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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 ]
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 ...
Rarefying osteitis is a general term for a radiolucent lesion on a radiograph usually diagnosed as a periapical abscess or a periapical cyst. [1] [2] References
In a study, 14.7% of patients were symptomatic, with pain being the most common symptom and may be associated with osteomyelitis. [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]
Periradicular surgery should be very considered where previous endodontic treatment has failed, and possible re-root treatment is the preferred option. [4] If re-root treatment is not possible, will not correct the problem or patient factors prevent it, periradicular surgery is indicated.
Dental radiographs, commonly known as X-rays, are radiographs used to diagnose hidden dental structures, malignant or benign masses, bone loss, and cavities.. A radiographic image is formed by a controlled burst of X-ray radiation which penetrates oral structures at different levels, depending on varying anatomical densities, before striking the film or sensor.
In some cases, the pain presents as a long dull ache as this is due to necrosis of the apical nerves being the last part of the pulp to necrose. Therefore, the pain is from the apical nerves, which have residual vitality remaining when the majority of the pulp is necrosed due to the supply of blood to the more medial parts of the apical nerve. [11]
Periapical cysts are labeled at left. Periapical cysts comprise approximately 75% of the types of cysts found in the oral region. The ratio of individuals diagnosed with periapical cysts is 3:2 male to female, as well as individuals between 20 and 60 years old. Periapical cysts occur worldwide. Types of Periapical cysts: Apical: 70% Lateral: 20%