Periodontitis

Question 1

Classifications of Apical periodontitis

Answer 1

• Acute and Chronic
• Acute Serous/Purulent Apical Periodontitis
• Chronic Granulomatous Diffuse/Exacerbated Apical Periodontitis

Question 2

Causes of Periodontitis

Answer 2

• Plaque
• Trauma(Fracture)
• Medication(Toxic)
• Allergy

Question 3

Symptoms of Acute Apical Periodontitis

Answer 3

• Constant dull throbbing pain
• Responds negative to vitality tests/delayed positive
• Pain on biting or percussion
• No obvious radiographic changes

Question 4

Symtoms of Chronic Periodontitis

Answer 4

• Mostly asymptomatic
• Pain and sensitivity if acute exacerbation occurs
• Soft tissue over apex may or may not be tender
• Tooth does not respond to thermal or electric pulp tests

Question 5

Radiographic detection of Chronic Periodontitis

Answer 5

• CT more accurate in detection
• Small to large radiolucencies(2cm)
• Loss of apical lamina dura
• Circumscribed or ill defined lesion
• Root resorption
• Difficult to distinguish between cysts based on size

Question 6

Acute Serous Apical Periodontitis

Answer 6

-Persistent pain that is easy to localise

• Pain with percussion
• Treated with Endo

Question 7

Acute Purulent Apical Periodontitis Clinical characteristics

Answer 7

• Pus
• Pain
• Edema usually buccally
• Tooth sensitive to touch -Negative vitality tests
• Systemic symptoms(fever, malaise, nausea, muscle and joint pain)

Question 8

Acute Purulent Apical Periodontitis Treatment

Answer 8

• Drainage of pus
• Root canal treatment
• Antibiotics

Question 9

Chronic Granulomatous Diffuse Apical Periodontitis

Answer 9

• Inflamed granulation tissue at apex of non vital tooth→surrounded by fibrous connective tissue wall
• May occur due to periapical abscess or arise as an initial lesion
• Spurts of enlargement with periodic acute exacerbations