Severe pain of dentoalveolar abscess

#Sudden relief of severe pain associated with a dentoalveolar abscess can be explained by which of the following?
A. Neutralizing effect of tissue enzymes
B. Walling-off of the infection by the body
C. Rupture of the abscess from the periosteum into the soft tissue
D. Neurotoxic effects of bacterial toxins anesthetize the nocioceptors

The correct answer is C. Rupture of the abscess from the periosteum into the soft tissue.

Dentoalveolar abscesses are an accumulation of pus within the teeth, gums,
and supporting alveolar bone.

The accumulation of pus within the
dentoalveolar abscess creates hydrostatic
pressure, resulting in the sensation of a
severe pain.

Dentoalveolar abscesses are treated
through root canal treatment and possibly
incision and drainage depending upon case
severity.

Drainage of the lesion releases the pressure
caused by the suppuration and results in a
sudden relief of pain is experienced by the
patient.

The major symptom of dentoalveolar
abscess is a severe, intense, and throbbing
pain which worsens with the passage of
time.

Dentoalveolar abscesses can be partially
diagnosed by noting the presence of a
periapical radiolucency.

Cementoblastoma is more often seen

# The cementoblastoma is more often seen:
A. In the mandible than in the maxilla, and more often posterior than in the anterior regions
B. In the mandible than in the maxilla, and more often anterior than in the posterior regions
C. In the maxilla than in the mandible, and more often posterior than in the anterior regions
D. In the maxilla than in the mandible, and more often anterior than in the posterior regions

The correct answer is A. In the mandible than in the maxilla, and more often posterior than in the anterior regions

The cementoblastoma, also known as the true cementoma, is a rare benign neoplasm of cementoblast origin. It occurs predominantly in the second and third decades, typically before 25 years of age. It is more often seen in the mandible than in the maxilla and more often posterior than in the anterior regions. It is intimately associated with the root of a tooth, and the tooth remains vital. It may cause cortical expansion and, occasionally, lowgrade intermittent pain. Radiographically, this is a well-circumscribed radiopaque lesion that replaces the root of the tooth. It is usually surrounded by a radiolucent ring. Because of the intimate association of this lesion with the tooth root, this lesion cannot be removed without sacrificing the tooth. There is no recurrence.

Note: To distinguish this lesion from condensing osteitis - in condensing osteitis, you can distinguish

the root outline.

Odontogenic keratocyst (OKC) is derived from:

# The odontogenic keratocyst (OKC) is derived from:
A. Hertwig's epithelial root sheath
B. The reduced enamel epithelium
C. Remnants of the dental lamina
D. A pre-existing osteoma

The correct answer is: B. Reduced enamel epithelium.

Keratocysts differ from other odontogenic cysts in their microscopic appearance and clinical behavior.

They may resemble periodontal, primordial, or follicular cysts. Usually, they cannot be distinguished

radiographically. 

Clinical features:

• Wide age range. peak occurrence in 2nd and 3rd decades

• Lesions found in children are often reflective of multiple odontogenic keratocysts as a component

of the nevoid basal cell carcinoma syndrome

• More common in males than females

• The chief site of involvement is the mandible, in approximately a 2 to 1 ratio

• In the mandible. most occur within the posterior portion of the body and ramus region

• Typically asymptomatic

Radiographic features:

• Well-demarcated area of radiolucency with a scalloped, radiopaque margin

• Unilocular or multilocular

Microscopicall y:

• The lining epithelium is thin and parakeratinized.

• The basal layer is palisaded with prominent, polarized, and intensely staining nuclei of uniform

diameter

• The lumen may contain large amounts of keratin debris or clear fluid similar to serum transudate

• The parakeratotic type fonns 85 to 95% of all odontogenic keratocysts; the balance is made

up of the orthokeratinized variant.

Most common cause of xerostomia is:

# The most common cause of xerostomia is:
A. Hereditary
B. Medications
C. Tooth decay
D. Mouth breathing

The correct answer is B. Medications.

Xerostomia (dry mouth) is not a disease, however, it can be a symptom of certain diseases. Many times xerostomia is caused by failure of the salivary glands to function normally, but the sensation can also occur in people with normal salivary g lands. Xerostomia can cause health problems by a ffecting nutrition, as well as psychological heal th. At its most extreme, it can lead to rampant tooth decay and periodontal disease.

Perhaps the most prevalent cause of xerostomia is medica tion. The main culprits are antihistamines, antidepressants, anticholinergics (e.g .. atropine and scopolamine) , anorexiants, antihypertensive, antipsychotics {e.g. , chlorpromazine and prochlorperazine), anti-Parkinson agents, diuretics and sedatives.

The most common disease causing xerostomia is Sjogren's syndrome (SS), a chronic inflammatory autoimmune disease that occurs predominantly in postmenopausal women.

Sarcoidosis and amyloidosis are other chronic inflammatory diseases that cause xerostomia.

Other systemic diseases that can cause xerostomia include rheumatoid arthritis, systemic lupus erythema tosus, and scleroderma. 

Remember: Xerostomia is the most common toxicity associated with radiation therapy to the head and neck.