Pulp
On this page 7 sections
PERIODONTAL ABSCESS VS PERIAPICAL ABSCESS
Clinical differentiation
| Feature | Periodontal abscess | Periapical abscess |
|---|---|---|
| Source | Periodontal pocket or periodontal tissues | Infected/necrotic pulp |
| Tooth vitality | Usually vital | Usually non-vital |
| Typical location | Lateral aspect of root or gingival margin | Root apex |
| Periodontal probing | Deep pocket may be present | May have no pre-existing deep pocket |
| Radiographic finding | Lateral bone loss may occur | Periapical radiolucency may occur |
| Typical treatment | Drainage, periodontal debridement and management of the pocket | Endodontic treatment or extraction, with drainage as needed |
FCPS tip: A periodontal abscess is classically associated with a vital tooth; a periapical abscess is classically associated with a non-vital tooth. Always assess pulp vitality in context, because combined lesions can complicate the presentation.
PERICORONITIS
21. Definition
Pericoronitis is inflammation of the soft tissue surrounding a partially erupted tooth, most commonly a mandibular third molar.
Etiology
- Plaque and food debris accumulate beneath the operculum.
- The area is difficult to clean.
- Infection can develop in the space beneath the soft-tissue flap.
Clinical features
- Pain around a partially erupted tooth.
- Swelling and tenderness of the operculum.
- Purulent discharge may occur.
- Trismus may develop.
- Fever or spreading infection may occur in severe cases.
Treatment
- Irrigation and gentle debridement beneath the operculum.
- Pain control and oral hygiene measures.
- Antibiotics only when indicated, such as systemic involvement or spreading infection.
- Definitive management may include extraction or, in selected cases, operculectomy after the acute episode is controlled.
FCPS tip: Partially erupted mandibular third molar + inflamed operculum + pain/trismus = pericoronitis.