Periodontal Abscesses Flashcards
What % of teeth with periodontal abscesses get extracted?
45%
What is the main cause of tooth loss in the maintenance phase?
Lateral periodontal abscess
What is the clinical appearance of a lateral periodontal abscess?
- Swollen gingiva
- Push discharging through
- TTP tooth
- Mobile tooth
Is it common to get facial swelling or swollen glands with periodontal abscess?
No
What is the big test to do to determine if the tooth has a perio lesion compared to an endo lesion?
Vitality test - endo lesion will give a negative response
What are the two contributors to getting a periodontal abscess?
1) Impaired Host defence
- Diabetic patients
- Drugs causing gingival enlargement
2) Local factors
- Pre-existing periodontitis
- Obstruction of the opening of a deep pocket
- Plaque and calculus impaction from scaling
- Impaction of foreign bodies into tissue
- Iatrogenic foreign bodies (leaving sutures or membranes exposed during surgery)
What are the names of the common bacteria which can cause periodontal abscess?
P. Gingivalis
Prevotella melaniogenica
Fusobacterium nucleatum
What tests do we need to do for a patient with a periodontal abscess?
History - past treatment, risk factors, pain history
Examination - any other periodontal disease, caries or restored teeth
Vitality rest and radiographs
GP point into sinus - insert a GP into sinus and see where it leads to
What is the initial treatment of a periodontal abscess?
What is the long term treatment?
Initial = drain abscess if possible, sub gingival scaling under LA, course of antimicrobials such as metronidazole, amoxicillin or azithromycin
Long term = explain to patient they may need an extraction in the future, give regular treatment to prevent recurrence, patient may need surgery if there is not much response to initial therapy
If a patient has an endo-perio lesion, do we treat the endo or perio problem first?
ENDO
