peri-apical abcess
Periapical Abscess

Localized Collection of Pus in the Alveolar Bone at the Root Apex of the Tooth , following the Death of Pulp with Extension of the Infection through the Apical Foramen into Periradicular Tissue
A/E ( Etiology ) :-
– Most common Cause is Invasion of Bacteria from Necrotic Pulp Tissue
– Trauma , Chemical or any Mechanical Injury resulting in Pulp Necrosis
– Irritation of Periradicular Tissue by Chemical or Mechanical Treatment during RCT
– Acute Apical Periodontitis if it is associated with Bacterial Infection
Types :-
1- Acute Periapical Abscess
2- Chronic Periapical Abscess
3- Phoenix Periapical Abscess (Acute Exacerbation of a Chronic Periapical Abscess )
D.Dx :-
1- Acute Periapical Abscess & Acute Apical Periodontitis ::
** Both of them Tenderness on percussion and palpation
** Both of them have Pain on biting
** Both of them feeling that the tooth is slightly elevated in its socket .. Pain on mere touch
** Both of them may have “ Pseudomobility “

– Acute Apical Periodontitis :-
* Radiographic Appearance is essentially Normal at this Stage Except for a Slight Widening
of PDL Space
* May occur in Vital Tooth due to occlusal trauma, high points in restoration, wedging or forcing object between teeth
* Swelling 

– Acute Periapical Abscess :-
* Non-Vital Tooth
* Swelling 
* Radiographic Appearance Widening of PDL Space + Rounded Well-Defined RDL

🔵🔵 So , How can we Differentiate Chronic Periapical Abscess from the Previous Lesions ‼️

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