Oral Path: Exam #2 Inflammation & Repair

Periapical abscess

An accumulation of purulent exudate (pus) at the apex of a nonvital tooth root

Hyperplasia

An increase in the number of cells

Hypertrophy

An increase in the size of individual cells

Scar tissue

By 2 weeks after injury, the initial granulation tissue has been remodeled into mature, fibrous connective tissue known as

Liver

C-Reactive Protein (CRP) is produced in the ______ and used as a systemic marker for inflammation

Large open carious lesions

Chronic hyperplasticity pulpitis, or pulp polyp, is an excessive proliferation of chronically inflamed dental pulp tissue found in teeth with what condition

Granulomatous

Chronic inflammation often presents with ______ tissue, which is a microscopic grouping of macrophages surrounded by lymphocytes & plasma cells

Wrinkled

Corrugated means

Flange

Denture-induced fibrous hyperplasia is caused by an ill-fitting denture, typically where the ______ is too long

Pyrogens

Fever-producing substances produced by WBC's & pathogens that act on the hypothalamus

By way of prostaglandins

How does the hypothalamus increase body temp to cause a fever

Lingual surfaces

In patients with bulimia, erosion typically affects which surfaces of he maxillary anterior teeth

Innate

Inflammation is what type of response to injury

Highly vascularized

Looking at the appearance of the lesion, why does the lesion present so erythematous?

Chronic inflammation

Lymphocytes & plasma cells are primarily seen in which type of inflammation?

-Phagocytosis of necrotic tissue -Assisting in immune response

Main function of a macrophage in the inflammatory response

Margination

Movement of WBC to the periphery of blood vessels

Blood clot forms (contains fibrin, red blood cells, & platelets)

On the day of injury, what is the 1st step in the repair process?

Allows the body to eliminate injurious agents, contain injuries, & heal defects

Primary purpose of the inflammatory response?

Histamine

The complement system involves a cascade of plasma proteins that, when activated, can cause mast cells to release...

Necrosis

The death of tissue or an organ resulting from irreversible damage to cells

-Hyperemia (excess blood to an area) -Heat & Redness

The dilation of microcirculation during inflammation leads to

Chemotaxis

The directed movement of WBC's toward the site of injury, guided by a chemical gradient is called...

Histamine

The effect of ______ being released during inflammation causes an increase in vascular permeability & vasodilation

Lymphadenopathy

The enlargement & firmness of lymph nodes

Edema (swelling)

The escape of inflammatory fluid or exudate, from the blood vessels into the surrounding tissue causes..

Bruxism

The grinding & clenching of teeth for nonfunctional purposes

Granulation tissue

The initial connective tissue formed during repair, which is highly vascularized & contains many fibroblasts & inflammatory cells

Pavementing

The lining of blood vessels by WBC during inflammation is called.

Erosion

The loss of tooth structure due to chemical action, without bacterial involvement

Emigration

The process by which WBC's escape from blood vessels through gaps in endothelial cells to enter the injured tissue

Phagocytosis

The process by which WBC's ingest & then digest forge in substances, such as pathogens & tissue debris

Primary intention

Type of healing that involves the use of sutures

Tertiary intention

Type of healing that is delayed due to an active infection, prevents surgical closure

Secondary intention

Type of healing when tissue loss is significant & the edges of a wound cannot be joined, it heals from the bottom up

Abfraction

Wearing away of tooth structure due to biomechanical forces, such as tooth flexure from occlusal stress

60-70%

What % of all WBC's are neutrophils?

Heat & Redness

What 2 localized cardinal signs of inflammation are directly caused by Hyperemia?

-Loss of normal tissue function -Pain -Heat -Redness -Swelling

What are the Localized Cardinal (Classic) signs of inflammation?

-Fever -Leukocytosis -Elevated C-reactive protein (CRP) -Lymphadenopathy

What are the Systemic Cardinal(classic) signs of inflammation?

-Inflammation -Immunity -Repair

What are the body's 3 primary responses to injury?

Tobacco Pouch Keratosis

What condition presents with a corrugated white lesion with constant exposure to tobacco

-Caused by hyperplasia -Caused by denture not fitting properly -Both will need to have excess tissue/projections removed prior to adjusting or making new denture

What do both of these lesions have in common?

Systemic involvement of the inflammatory or immune response

What does lymphadenopathy indicate?

Increase in the permeability of the microcirculation

What event follows dilation of microcirculation in the inflammatory process?

Constriction of the microcirculation (small blood vessels)

What is the 1st microscopic event that occurs immediately after tissue injury?

Dilation of the microcirculation

What is the 2nd microscopic event in the inflammatory sequence, following initial constriction?

Serous: watery with few WBC Purulent: (pus) contains many white blood cells & tissue debris

What is the difference between serous & purulent exudate?

Phagocytosis

What is the main function of neutrophilis in the inflammatory response?

Radicular cyst ( or periapical cyst)

What is the most common cyst in the oral region, develops from a Periapical Granuloma and is lined by epithelium

Alveolar Osteitis

What is the term to describe a post operative complication after extraction of teeth? Often associated with pain and malodor

traumatic ulcer

What type of ulcer has a yellowish-white center & a red halo, may be hard if chronic

Monocyte, which becomes a macrophage on the tissue

Which WBC is the 2nd to arrive at the site of injury?

Hyperplasia

Which cellular adaptation (hyperplasia or hypertrophy) involves cell division?

The lower lip

Which part of the real cavity does solar cheilitis affect?

Kinin

Which system is a biochemical mediator system that is active in early phases of inflammation & causes increased vascular dilation, permeability, and induces pain?

Neutrophil (also known as polymorphonuclear leukocyte or PMN)

Which type of WBC is the 1st to arrive at the site of an acute injury?

By the loss of plasma fluid (exudate) from the blood vessels into the tissue

Why does blood viscosity increase during the inflammatory response?

Chronic Hyperplasticity Pulpitis

Your patient complains about a red, soft, lesion coming out of his broken molar, the area had been diagnosed for a Crown previously. What is the lesion?

Friction Keratosis

Your patient states they have a broken tooth that is sharp and keep rubbing on the tongue, what condition is most likely the case?

Purulent

which type of exudate contains many white blood cells & tissue debris?

-Hyperplasia -Hypertrophy -Atrophy

3 cellular adaptations that can occur in response to a less serve injury

Inflammatory papillary hyperplasia

A 'cobblestone' appearance, palatal mucosa covered by multiple erythematous papillary projections

Lymphocyte

A WBC that is found in chronic inflammation & will trigger the start of the immune response

Pyogenic Granuloma

A ___ is a common reactive lesion on the gingiva that is a proliferation of connective tissue with numerous blood vessels, bleeds easily, and is often seen in pregnant woman

Mucocele

A _____ is a mucous retention lesion formed when a salivary gland duct is severed, causing saliva to spill into the adjacent connective tissue

Frictional keratosis

A benign, protective hyperkeratotic white lesion caused by chronic rubbing or friction on a mucosal surface is called...

Solar cheilitis

A condition caused by cumulative sun exposure

Residual cyst

A cyst that remains at the site of a tooth extraction after a radicular cyst was not fully removed

Periapical Granuloma

A localized mass of chronically inflamed granulation tissue that forms at the apex of a nonvital tooth

Ranula

A mucous retention lesion that is typically associated with the submandibular & sublingual salivary glands? The lesion can grow when more saliva is produced

Traumatic neuroma

A painful lesion caused by trauma to a peripheral nerve, resulting in a proliferation of nerve cells & scar tissue

Abrasion

A physical injury to teeth that is caused by a repetitive mechanical process

Condensing Osteitis (or focal sclerosing osteomyelitis)

A radiopaque area at the apex of a tooth, representing a reaction to a low-grade infection

Sialolith

A salivary gland stone formed by the precipitation of calcium salts, which can obstruct a salivary duct

Leukocytosis

A systemic sign of inflammation characterized by an increased in the # of circulating WBC's

Lines Alba

A white, raised line on the buccal mucosa at the level of the occlusal plane, often caused by clenching habit