCLAST

Scalloped effect produced by the multinucleated odontoclasts as they resorb the dentinal surface

SECONDARY DENTIN

Deposited in the pulp chamber after the formation of primary dentin has been completed

PULP STONES/DENTICLES

Foci of calcification in the dental pulp

cause is unknown

HYPERCEMENTOSIS

Excessive deposition of cementum on the tooth roots

Fracture

discontinuity of the bone

Greenstick fracture

it is an incomplete fracture; usually seen in pediatric patients because their bone is still soft and flexible; difficult to be seen on a plain radiograph (panoramic)

Closed fracture

there is a break on the bone but the outer soft tissue are very much intact; fractured bone is still covered and no communication with the outer environment; has a better prognosis

Open/complex fracture

there is a break on the skin the causes exposure or protrusion of the bone segment with the outer environment

Comminuted fracture

these are multiple bone fracture; it was fractured in several pieces • Management of fractures – through the use of plates and screws

Symphysis fracture

if the fracture line is located on the symphysis; midline of the mandible- from canine to canine

Parasymphysis/parasymphyseal fracture

if the fracture starts in the center but moves towards the canine and pre molar

maxilla-mandibular fixation (MMF) or intermaxillary fixation (IMF)

it is a treatment that involves binding the movable lower jaw to the stable upper jaw using wires, elastic bands, or metal splints which keeps the lower jaw bone from moving while it heals;

INFRACTION

incomplete fracture (crack) of the enamel without loss of tooth structure

UNCOMPLICATED CROWN FRACTURE

simple fracture of the crown involving little or no dentin

COMPLICATED CROWN FRACTURE

extensive fracture of the crown involving considerable dentin and exposing the pulp

ROOT FRACTURE

reveals a mobile coronal fragment attached to the gingiva that may be displaced

may be a horizontal, oblique, or vertical fracture

HORIZONTAL FRACTURE

usually results from direct physical trauma

VERTICAL FRACTURE

usually seen in endodontically treated tooth as a result of repetitive excessive occlusal forces

COMPLETE FRACTURE

when total separation is visible or fragments can be moved independently

INCOMPLETE FRACTURE

absence of visible separation

INTRAOSSEOUS FRACTURE

terminating below the level of the alveolar bone and resulting in periodontal problems

SUPRAOSSEAOUS FRACTURE

fracture is above the crest area

CONCUSSION

injury to the tooth-supporting structures without abnormal loosening or displacement of the tooth

SUBLUXATION

injury to tooth-supporting structures with abnormal loosening but without tooth displacement

LATERAL LUXATION

Displacement (can be labial, lingual, mesial, or distal) of the tooth in a direction other than axially

The periodontal ligament is torn and contusion or fracture of the supporting alveolar bone occurs

INTRUSION

Apical displacement of tooth into the alveolar bone

EXTRUSION

Partial displacement of the tooth axially from the socket

AVULSION

Complete displacement of tooth out of socket

CLASS 1

simple fracture of the crown involving little or no dentin

CLASS 2

extensive fracture of the crown involving considerable dentin but not the dental pulp

CLASS 3

extensive fracture of the crown involving considerable dentin and exposing the pulp

CLASS 4

the traumatized tooth becomes nonvital with or without loss of crown structure

CLASS 5

tooth lost as a result of trauma (avulsion)

CLASS 6

fracture of the root with or without loss of crown structure

CLASS 7

displacement of tooth without fracture of crown or root

CLASS 8

fracture of the crown en masse and its replacement

CLASS 9

pediatric trauma occurs on pediatric patient

PULP

A soft tissue of mesenchymal origin residing within the pulp chamber and root canals of teeth

Coronal pulp

pulp chamber

Radicular pulp

root canal

Formative

The pulp tissue with the presence of odontoblast are the ones responsible for the formation of primary dentin first followed by secondary dentin for function and tertiary dentin to other injuries of the tooth

Protective

The presence of different types of secondary and tertiary dentin, it gives protection making the pulp tissue further from the source of injury

Nutritive

No capillaries in the circulatory system of the tooth; there is a direct connection between arterioles and venules which gives nutrition and food and maintains the vitality of the tooth

Sensory

The different terminal branches of trigeminal nerve which is the dental plexus

Even if there are different stimulus, pulp tissue cannot distinguish these different stimulus and pain is the only one felt

INFLAMMATION

Local physiologic reaction of the body (including pulp tissue) to noxious stimuli or irritants

Bacteria

Caries is microbial in nature and there are evidences that it has in the dentinal tubules and can go in the pulp tissue

Trauma

Cracked tooth syndrome – if the tooth becomes cracked or fractured à that is already a source of entry of bacteria and if it nearing the pulp tissue, it can also involve coronal pulp

Thermal

Iatrogenic – there should be a water supply because burs can generate heat and if there is water, it can cause irritation of tooth

Chemicals

Zinc phosphate eugenol – base (used for restoration, for protection of the pulp tissue) and luting (used as an adhesive to cement the crown) agent ; not advisable to use if deep and near the pulp and vital because it releases acid

Galvanic current

Produced when two dissimilar metals comes in contact

Septicemia

blood poisoning by bacteria

Partial/subtotal pulpitis

Only a portion of the pulp tissue is affected; early stages

Generalized/total pulpitis

The entire pulp tissue is affected because it is already progressive

Pulpitis aperta/open

If there is pulp exposure

Pulpits clausa/closed

If the tooth/restoration is very much intact

Caries that has not progress to expose the pulp tissue and yet there is inflammation

ACUTE PULPITIS

Immediate sequela of hyperemia

SEROUS TYPE (ACUTE SEROUS PULPITIS)

Mild form usually involving a portion of unexposed pulp

Pain is more severe than in hyperemia

(-) percussion

SUPPURATIVE TYPE (PURULENT) (ACUTE SUPPURATIVE PULPITIS)

Progressive type

Accumulation of pus and exudates in an exposed pulp

CHRONIC PULPITIS

Odontoblastic layer is intact

Cell-free zone, while recognizable, has within its capillaries that are readily visible

CHRONIC HYPERPLASTIC PULPITIS/PULP POLYP

an excessive exuberant proliferation of chronically inflamed pulp tissue

NECROSIS

death of the pulp without bacterial invasion or infection

GANGRENE

organic decomposition from bacterial infection

PUTREFACTION

Organic decomposition of the pulp by bacteria and fungi with formation of the foul-smelling products

apical periodontal ligament

acute apical inflammation

First structure that will be affected is the _________

ACUTE APICAL ABSCESS

Accumulation of pus in apical periodontal membrane

neutrophils

Apical abscess - filled with _____ they are the hallmark of acute inflammation

PERIAPICAL GRANULOMA

Localized mass of chronic granulation tissue formed in response to a mild irritation or infection

GUMBOIL / PARULIS

AKA parulis

Accumulation of pus in the gingival tissue