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The bacteria gains access to the periapical region of the tooth through deeper infection of the pulp, traveling through the roots. The resulting pulpal necrosis causes proliferation of epithelial rests of Malassez which release toxins at the apex of the tooth. The body's inflammatory response will attack the source of the toxins, leading to ...
Periapical periodontitis or apical periodontitis [9] (AP) is an acute or chronic inflammatory lesion around the apex of a tooth root, most commonly caused by bacterial invasion of the pulp of the tooth. [10]
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.
Tooth #5, the upper right second premolar, after extraction. The two single-headed arrows point to the CEJ, which is the line separating the crown (in this case, heavily decayed) and the roots. The double headed arrow (bottom right) shows the extent of the abscess that surrounds the apex of the palatal root.
Lateral periodontal cysts radiographically present as a rounded, teardrop shape that are usually less than 10mm in size, presenting with a uni-cystic well-delineated radiolucency. Lesions are situated usually between the tooth lateral surface between the root apex and alveolar crest. [10] A prominent cortical boundary [11] is also usually observed.
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. [18]
Lesions in proximity to the apex of a tooth, especially those associated with caries or periodontal disease, may have a greater chance of becoming infected. [3] Lastly, local infection within a COD lesion, often leading to necrosis of the area, is another risk factor for symptomatic COD. [3]
On dental radiographs, the calcifying odontogenic cyst appears as a unilocular (one circle) radiolucency (dark area). In one-third of cases, an impacted tooth is involved. Histologically, cells that are described as " ghost cells ", enlarged eosinophilic epithelial cells without nuclei, are present within the epithelial lining and may undergo ...