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Periapical dental radiograph showing chronic periapical periodontitis on the root of the left maxillary second premolar. Note large restoration present in the tooth, which will have undergone pulpal necrosis at some point before the development of this lesion. Specialty: Endodontics [1] Complications
A dental abscess is a localized collection of pus associated with a tooth. The most common type of dental abscess is a periapical abscess, and the second most common is a periodontal abscess. In a periapical abscess, usually the origin is a bacterial infection that has accumulated in the soft, often dead, pulp of the tooth.
Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. [5] In its early stage, called gingivitis, the gums become swollen and red and may bleed. [5] It is considered the main cause of tooth loss for adults worldwide.
Necrotizing periodontal diseases are non-contagious infections but may occasionally occur in epidemic-like patterns due to shared risk factors. The milder form, necrotizing ulcerative gingivitis (also termed "trench mouth"), [9] is characterized by painful, bleeding gums and ulceration and necrosis of the interdental papilla.
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.
A periodontal pocket contains dental plaque, bacteria and subgingival calculus. [6] Periodontal pathogens continually find their way into the soft tissues, but normally they are held in check by the immune system. [7] A periodontal abscess represents a change in this balance, related to decreased local or systemic resistance of the host. [8]
Chronic periodontitis is initiated by Gram-negative tooth-associated microbial biofilms that elicit a host response, which results in bone and soft tissue destruction. In response to endotoxin derived from periodontal pathogens, several osteoclast-related mediators target the destruction of alveolar bone and supporting connective tissue such as the periodontal ligament.
Odontogenic infections can be severe if not treated and are associated with mortality rate of 10 to 40%. [4] Furthermore, about 70% of odontogenic infections occur as periapical inflammation, i.e. acute periapical periodontitis or a periapical abscess. [3] The next most common form of odontogenic infection is the periodontal abscess. [3]
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