the breaking of a part that may affect the crowns and roots of teeth, or the bones of the maxilla and mandible
fractures
Which area do crown fractures most often involve?
anterior teeth
What do most crown fractures result from?
accidental falls or motor vehicle accidents
true or false. crown fractures may involve just the enamel or go all the way to the pulp.
true
What do radiographs allow views of considering crown fractures?
evaluation of proximity of pulp chamber to fracture and examination of root
Less common than crown fractures and usually can result from an accident or traumatic blow.
Root fractures
Where are root fractures most often found?
Maxillary central incisors
true or false. Root fractures may involve more than one root on multi-rooted teeth
true
How does a root fracture appear if the x-ray beam is parallel with the plane of the fracture?
a sharp radiolucent line
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
What type of fractures occur more often then fractures of any other bone of the face?
jaw fractures (mandible)
What are 3 main reasons for jaw fractures?
assaults
accidents
sport injuries
What is the film of choice to evaluate mandibular fractures?
panoramic radiograph
How does a mandibular fracture appear on a radiograph?
radiolucent line
true or false. Maxillary fractures are hard to see on a radiograph
true
In addition to fractures, trauma may result in________________of teeth
displacement
What are 3 things that radiographs are used to evaluate with jaw injuries?
root or alveolar bone fractures
periodontal ligament damage
pulpal problems
What are 2 types of luxation?
intrusion
extrusion
the abnormal displacement of teeth
luxation
the abnormal displacement of teeth into the bone
intrusion
the abnormal displacement of teeth out of the bone
extrusion
What type of radiograph should be taken on luxated teeth?
PA
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
The complete displacement of a tooth from the alveolar bone
avulsion
What do most avulsions result from?
assault or accidental fall
What are radiographs helpful to evaluate with avulsion?
socket area
region for splintered bone
Name 2 types of radiographic changes caused by resorption
physiologic
pathologic
a process that is seen with the normal shedding of primary teeth
physiologic resporption
a regressive alteration of tooth structure that is observed when a tooth is subjected to abnormal stimuli
pathologic resorption
What are 2 ways that resorption of teeth can be described by depending on the location of the process?
external
internal
resorption that is seen along the periphery of root surfaces
external resorption
What 7 things is external resorption often associated with?
reimplanted teeth
abnormal mechanical forces
trauma
chronic inflammation
tumors or cysts
impacted teeth
idiopathic causes
What area of the tooth does external resorption often affect?
the apices (appears blunted)
in external resorption the root length appears______________than normal
shorter
true or false. In external resorption, the lamina dura and bone appear normal
true
are there any signs or symptoms associated with external resorption?
no
can external resorption be detected clinically?
no
are teeth with external resorption mobile?
no
is there any effective treatment for external resorption?
no
Resorption that occurs within the crown or root and involves the pulp chamber, canals, and surrounding dentin
internal resorption
What are 3 precipitating factors believed to stimulate internal resorption?
trauma
pulp capping
pulp polyps
What does internal resorption appear like on a radiograph?
round-to-ovoid radiolucency seen in midcrown to midroot
true or false. internal resorption is usually asymptomatic?
true
Can a root canal help a tooth with internal resorption?
if it is not weakened
When is extraction recommended for a tooth with internal resorption?
if the tooth is weakened
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
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
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
_______________________________can act as irritants to pulp and stimulate secondary dentin
traumatic conditions
What are 6 conditions that can act as irritants to pulp and cause pulpal obliteration
attrition
abrasion
caries
dental restorations
trauma
abnormal mechanical forces
calcifications that are found in the pulp chamber or pulp canals of teeth, and the cause is unknown
pulp stones
How do pulp stones appear on a radiograph?
round, ovoid, or cylindrical radiopacities
true or false. Pulp stones vary in size, shape, and number and there is no treatment required
both statements are true
a lesion that is located around the apex (tip of the root) of a tooth and may appear either radiolucent or radiopaque
periapical lesion
What are 3 periapical radiolucencies?
granulomas
cysts
abscesses
Can you diagnos periapical radiolucencies with radiographs alone? Why?
no, because they all look the same, so you must diagnos based on clinical findings
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
a localized mass of chronically inflamed granulation tissue at the apex of a nonvital tooth, it results from pulpal death and necrosis
periapical granuloma
true or false. A periapical granuloma may give rise cyst or abscess
true
true or false. periapical granulomas may be asymptomatic but have a pervious history of sensitivity to hot and cold
true
What 2 treatments might be used for periapical granuloma?
Root canal
extraction with curettage of apical region
How are periapical granulomas initially seen on a radiograph?
as a widened perio ligament space at apex
true or false. with time, the periapical granuloma widens to a round or ovoid radiolucency
true
is the lamina dura visible between the apex and lesion on a tooth with periapical granuloma?
no
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
What are the most common of all tooth-related cysts and comprise of 50-70% of all cysts in the oral cavity?
periapical cysts
true or false. Periapical cysts are typically asypmtomatic
true
How are periapical cysts usually treated?
endodontic therapy
extraction as well as curettage of the apical region
How do periapical cysts appear on a radiograph?
round or ovoid radiolucency
a localized collection of pus in the periapical region of a tooth that results from pulpal death
periapical abscess
what are 2 types of periapical abscesses?
acute
chronic
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
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
How does a chronic periapical abscess look clinically?
a gumboil seen in the apical region of the tooth at the site of drainage
How do you treat periapical abscess?
endodontic therapy
extraction
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
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
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
What is the most common symptom of a periodontal abscess?
pain
What are 3 types of periapical radiopacities?
condensing osteitis
sclerotic bone
hypercementosis
Can periapical radiopacities be diagnosed based on their radiographic appearance?
yes, as well as clinical information and patient history
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
true or false. Condensing osteitis may vary in size and shape, and does not appear to be attached to the tooth root
true
What is the most common periapical radiopacity seen in adults?
condesing osteitis or chronic focal sclerosing osteomyelitis
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
what teeth is most frequently involved with condensing osteitis?
mandibular first molar
a well-defined radiopacity that is seen below the apices of vital, noncarious teeth, also known as osteosclerosis or idiopathic periapical osteosclerosis
sclerotic bone
true or fals. The cause of sclerotic bone is unknown
true
Is the lesion of a sclerotic bone attached to a tooth?
no
true or false. Sclerotic bone is asymptomatic and comes in various shapes and sizes
both statements are true
Excess deposition of cementum on root surfaces that results from supraeruption, inflammation or trauma or no cause
hypercementosis
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
true or false. teeth affected by hypercementosis are vital and do not require treatment
