3. LEARNING OBJECTIVES
By the end of lecture final year BDS student should be able
to :
Classify peri radicular lesions of pulpal origin along with
their clinical and histological features.
4. RE-CAP
A 23-year-old female presented to you with chief complain
of pain in tooth 36. Clinical examination showed a reddish,
cauliflower like outgrowth of connective tissue into the
caries that has resulted in a large occlusal exposure. The
tooth responded within normal limits when palpated and
percussed. What is your diagnosis?
Excessive gingival overgrowth
Giant cell granuloma
Hyperplastic pulpitis
Irreversible pulpitis
5. A patient aged 25 years old came to the OPD with a history of
trauma to upper central incisor a year back. The tooth was
grayish- blue. During examination you perform pulp vitality
test with ethyl chloride (cold) spray to which the tooth did
not respond. What is the most probable reason for negative
response?
Irreversible pulpitis
Necrosis
Normal pulp
Reversible pulpitis
9. NORMAL PERIAPICAL TISSUES
Clinically and radiographically the
tooth has normal periapical tissue
Normal lamina dura and periodontal ligament
and structures.
Normal response to palpation and percussion
11. SYMPTOMATIC APICAL PERIODONTITIS
Clinical Features:
Moderate to severe spontaneous discomfort as well as pain on biting or
percussion.
Responsive to cold heat and electricity.
Percussion can cause marked to excruciating pain.
May or may not be associated with an apical radiolucent area.
Thickening of PDL
Normal PDL or intact lamina dura.
Treatment adjustment of occlusion, removal of irritants or a pathologic
pulp or removal of periapical exudate.
12.
13. HISTOLOGICAL FEATURES OF SAP
PMN leukocytes and macrophages are visible within localized area at the
apical region of the pulp.
Small area of liquefaction necrosis (abscess)
Bone and root resorption maybe present
16. HISTOLOGICAL FEATURES OF ASAP
Proliferation of fibroblast and
endothelial cells
Lymphocytes, plasma cells and
phagocyte
Foam cells and cholesterol clefts
Epithelial rest of malassez
