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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]
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."
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 ]
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 ...
The diagnosis of pulp necrosis can be based on the following observations: negative vitality, a periapical radiolucency, a grey tooth discoloration and even peri-apical lesions. [17] This altered translucency in the tooth is due to disruption and cutting off of the apical neurovascular blood supply.
Periapical COD occurs most commonly in the mandibular anterior teeth while focal COD appears predominantly in the mandibular posterior teeth. Florid COD is an extensive variant of periapical COD where lesions occur in multiple quadrants which can encompass the maxilla and mandible, and infrequently can cause jawbone deformity.
Pain; A common clinical feature is exacerbated and exaggerated pain. There may or may not be associated with pus & suppuration. [3] 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
Test cavity which has an absence of pain sensation and has an empty pulp chamber/ canal. [1] Radiographs (usually periapical) - a V-shaped radiopaque structure could be seen superimposing on top of the affected crown. [2] [3] It could detect DE before tooth eruption. However, DE presentation on the radiograph can be quite similar to a mesiodens ...