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Oral Pathology I …

Oral Pathology I
Third Year

Published in: Health & Medicine

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  • 1. Inflammatory Jaw lesions I
  • 2. Pulpitis Definition: Inflammation of the dental pulp, which can be acute or chronic. Etiology • Dental Caries. • Traumatic exposure. • Fracture of the crown. • Thermal changes. • Chemical irritation. • Cracked tooth syndrome. Types of pulpitis Acute Chronic  Reversible.  Closed.  Irreversible.  Opened (Hyperplastic)
  • 3. Acute Reversible Pulpitis Etiology: • Dental Caries. • Cavity preparation. • Thermal changes in large metallic fillings. Clinical Features: • Pain: mild to moderate and stimulated. • The etiological factor is obvious. Histopathological Features: • Pulp hyperemia (dilatation of blood vessels). • Exudation. • Inflammatory cell infiltration (neutrophils). • Reactions usually remain localized adjacent to the cause. • Treatment: Remove the cause.
  • 4. Acute Irreversible Pulpitis Etiology: Clinical Features: • Pain: Sever, spontaneous and • Acute Dental Caries. continuous. • Pulp exposure. • Little response to simple analgesics. • Sever Irritation. • Pain increase when patient lies down. • The etiological factor is obvious. Histopathological Features: • Inflammation involves the whole dental pulp. • Vascular dilatation and edema. • Inflammatory [granular cell] infiltration. • Odontoblasts near to the cause are destroyed. • Formation of a minute pulp abscess. • In a few days pulp undergoes liquefaction and necrosis. • Treatment: RCT.
  • 5. Chronic Pulpitis Etiology: • Previous acute pulpitis. • Chronic Dental Caries. Clinical Features: • Pain: absent or mild to moderate, dull ache and intermittent. • Reaction to thermal changes is reduced in comparison to acute pulpitis. • The etiological factor is obvious. Histopathological Features: • Mononuclear inflammatory cell infiltration. • Evidence of fibroblastic activity. • Minute abscess if exist it is localized by granulation tissue. • Treatment: RCT.
  • 6. Chronic Hyperplastic Pulpitis Etiology: Clinical Features: • Opened cavity. • Red pinkish soft nodule protruding • Starts as chronic or into the cavity. acute. • Almost in children and young adults. • Wide apical foramen • Relatively insensitive to manipulation. [Children]. • Most common in deciduous molars. • Must be differentiate from gingival polyp. Histopathological Features: • The polyp consists of granulation tissue. • It contains delicate connective tissue, fibers and blood vessels. • Mononuclear inflammatory cell infiltration. • The polyp is covered with SS epithelium. • Treatment: RCT or extraction of the tooth.
  • 7. Periapical inflammation Periapical Granuloma Periapical abscess Chronic abscess or osteomyelitis Cellulitis Skin or mucosal sinus Bacteremia Periapical Cyst
  • 8. Acute Abscess Etiology: • Acute pulpitis. Chronic periapical lesions. Clinical Features: • Pain: sever and increases with percussion. • Non-vital tooth. • The tooth is slightly extruded in its socket. • Fever, malaise & regional lymphadenitis. • Osteomyelitis and swollen adjacent area. Histopathological Features: • Zone of liquefaction composed of: ▫ Exudates. ▫ Necrotic tissue. ▫ Dead neutrophils. • Dilated blood vessels. • Inflammatory [granular cell] infiltration. Treatment: • Drainage. Antibiotics. Supportive Tx.
  • 9. X-Ray Pulpitis: • Evaluation of the pulp champer. • Evaluation of the periapical region. Acute abscess: • Thickening of periodontal membrane. • Loss of the lamina dura. Electrical Pulp Tester • • • • Acute reversible pulpitis. Acute irreversible pulpitis. Chronic pulpitis. Acute abscess.