APICAL PATHOLOGY AND RADIOLUCENCY

Question 1

Development of apical pathology of 36 (3)

Answer 1

 Apical periodontitis is inflammation and destruction of periradicular tissues caused by etiological agents of endodontic origin. It is generally a sequel to endodontic infection.

 Initially, the tooth pulp becomes infected and necrotic by an autogenous oral microflora. The endodontic environment provides a selective habitat for the establishment of a mixed, predominantly anaerobic, flora. Collectively, this habitat-adapted polymicrobial community residing in the root canal has several biological and pathogenic properties, such as antigenicity, mitogenic activity, chemotaxis, enzymatic histolysis, and activation of host cells. The microbial invaders in the root canal can advance, or their products can egress, into the periapex.

 In response, the host mounts an array of defenses consisting of several classes of cells, intercellular messengers, antibodies, and effector molecules. The microbial factors and host defense forces encounter, clash with, and destroy much of the periapical tissue, resulting in the formation of various categories of apical periodontitis lesions.

Question 2

22 apex radiolucency: differential diagnosis and further imaging to differentiate (2)

Answer 2

 Periapical Abscess

 Periapical Granuloma