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Periapical periodontitis; Other names: Apical periodontitis, periradicular periodontitis: 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.
The pain associated with pulp necrosis is often described as spontaneous. [15] Hot temperatures are reported to have exacerbating factors, and cold temperatures are said to soothe this pain. In some cases, the pain presents as a long dull ache as this is due to necrosis of the apical nerves being the last part of the pulp to necrose.
This has led to the popular belief that necrotizing gingivitis is contagious, but this is not the case. The main features of necrotizing gingivitis are painful, bleeding gums and ulceration and necrosis of the interdental papilla. There may also be intra-oral halitosis, cervical lymphadenitis (swollen lymph nodes in the neck) and malaise.
It may develop rapidly from a periapical granuloma, as a consequence of untreated chronic periapical periodontitis. [ 1 ] Periapical is defined as "the tissues surrounding the apex of the root of a tooth " and a cyst is "a pathological cavity lined by epithelium , having fluid or gaseous content that is not created by the accumulation of pus."
Dental abscess; Other names: Dentoalveolar abscess, periapical abscess, tooth abscess, root abscess: A decayed, broken down tooth, which has undergone pulpal necrosis.A periapical abscess (i.e. around the apex of the tooth root) has then formed and pus is draining into the mouth via an intraoral sinus ().
Periapical COD occurs most commonly in the mandibular anterior teeth while focal COD appears predominantly in the mandibular posterior teeth. Florid COD is an extensive variant of periapical COD where lesions occur in multiple quadrants which can encompass the maxilla and mandible, and infrequently can cause jawbone deformity.
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.
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 ...