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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.
Intraoral X-rays or a 3-D cone beam scan of the affected area can be used to obtain radiological images and confirm diagnosis of cysts in the periapical area. Circular or ovoid radiolucency surrounding the root tip of approximately 1-1.5 cm in diameter is indicative of the presence of a periapical cyst. [2]
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 ...
The radiolucency is generally well defined and well corticated. The radiolucency often have a sclerotic border indicating bony reaction, but a secondarily infected cyst may display ill-defined borders. However, a large dentigerous cyst may give the impression of a multilocular process due to the persistence of bone trabeculae within the ...
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 ]
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 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]