Dental abscess
Updates to Article Attributes
Dental (periapical) abscess is an acute infection of the periapical tissue around the root of the tooth.
Clinical presenation
Patients may present with pain, oedema and purulent discharged localised to the site of pathology with or without fever and tender cervical lymphadenopathy 1.
Pathology
Caries result in damage to the tooth enamel, which allows bacteria access to the dental pulp. From here the infection spreads down the root canal and out the apical foramen where abscess formation occurs 2,4.
Radiographic features
Early dental abscesses, within the first ten days, may not have any radiographic features 3-4.
Plain film/OPG and CT
- well-defined lucency at or distal to the root apex, usually less than 1cm with or without surrounding (<22mm) sclerosis 2-4
Treatment and prognosis
Some dental abscesses will spontaneously resolve but dental surgery and antibiotics is generally required 1,4.
Complications
Dental abscesses can exert pressure on the root of tooth, which contains the neurovascular bundle, and can lead to devitilisationdevitalisation of the tooth 5.
Complications range from contigious or haemategenous spread of infection and include potentially fatal conditions 1-4:
- osteomyelitis
- meningitis and cerebral abscess
- Ludwig's angina
- deep neck space infections
- sinusitis
Differential diagnosis
-</li></ul><h4>Treatment and prognosis</h4><p>Some dental abscesses will spontaneously resolve but dental surgery and antibiotics is generally required <sup>1,4</sup>. </p><h5>Complications</h5><p>Dental abscesses can exert pressure on the root of tooth, which contains the neurovascular bundle, and can lead to devitilisation of the tooth <sup>5</sup>. </p><p>Complications range from contigious or haemategenous spread of infection and include potentially fatal conditions <sup>1-4</sup>:</p><ul>- +</li></ul><h4>Treatment and prognosis</h4><p>Some dental abscesses will spontaneously resolve but dental surgery and antibiotics is generally required <sup>1,4</sup>. </p><h5>Complications</h5><p>Dental abscesses can exert pressure on the root of tooth, which contains the neurovascular bundle, and can lead to devitalisation of the tooth <sup>5</sup>. </p><p>Complications range from contigious or haemategenous spread of infection and include potentially fatal conditions <sup>1-4</sup>:</p><ul>
- +<li><a title="Acute sinusitis" href="/articles/acute-sinusitis">sinusitis</a></li>
-<li><a href="/articles/periapical_cyst">periapical cysts</a></li>-<li><a href="/articles/periapical-granulomas">periapical granulomas</a></li>- +<li><a href="/articles/periapical-cyst">periapical cyst</a></li>
- +<li><a href="/articles/periapical-granuloma">periapical granuloma</a></li>
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Image 7 CT (bone window) ( create )
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