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A failed root canal treatment may also create a similar abscess. A dental abscess is a type of odontogenic infection, although commonly the latter term is applied to an infection which has spread outside the local region around the causative tooth.
If the tooth is to be removed, drainage will occur via the socket. Otherwise, if pus is already discharging from the periodontal pocket, this can be encouraged by gentle irrigation and scaling of the pocket whilst massaging the soft tissues. If this does not work, incision and drainage is required, as described in Dental abscess#Treatment.
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.
These abscesses are formed from a blockage in a periodontal pocket and have a vital pulp associated with the tooth. [5] Usually treatment involves the drainage and irrigation of the abscess with antiseptic mouthwash (0.2% Chlorhexidine) and antibiotic therapy is rarely required. [8]
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.
Root canal treatment (blue arrows) carried out on the lower right first molar with temporary restoration in place Incision of an abscess above a front tooth and insertion of a surgical drain Odontogenic infection involving the buccal space. Above, deformation of the cheek on the second day.
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