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Pericoronitis is inflammation of the soft tissues surrounding the crown of a partially erupted tooth, [1] including the gingiva (gums) and the dental follicle. [2] The soft tissue covering a partially erupted tooth is known as an operculum, an area which can be difficult to access with normal oral hygiene methods.
Also infection can spread down the tissue spaces to the mediastinum, causing significant consequences on the vital organs such as the heart. Another complication, usually from upper teeth, is a risk of sepsis traveling through pathways to which it can possibly lead to endocarditis, brain abscess (extremely rare), or meningitis (also rare).
Odontogenic infection starts as localised infection and may remain localised to the region where it started, or spread into adjacent or distant areas. It is estimated that 90–95% of all orofacial infections originate from the teeth or their supporting structures and are the most common infections in the oral and maxilofacial region. [3]
Periapical dental radiograph showing chronic periapical periodontitis on the root of the left maxillary second premolar. Note large restoration present in the tooth, which will have undergone pulpal necrosis at some point before the development of this lesion. Specialty: Endodontics [1] Complications
This infection is what causes necrosis of the pulp. [4] Larger cysts may cause bone expansion or displace roots. Discoloration of the affected tooth may also occur. Patient will present negative results to electric and ice test of the affected tooth but will be sensitive to percussion. Surrounding gingival tissue may experience lymphadenopathy.
Trauma to the tissues, such as serious impact on a tooth or excessive pressure exerted on teeth during orthodontic treatment, can be a possible cause as well. [17] Occlusal overload may also be involved in the development of a periodontal abscess, but this is rare and usually occurs in combination with other factors.
Recurrence can occur as early as 5 years and as late as 40 years after removal. [10] Recurrence is usually seen within 5 years of treatment. Early findings of recurrence can be easily treated with minor surgery and curretage. [10] Any fragment of the cyst that is left behind has the potential to survive and grow.
The most common location of dry socket: in the socket of an extracted mandibular third molar (wisdom tooth). Since alveolar osteitis is not primarily an infection, there is not usually any pyrexia (fever) or cervical lymphadenitis (swollen glands in the neck), and only minimal edema (swelling) and erythema (redness) is present in the soft tissues surrounding the socket.