The classification of periapical lesions of endodontic origin and clinical evaluation of the aetiology and pathogenesis of their development
There are various literatures that classify periapical lesions. Often these have been based on histological findings and so the resulting classifications having minor differences in terminology. This could easily lead to confusion between clinicians and subsequently incorrect diagnosis.
The correct diagnosis of any disease is the foundation to the treatment required, to restore the patient back to a healthy state. Therefore the importance of classifying periapical lesions is essential to form a correct diagnosis, which leads to proper treatment of the tooth (both in acute emergency situations and the …show more content…
Radiographically this presents as a diffuse radiopaque lesion, which can occur around the apex of any tooth but is often visible around posterior mandibular teeth. This condition is known as condensing osteitis and is a variant of symptomatic apical periodontitis
Lesions are generally asymptomatic, but depending on whether the cause is pulpitis or pulpal necrosis, there may be a response to vitality, percussion and palpation. Root canal treatment is indicated in these cases.
Acute apical abscess
Pulp infection and necrosis leads to a rapid severe localised inflammatory reaction, which destroys periapical tissues.
The pain is spontaneous and of rapid onset. The affected tooth is extremely painful to percussion and palpation, with possible mobility. Due to necrosis of the pulp there is no pulp vitality. Pus formation is present and swelling of the tissues. The swelling can be confined to alveolar bone, or be present in the soft tissues of the mucobuccal fold, or have spread into the fascia planes causing a cellulitis. The patient will often experience cervical and submandibular lymphadenopathy along with fever and malaise.
Radiographic changes can vary from no change to widening of the PDL or to signs of periapical destruction in the form of
There are various literatures that classify periapical lesions. Often these have been based on histological findings and so the resulting classifications having minor differences in terminology. This could easily lead to confusion between clinicians and subsequently incorrect diagnosis.
The correct diagnosis of any disease is the foundation to the treatment required, to restore the patient back to a healthy state. Therefore the importance of classifying periapical lesions is essential to form a correct diagnosis, which leads to proper treatment of the tooth (both in acute emergency situations and the …show more content…
Radiographically this presents as a diffuse radiopaque lesion, which can occur around the apex of any tooth but is often visible around posterior mandibular teeth. This condition is known as condensing osteitis and is a variant of symptomatic apical periodontitis
Lesions are generally asymptomatic, but depending on whether the cause is pulpitis or pulpal necrosis, there may be a response to vitality, percussion and palpation. Root canal treatment is indicated in these cases.
Acute apical abscess
Pulp infection and necrosis leads to a rapid severe localised inflammatory reaction, which destroys periapical tissues.
The pain is spontaneous and of rapid onset. The affected tooth is extremely painful to percussion and palpation, with possible mobility. Due to necrosis of the pulp there is no pulp vitality. Pus formation is present and swelling of the tissues. The swelling can be confined to alveolar bone, or be present in the soft tissues of the mucobuccal fold, or have spread into the fascia planes causing a cellulitis. The patient will often experience cervical and submandibular lymphadenopathy along with fever and malaise.
Radiographic changes can vary from no change to widening of the PDL or to signs of periapical destruction in the form of