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A phoenix abscess is an acute exacerbation of a chronic periapical lesion. It is a dental abscess that can occur immediately following root canal treatment. Another cause is due to untreated necrotic pulp (chronic apical periodontitis). [1] It is also the result of inadequate debridement during the endodontic procedure.
A dental abscess is a localized collection of pus associated with a tooth. The most common type of dental abscess is a periapical abscess, and the second most common is a periodontal abscess. In a periapical abscess, usually the origin is a bacterial infection that has accumulated in the soft, often dead, pulp of the tooth.
In 1890, W.D. Miller, considered the father of oral microbiology, was the first to associate pulpal disease with the presence of bacteria. [11] This was confirmed by Kakehashi, who, in 1965, proved that bacteria were the cause of pulpal and periradicular disease in studies using animal models; pulpal exposures were initiated in both normal and germ-free rats, and while no pathologic changes ...
Given the natural history of a mouth infection, the vast majority of clinically-treated oral infections are polymicrobial, or caused by multiple different species of bacteria at the same time. [9] Until the source of the infection is controlled with some form of drainage and antibiotics, a mouth infection will likely not resolve on its own.
Periodontal abscesses may be difficult to distinguish from periapical abscesses. Since the management of a periodontal abscess is different from a periapical abscess, this differentiation is important to make (see Dental abscess#Diagnostic approach) For example, root canal therapy is unnecessary and has no impact on pain in a periodontal abscess.
A periapical abscess responds well to antibiotics if chewing gum is used during the first two half-lives of each dose (caution: overzealous mastication may result in muscle pain). Another condition in which antibiotics are indicated is staphylococcal mucositis and it is mostly found in immunocompromised patients and the elderly. [ 2 ]
Periapical periodontitis of some form is a very common condition. The prevalence of periapical periodontitis is generally reported to vary according to age group, e.g. 33% in those aged 20–30, 40% in 30- to 40-year-olds, 48% in 40- to 50-year-olds, 57% in 50- to 60-year-olds and 62% in those over the age of 60. [ 13 ]
Periapical radiograph showing peri-radicular radiolucency and bone loss caused by an odontogenic infection under the roots of two anterior teeth in a 30-year-old patient An odontogenic infection is an infection that originates within a tooth or in the closely surrounding tissues. [ 1 ]