Periapical Abscess: Causes, Symptoms, and Treatment Explained

Periapical Abscess: Causes, Symptoms, and Treatment Explained

Question. Write a short note on periapical abscess.

Answer.

Periapical Abscess

Periapical abscess is an acute or chronic suppurative process of the dental periapical region.

It is also known as a dentoalveolar abscess or alveolar abscess.

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

“Impact of poor oral hygiene on periapical abscess risk”

Types Of Periapical Abscess

Acute: It is associated with severe pain in a tooth.

Chronic: It is long-standing, and symptoms are of low grade.

“Role of untreated cavities in periapical abscess formation”

Clinical Features

Acute Periapical Abscess

• Patient complains of severe pain, which is of a throbbing variety.
• There is also the presence of swelling in the associated area.
• The mucosa surrounding the swelling becomes tough and inflamed.
• A slight fever is present.
• Regional lymphadenitis is present.
• The patient feels sensitivity in the affected tooth.
• The tooth is tender to palpation and is mobile.

“Risk factors for developing a periapical abscess”

Chronic periapical abscess

• Pain has been present for a longer time. The nature of the pain is dull.
• Sinus formation is seen either intraorally or extraorally.
• At the opening of the sinus mass of inflamed granulation tissue is present, known as a parulis.
• Lymphadenopathy is present.

“Red flags of severe periapical abscess”

Histopathology

• Area of suppuration consists of central area of disintegrating PMN leukocytes surrounded by lymphocytes, cellular debris, necrotic material and the bacterial colonies.
• Dilated blood vessels are seen in PDL and adjacent marrow spaces of bone.
• Inflammatory cell infiltrate is seen in the marrow spaces.
• In a chronic periapical abscess, the chronic inflammatory infiltrate consists of lymphocytes, plasma cells, and macrophages.

“Treatment options for a periapical abscess”

Treatment

Drainage of the abscess is done, followed by opening of a root canal or extraction of the tooth.