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The most common location of dry socket: in the socket of an extracted mandibular third molar (wisdom tooth). Since alveolar osteitis is not primarily an infection, there is not usually any pyrexia (fever) or cervical lymphadenitis (swollen glands in the neck), and only minimal edema (swelling) and erythema (redness) is present in the soft tissues surrounding the socket.
Pericoronitis is inflammation of the soft tissues surrounding the crown of a partially erupted tooth, [1] including the gingiva (gums) and the dental follicle. [2] The soft tissue covering a partially erupted tooth is known as an operculum, an area which can be difficult to access with normal oral hygiene methods.
Wisdom teeth become impacted when there is not enough room in the jaws to allow for all of the teeth to erupt into the mouth. Because the wisdom teeth are the last to erupt, due to insufficient room in the jaws to accommodate more teeth, the wisdom teeth become stuck in the jaws, i.e., impacted. There is a genetic predisposition to tooth impaction.
This infection is what causes necrosis of the pulp. [4] Larger cysts may cause bone expansion or displace roots. Discoloration of the affected tooth may also occur. Patient will present negative results to electric and ice test of the affected tooth but will be sensitive to percussion. Surrounding gingival tissue may experience lymphadenopathy.
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]
Most often, the cause of impaction is inadequate arch length and space in which to erupt. That is the total length of the alveolar arch is smaller than the tooth arch (the combined mesiodistal width of each tooth). The wisdom teeth (third molars) are frequently impacted because they are the last teeth to erupt in the oral cavity.
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The high prevalence of tooth impactions and dental infections that occur in the bones of the jaws is also significant to explain why cysts are more common at these sites. Cysts that arise from tissue(s) that would normally develop into teeth are referred to as odontogenic cysts. Other cysts of the jaws are termed non-odontogenic cysts. [2]