Phoenix Abscess: When Chronic Dental Lesions Flare Up

Phoenix Abscess: When Chronic Dental Lesions Flare Up

Question. Write a short note on the phoenix abscess.

Answer.

Phoenix Abscess

Acute exacerbation of a chronic periapical lesion is called a phoenix abscess.

Phoenix abscess is also known as a recrudescent abscess.

Phoenix abscess is also defined as an acute inflammatory reaction superimposed on an existing chronic lesion, such as a cyst or granuloma.

phoenix abscess

“Role of chronic periapical lesions in Phoenix abscess”

Etiologyz

Chronic periradicular lesions, such as granuloma,s are in a state of equilibrium during which they can be completely asymptomatic.

But, sometimes, an influx of necrotic products from diseased pulp or bacteria and their toxins can cause the dormant lesion to react and this leads to initiation of an acute inflammatory response.

Lowered body defenses and mechanical irritation during root canal treatment also trigger an acute inflammatory response.

“Clinical examination for Phoenix abscess”

Clinical features

• First symptom is that, there is tenderness on percussion.
• Tooth is slightly extruded from socket and is mobile.
• Patient can or cannot have swelling. Swelling, if present is localized and if left untreated may become diffuse (cellulitis), leading to asymmetry of the patients face. In case of upper canines, it may even extend to the eyelids.
• Patient can be present with fever, malaise and lymphadenopathy.
• Tissue at the surface of swelling appears taut and inflamed;pus starts to form beneath it.
• As the liquefaction continues, tissue ruptures due to the pressure to form a sinus tract which opens on the labial/buccal mucosa. This process is the beginning of chronic alveolar abscess.

acute exacerbation of chronic periapical periodontitis

“Pathophysiology of a Phoenix abscess explained”

Histopathology

There is presence of areas of liquefaction necrosis with disintegrated polymorphonuclear leukocytes and cellular debris surrounded by macrophages. lymphocytes, plasma cells in periradicular tissues.

“Treatment options for a Phoenix abscess”

Treatment

• Establishment of drainage is done.
• As symptoms subsides root canal therapy should be done.