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The bacteria gains access to the periapical region of the tooth through deeper infection of the pulp, traveling through the roots. The resulting pulpal necrosis causes proliferation of epithelial rests of Malassez which release toxins at the apex of the tooth. The body's inflammatory response will attack the source of the toxins, leading to ...
Tooth #5, the upper right second premolar, after extraction. The two single-headed arrows point to the CEJ, which is the line separating the crown (in this case, heavily decayed) and the roots. The double headed arrow (bottom right) shows the extent of the abscess that surrounds the apex of the palatal root.
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.
In the dental specialty of endodontics, periradicular surgery is surgery to the external root surface. Examples of periradicular surgery include apicoectomy , root resection , repair of root perforation or resorption defects, removal of broken fragments of the tooth or a filling material, and exploratory surgery to look for root fractures.
Lateral periodontal cysts radiographically present as a rounded, teardrop shape that are usually less than 10mm in size, presenting with a uni-cystic well-delineated radiolucency. Lesions are situated usually between the tooth lateral surface between the root apex and alveolar crest. [10] A prominent cortical boundary [11] is also usually observed.
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.
As Original Medicare does not cover dental extractions in most cases, a person may need to cover the full cost of the procedure. If an extraction is medically necessary before surgery, then ...
For these patients, dental prophylaxis and regular monitoring are the primary recommended treatment steps which will help prevent future risk of infection. [8] Symptomatic patients may receive treatment options that include surgical curettage with bleeding stimulation or pulp vitality testing in areas showing periapical inflammation.
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