Changes

Inflammation caused by endodontic disease affects the surrounding bone and teeth, resulting in changes that can be radiographically detected. Radiographs that are meant to evaluate the periapical tissues should include the entire [[Enamel Organ#Root|root]] tip and surrounding bone, be well positioned to avoid elongation, foreshortening, angulation, or distortion of the image. <br><br>

Inflammation caused by endodontic disease affects the surrounding bone and teeth, resulting in changes that can be radiographically detected. Radiographs that are meant to evaluate the periapical tissues should include the entire [[Enamel Organ#Root|root]] tip and surrounding bone, be well positioned to avoid elongation, foreshortening, angulation, or distortion of the image. <br><br>

Radiographic signs of endodontic disease that are associated with the '''tissues around tooth roots''' include:

Radiographic signs of endodontic disease that are associated with the '''tissues around tooth roots''' include:

*Increased width of the apical radiolucent [[Enamel Organ#Periodontal Ligament|periodontal ligament]] space

*Increased width of the apical radiolucent [[Enamel Organ#Periodontal Ligament|periodontal ligament]] space.

*Loss of the radiopaque lamina dura at the apex or other portals of exit such as lateral canals

*Loss of the radiopaque lamina dura at the apex or other portals of exit such as lateral canals.

*Diffuse periapical radiolucency with indistinct borders that may indicate an acute abscess

*Diffuse periapical radiolucency with indistinct borders that may indicate an acute abscess.

*Clearly evident periapical radiolucency with distinct borders that is evidence of a more chronic lesion

*Clearly evident periapical radiolucency with distinct borders that is evidence of a more chronic lesion.

*Diffuse area of radiopacity where low-grade chronic inflammation results in sclerosing osteitis

*Diffuse area of radiopacity where low-grade chronic inflammation results in sclerosing osteitis.

*Changes in the trabecular bone pattern around the root apex

*Changes in the trabecular bone pattern around the root apex.

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Radiographic signs of endodontic disease that are associated with the '''tooth''' itself include:

Radiographic signs of endodontic disease that are associated with the '''tooth''' itself include:

*Root tip resorption

*Root tip resorption.

*Internal [[Enamel Organ#Root|root]] or [[Enamel Organ#Crown|crown]] resorption. Inflammation of the pulp can cause internal resorption.

*Internal [[Enamel Organ#Root|root]] or [[Enamel Organ#Crown|crown]] resorption. Inflammation of the pulp can cause internal resorption.

*External root resorption. Inflammation in the periodontal ligament can cause external root resorption.

*External root resorption. Inflammation in the periodontal ligament can cause external root resorption.

==Lucencies That Can Mimic Endodontic Lesions==

==Lucencies That Can Mimic Endodontic Lesions==

Apical radiographs can be challenging to interpret due to the two-dimensional depiction of complicated anatomy that combines [[Bones - Anatomy & Physiology#Organisation of Bone|trabecular (spongy) bone, compact bone]], soft tissue, and air spaces all projected at various angles and configurations. Other confusing lucencies and opacities can be created by the summation effect of superimposed structures, projecting overlying anatomy in a way that makes it appear to be associated with a tooth root or its supporting bone. These can include bony foraminae, bony fissures, bony canals, and trabeculae. Many nonpathological lucencies, opacities, and apparent deviations from normal can be distinguished from true lesions by comparison with a radiograph of the contralateral tooth.

Apical radiographs can be challenging to interpret due to the two-dimensional depiction of complicated anatomy that combines [[Bones - Anatomy & Physiology#Organisation of Bone|trabecular (spongy) bone, compact bone]], soft tissue, and air spaces all projected at various angles and configurations. Other confusing lucencies and opacities can be created by the summation effect of superimposed structures, projecting overlying anatomy in a way that makes it appear to be associated with a tooth root or its supporting bone. These can include bony foraminae, bony fissures, bony canals, and trabeculae. Many non-pathological lucencies, opacities, and apparent deviations from normal can be distinguished from true lesions by comparison with a radiograph of the contralateral tooth.

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==Causes of Endodontic Disease==

==Causes of Endodontic Disease==

Two categories of insult that most commonly cause endodontic disease are '''bacterial infection''' and '''dental trauma'''. <br><br>

Two categories of insult that most commonly cause endodontic disease are '''bacterial infection''' and '''dental trauma'''. <br><br>

Bacteria can also enter the endodontic system of a nontraumatized tooth through extension of [[Periodontal Disease|periodontal disease]]. If the periodontal epithelial attachment migrates apically to an endodontic vascular entrance such as a lateral canal, furcation communication, or the apical foramen or delta, then the pulp could become infected. This is referred to as a primary periodontal lesion with secondary endodontic involvement (it has also been referred to as a “perio-endo lesion”). Apical and radicular LEOs can dissect coronally along the side of the root to exit in the sulcus, creating a primary endodontic lesion with secondary periodontal disease (has also been referred to as an “endo-perio lesion”). The bony defects around a tooth with primary endodontic disease and concurrent but unrelated periodontal disease can meet to form a combined periodontal and endodontic lesion.<br><br>

Bacteria can also enter the endodontic system of a non-traumatized tooth through extension of [[Periodontal Disease|periodontal disease]]. If the periodontal epithelial attachment migrates apically to an endodontic vascular entrance such as a lateral canal, furcation communication, or the apical foramen or delta, then the pulp could become infected. This is referred to as a primary periodontal lesion with secondary endodontic involvement (it has also been referred to as a “perio-endo lesion”). Apical and radicular LEOs can dissect coronally along the side of the root to exit in the sulcus, creating a primary endodontic lesion with secondary periodontal disease (has also been referred to as an “endo-perio lesion”). The bony defects around a tooth with primary endodontic disease and concurrent but unrelated periodontal disease can meet to form a combined periodontal and endodontic lesion.<br><br>

[[Enamel Organ#Pulp|Pulp]] inflammation and necrosis can also result from deep [[Dental Caries|dental caries]] with extension of the bacterial infection to the pulp.<br><br>

[[Enamel Organ#Pulp|Pulp]] inflammation and necrosis can also result from deep [[Dental Caries|dental caries]] with extension of the bacterial infection to the pulp.<br><br>

Blunt trauma can cause pulp haemorrhage and endodontic disease even when the tooth crown does not fracture. Although the pulp has some ability to heal after mild trauma, the most common result of pulp trauma is irreversible pulpitis even when there is no bacterial contamination of the pulp. <br><br>

Blunt trauma can cause pulp haemorrhage and endodontic disease even when the tooth crown does not fracture. Although the pulp has some ability to heal after mild trauma, the most common result of pulp trauma is irreversible pulpitis even when there is no bacterial contamination of the pulp. <br><br>

[[Category:Endodontic Conditions]]

[[Category:Endodontic Conditions]]

[[Category:To Do - Dentistry Images]]

[[Category:To Do - Dentistry Images]]

[[Category:To Do - Dentistry preMars]]

[[Category:To Do - Mars Check]]