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The radiographic features of periapical inflammatory lesions vary depending on the time course of the lesion. Because very early lesions may not show any radiographic changes, diagnosis of these lesions relies solely on the clinical symptoms. More chronic lesions may show lytic (radiolucent) or sclerotic (radiopaque) changes, or both.
The body's inflammatory response will attack the source of the toxins, leading to periapical inflammation. The many cells and proteins that rush to an area of infection create osmotic tension in the periapex which is the source of internal pressure increase at the cyst site.
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.
This condition arises as a response to dental infections, such as periapical pulp inflammation or low-intensity trauma. The lesion typically appears as a radiopacity in the periapical area due to the sclerotic reaction. While most commonly associated with non-vital teeth, condensing osteitis can also occur in vital teeth following occlusal trauma.
The three types are periapical cemental dysplasia (common in those of African descent), focal cemento-osseous dysplasia (Caucasians), and florid cemento-osseous dysplasia (African descent). Periapical COD occurs most commonly in the mandibular anterior teeth while focal COD appears predominantly in the mandibular posterior teeth.
For periapical radiographs, the film or digital receptor should be placed parallel vertically to the full length of the teeth being imaged. [3] The main indications for periapical radiography are [4] Detect apical inflammation/ infection including cystic changes; Assess periodontal problems; Trauma-fractures to tooth and/or surrounding bone
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 ...
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.