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Questions and Answers
What characterizes the onset of an apical abscess?
What characterizes the onset of an apical abscess?
Which of the following is a common cause of pulp necrosis leading to an apical abscess?
Which of the following is a common cause of pulp necrosis leading to an apical abscess?
What differentiates a periodontal abscess from an apical abscess?
What differentiates a periodontal abscess from an apical abscess?
Which condition can contribute to an apical abscess due to trauma?
Which condition can contribute to an apical abscess due to trauma?
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What is a significant outcome of a periodontal abscess?
What is a significant outcome of a periodontal abscess?
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Which statement correctly describes pus formation in dental abscesses?
Which statement correctly describes pus formation in dental abscesses?
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What is NOT a potential cause of apical abscess according to the defined aetiology?
What is NOT a potential cause of apical abscess according to the defined aetiology?
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Which is a characteristic symptom of an apical abscess?
Which is a characteristic symptom of an apical abscess?
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What type of bacteria is primarily associated with periodontal abscesses?
What type of bacteria is primarily associated with periodontal abscesses?
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Which symptom is typically NOT associated with a periodontal abscess?
Which symptom is typically NOT associated with a periodontal abscess?
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Which clinical presentation is consistent with an apical abscess?
Which clinical presentation is consistent with an apical abscess?
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What is the treatment option specifically for managing a periodontal abscess?
What is the treatment option specifically for managing a periodontal abscess?
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Identify a feature that is NOT a typical sign of an apical abscess.
Identify a feature that is NOT a typical sign of an apical abscess.
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Which microorganism is primarily responsible for a significant percentage of apical lesions?
Which microorganism is primarily responsible for a significant percentage of apical lesions?
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What is a common systemic sign associated with the presence of an abscess?
What is a common systemic sign associated with the presence of an abscess?
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Which of the following is NOT a typical response in clinical testing for pulp vitality?
Which of the following is NOT a typical response in clinical testing for pulp vitality?
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Study Notes
Apical and Periodontal Abscesses
- Dental Abscess Definition: A localized collection of pus (dead tissue/bacteria) associated with a tooth.
Apical Abscess
- Definition: An inflammatory response to pulpal infection and necrosis, characterized by rapid pain onset, tooth tenderness to pressure, pus formation, and swelling of surrounding tissues.
-
Aetiology (Causes):
- Pulp Necrosis (death) due to:
- Bacterial invasion and toxins from carious lesions.
- Trauma (impact/fracture).
- Trauma from restorative procedures.
- Trauma from restorative materials.
- Trauma from occlusion.
- Bacterial invasion from lateral/accessory canals.
- Pulp Necrosis (death) due to:
-
Microorganisms: A mix of facultative and strict anaerobic Gram-negative bacteria, including:
- Viridans Streptococci
- Porphyromonas gingivalis (frequently present)
- Prevotella intermedia
- Prevotella melaninogenica
- Fusobacterium nucleatum
- Tannerella forsythia
- Treponema species
- Campylobacter species
- Capnocytophaga species
- Aggregatibacter actinomycetemcomitans and gram-negative enteric rods.
Periodontal Abscess
- Definition: A localized accumulation of pus within the gingival wall of a periodontal pocket/sulcus, resulting in significant tissue breakdown.
Clinical Presentation Comparison
| Feature | Apical Abscess | Periodontal Abscess |
|---|---|---|
| Pain | If pulp is vital (alive) | Painful, but often less severe than apical |
| Swelling | Lobulated swelling at tooth apex | Localized ovoid elevation in marginal gingivae/interdental papillae |
| Facial Swelling | Possible | Rarely |
| Temperature | Increased body temperature possible | Possible |
| Lymphadenopathy | Regional lymph node enlargement possible | Possible |
| Bleeding on Probing | Possible | Often present |
| Suppuration on Probing | Uncommon | Often present |
| Fistula/Sinus | Possible | Rare |
| Mobility | Possible | Possible, but more often localized |
| Pocket Depth | Not associated with deep pockets | Deep pocket is a defining characteristic |
| Dental History | History of carious lesion, restoration, previous abscess | History of periodontitis, periodontal treatment, previous abscess |
| Location | Apex/root sulcus | Marginal gingiva/interdental papilla |
Potential Causes of inflammation/abscess (General for both)
- Deep carious lesions
- Restorations (poor margins, leaking restorations)
- Previous endodontic treatment (RCT): (only for apical)
Diagnosis and Assessment
- Thermal Tests: Assessing tooth sensitivity to temperature changes.
- Electric Pulp Test: Assessing the vitality of the pulp tissue.
- Percussion: Assessing tenderness around the tooth.
- Sulcus Palpation: Assessing tenderness within the periodontal pockets.
Treatment Options
| Condition | Treatment Options |
|---|---|
| Both | Analgesics, warm salt water rinses |
| Both | Drain pus/swelling |
| Apical | Endodontic treatment (root canal therapy) |
| Periodontal | Periodontal treatment (scaling, root planing) |
| Both | Extraction (in severe cases) |
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