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Periapical granuloma, [1] also sometimes referred to as a radicular granuloma or apical granuloma, is an inflammation at the tip of a dead (nonvital) tooth. It is a lesion or mass that typically starts out as an epithelial lined cyst, and undergoes an inward curvature that results in inflammation of granulation tissue at the root tips of a dead tooth.
A periapical granuloma (also referred to as an 'apical granuloma' or 'radicular granuloma') is a mass of chronically inflamed granulation tissue that forms at the apex of the root of a nonvital (dead) tooth. [12] (Although not a true granuloma, given the absence of granulomatous inflammation, the term 'periapical granuloma' is widely accepted ...
It may develop rapidly from a periapical granuloma, as a consequence of untreated chronic periapical periodontitis. [1] Periapical is defined as "the tissues surrounding the apex of the root of a tooth" and a cyst is "a pathological cavity lined by epithelium, having fluid or gaseous content that is not created by the accumulation of pus." [2]
Other symptoms may include hypoesthesia, paresthesia, and discomfort. [3] In rare instances, patients may experience associated facial swelling with the presence or absence of pain due to concurrent infection. [4] Patients experiencing symptoms also tend to be older and have the periapical form of cemento-osseous dysplasia. [3]
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 ...
Generally all gingival diseases share common features such as signs and symptoms being restricted to gingiva, clinically detectable inflammation, and the potential for the gum tissues to return to a state of health once the cause is removed, without irreversible loss of attachment of the teeth. [4]
This condition arises as a response to dental infections, such as periapical pulp inflammation or low-intensity trauma. The lesion typically appears as a radiopacity in the periapical area due to the sclerotic reaction. While most commonly associated with non-vital teeth, condensing osteitis can also occur in vital teeth following occlusal trauma.
The signs & symptoms are similar to that of an acute periradicular abscess, but with a periradicular radiolucency present as well. [4] [5] [3] Loss of Vitality; The problematic tooth will have a non-vital pulp with no previous symptoms. [6] Vitality of teeth can be assessed through various means.