Acute Alveolar Abscess
Question. Describe etiology, histopathology and clinical features of acute alveolar abscess.
Answer. It is also known as dentoalveolar abscess.
It is defined as acute suppurative infection in periapical region of tooth.
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Etiology
- Extension of pulpal infection in periapical tissue.
- Fracture of tooth with pulp exposure.
- Accidental perforation of apical foramen during root canal treatment
- Extension of periodontal infection in periapical tissues.
- Anachoretic infection of periapical tissues.
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Clinical Features
- It is common odontogenic infection and constitutes 2% of apical radiolucencies.
- Due to acute abscess there is pain in the affcted tooth.
- Localized swelling and an erythematous change in overlying mucosa is present.
- Affected area of jaw may be tendered during palpitation.
- Pain aggravates during percussion and when pressure is applied with the opposing tooth.
- Application of heat intensifies pain, whereas application of cold relieves pain temporarily.
- Pus discharging sinus often develops on alveolar mucosa over the affected root apex and sometimes on skin overlying the jaw bone.
- Infection from acute periapical abscess often spreads to facial spaces, leading to space infections.
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Histopathology
- Lesion appears as zone of liquefaction necrosis, which is made up of proteinaceous exudates, necrotic tissue and large number of dead neutrophils
- Adjacent tissue surrounding the bone has many dilated blood vessels and infitration with the neutrophils.
- Inflammatory changes are observed in the PDL and adjoining bone marrow.
- Bony trabeculae in peri apical region may show empty lacunae, which results from death of osteocytes.
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