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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.
Apical periodontitis is typically the body's defense response to the threat of microbial invasion from the root canal. [1] Primary among the members of the host defense mechanism is the polymorphonuclear leukocyte, otherwise known as the neutrophil.
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." [2]
Aggressive periodontitis is distinguished from the chronic form mainly by the faster rate of progression. Loss of attachment may progress despite good oral hygiene and in the absence of risk factors such as smoking. Aggressive periodontitis may occur in younger persons and there may a genetic aspect, with the trait sometimes running in families ...
Periodontitis is very common, and is widely regarded as the second most common dental disease worldwide, after dental decay, and in the United States has a prevalence of 30–50% of the population, but only about 10% have severe forms. Chronic periodontitis affects about 750 million people or about 10.8% of the world population as of 2010. [86]
Common causes include inflammation of the pulp, (usually in response to tooth decay, dental trauma, or other factors), dentin hypersensitivity, apical periodontitis (inflammation of the periodontal ligament and alveolar bone around the root apex), dental abscesses (localized collections of pus), alveolar osteitis ("dry socket", a possible ...
Symptoms: Pain, loss of dental vitality, tenderness, dental mobility: Causes: Complication of root canal treatment or endodontic procedures, chronic apical periodontitis: Diagnostic method: Clinical and radiographic features: Treatment: Further endodontic treatment, antibiotics and analgesics, debridement, extraction, bite adjustment
Chronic periodontitis is initiated by Gram-negative tooth-associated microbial biofilms that elicit a host response, which results in bone and soft tissue destruction. In response to endotoxin derived from periodontal pathogens, several osteoclast-related mediators target the destruction of alveolar bone and supporting connective tissue such as the periodontal ligament.