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Chronic periodontitis is initiated by Gram-negative tooth-associated microbial biofilms that elicit a host response, which results in bone and soft tissue destruction. In response to endotoxin derived from periodontal pathogens, several osteoclast-related mediators target the destruction of alveolar bone and supporting connective tissue such as the periodontal ligament.
Periodontal abscess—a localized, purulent infection involving a greater dimension of the gum tissue, extending apically and adjacent to a periodontal pocket. [3] Pericoronal abscess—a localized, purulent infection within the gum tissue surrounding the crown of a partially or fully erupted tooth. [3]
Aggregatibacter actinomycetemcomitans is a Gram-negative, facultative anaerobe, nonmotile bacterium that is often found in association with localized aggressive periodontitis, a severe infection of the periodontium. It is also suspected to be involved in chronic periodontitis. [1]
The first line of treatment is the removal of the source of inflammation or infection by local operative measures. [9] Generally, the abscess can be eradicated through surgical drainage alone; however this is sometimes inadequate. Therefore, systemic antibiotic treatment may be required, but only if there is evidence of spreading infection. [9]
Dental plaque, the precursor of periodontal disease, is a complex biofilm consisting mainly of bacteria, but also archaea, protozoa, fungi and viruses. Viruses that specifically infect bacteria—bacteriophages—are most common in the oral cavity. Viral roles in the progression of periodontal disease as of 2017 remains poorly explored. [1]
Periapical periodontitis; Other names: Apical periodontitis, periradicular periodontitis: Periapical dental radiograph showing chronic periapical periodontitis on the root of the left maxillary second premolar. Note large restoration present in the tooth, which will have undergone pulpal necrosis at some point before the development of this lesion.
Host modulatory therapy is an emerging treatment concept in the management of periodontitis that aims to reduce tissue destruction and stabilise or even regenerate the periodontium by modifying the host response. Historically treatment of periodontitis has been focused on reducing the bacterial challenge.
The most common causes for odontogenic infection to be established are dental caries, deep fillings, failed root canal treatments, periodontal disease, and pericoronitis. [2] Odontogenic infection starts as localised infection and may remain localised to the region where it started, or spread into adjacent or distant areas.
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