Periapical lesions - acute Flashcards
What is periapical periodontitis?
inflammation in the periapicla area of the periodontal ligament
Resorption of bone at root apex
2 types of periapical periodontitis?
acute or chronic
What are the causes of periapical periodontitis?
Most common: Pulpitis and pulp necrosis
Trauma
Endodontic treatment
How does pulpitis and pulp necrosis cause PP?
bacteria
Bacterial toxins
Inflammatory products
Reach root apex
Spread of infection to the apical periodontal disease
How can trauma cause PP?
occlusal trauma
Excessive force in orthodontic treatment - cut blood supply and cause direct trauma to tooth
Direct blow to a tooth
Biting Ona hard body
Transient damage
How can endodontic treatment cause PP?
mechanical instrumentation through apex
Chemical irritation from filling material
Bacteria forced through apex
Features of acute PP?
pain upon pressure transferred through the exaudate to nerve endings
Well located pain
Tooth feels elevated in socket
No pain on thermal stimulation
Where is acute PP located?
acute inflammatory exaudate in between the apex and the alveolar bone
Can you see acute PP on a radiograph?
no features visible
If changes are present:
- widening of periodontal ligament
- lamina dura less defined at the apex
What type of inflammation is associated with acute PP?
transient
What happens if the irritant persists?
chronic and could lead to bone resorption
In cases of severe irritation, what can occur? (Bacteria reach inflammation)
suppuration in case of severe irritation leading to necrosis
Bacterial infection —> Neutrophil exaudate
Acute periapical abscess, alveolar abscess
What does acute or chronic periapical depend on?
Depends on severity of irritation
- low grade and continuous (chronic) or acute and sudden
What happens of you perform endodontic tx beyond the ape of the tooth?
Injure periapical tissues
If a pt has acute periapical periodontitis- how does the tooth feel in the socket?
High in the socket
As there is fluid underneath the tooth
