What Is Apical Periodontitis?

Acute or chronic inflammation of the periapical tissue of the tooth is called periapical inflammation. When pulpitis develops to advanced stages, when most or all of the pulp tissues are necrotic, or there is a bacterial infection, inflammation of the periapical tissues occurs; when the teeth are hit by a sharp external force, the periapical tissues are also violently injured and the apex Zhou Yan; iatrogenic infection can also cause periapical inflammation during treatment.

Basic Information

nickname: Periapical periodontitis
English name: periapicalperiodontitis

Visiting department: Stomatology
Common symptoms: pain
Contagious: no

Clinical manifestations of periapical periodontitis

Acute periapical periodontitis

In the early stage, the affected tooth has mild pain. At this time, the affected tooth clenches, and the pain can be temporarily relieved. With the increase of inflammation, the patient's teeth are extended, and the affected tooth is painful. The pain in periapical periodontitis is spontaneous and persistent, and the scope is limited. The patient can clearly indicate the tooth. If the acute periapical inflammation continues to develop and an acute apical abscess is formed, the pain will increase, the palpitation will be obvious, and there will be persistent jumping pain. The pus spreads under the periosteum, and the pain and swelling are obvious. Once the pus penetrates the periosteum and reaches the submucosa, the pain is reduced than before.

2. Chronic apical periodontitis

(1) Root apical granuloma generally does not have spontaneous pain, only discomfort when chewing, weakness in occlusion, abnormal feeling during percussion, and feeling of elongation of the affected teeth. At this time, the pulp of the tooth is mostly necrotic, and it can be acute when the body's resistance is low. attack.

(2) Apical abscesses are mostly without symptoms. There may be fistulas in the mucosa of the apical region of the affected teeth. Granulous tissue hyperplasia often occurs at the mouth of the fistula, and pus may be discharged from the fistula. Due to the drainage of the fistula, it is not easy to turn into acute. Inflammation.

(3) Root apical cysts are mostly without symptoms, and teeth are discolored. Teeth can show cysts at the apex of the root. If the cysts are enlarged, the surrounding bone is forced to absorb, and the mucosa at the root apex of the affected tooth is mostly semicircular, with ping pong. Ball feel.

Diagnosis of periapical periodontitis

Diagnosis can be made based on clinical manifestations and examination of the teeth for caries, deep periodontal pockets, tooth looseness, and pain. Chronic periapical periodontitis usually has no conscious symptoms. Inquire about the medical history in detail. The periapical periodontal pulp is mostly necrotic, the teeth are discolored, the percussion is uncomfortable, and the pulp vitality test is unresponsive. For a more accurate diagnosis of chronic apical periodontitis, an X-ray examination is required.

Periapical periodontitis treatment

Open pulp drainage

In the acute phase, the medullary cavity should be opened and the root canal removed to ensure that the root canal is unobstructed, so that the inflammation can be drained from the root canal. After the pulp is opened, a soft cotton twist can be placed at the root canal to facilitate drainage.

2. Cut drainage

The acute suppurative pus reaches the subperiosteal or submucosa, and the incision is made in the abscess of the corresponding apical region of the affected tooth to drain and drain the pus.

3. Root Canal Therapy

After the acute phase remission, thoroughly remove the infection in the root canal, and fill the root canal tightly for permanent treatment.

4. Apical curettage

This operation is performed when the lesion is large to eliminate the apical lesions, but it is limited to the upper and lower anterior teeth.