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A phoenix abscess is an acute exacerbation of a chronic periapical lesion. It is a dental abscess that can occur immediately following root canal treatment. Another cause is due to untreated necrotic pulp (chronic apical periodontitis). [1] It is also the result of inadequate debridement during the endodontic procedure.
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.
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 ...
In addition to periapical abscesses, periapical periodontitis can give rise to various related lesions, including periapical granulomas and cysts. [11] A periapical granuloma (also referred to as an 'apical granuloma' or 'radicular granuloma') is a mass of chronically inflamed granulation tissue that forms at the apex of the root of a nonvital ...
The first line of treatment is the removal of the source of inflammation or infection by local operative measures. [9] Generally, the abscess can be eradicated through surgical drainage alone; however this is sometimes inadequate. Therefore, systemic antibiotic treatment may be required, but only if there is evidence of spreading infection. [9]
Periodontal abscesses may be difficult to distinguish from periapical abscesses. Since the management of a periodontal abscess is different from a periapical abscess, this differentiation is important to make (see Dental abscess#Diagnostic approach) For example, root canal therapy is unnecessary and has no impact on pain in a periodontal abscess.
Endo-Perio: infection from the pulp tissue within a tooth may spread into the bone immediately surrounding the tip, or apex, or the tooth root, forming a periapical abscess. This infection may then proliferate coronally to communicate with the margin of the alveolar bone and the oral cavity by spreading through the periodontal ligament.
Infection of the periapical tissue will generally resolve with the treatment of the pulp, unless it has expanded to cellulitis or a radicular cyst. The success rate of restorative treatment and sedative dressings in reversible pulpitis, depends on the extent of the disease, as well as several technical factors, such as the sedative agent used ...
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