Apical periodontitis

Apical periodontitis is more often called apical periodontitis, apex in Latin is the top, the upper part. Accordingly, the apical inflammatory process in the periodontium is a disease localized in the upper part of the tooth root.

By the nature of the process, apical periodontitis is divided into acute and chronic. Chronic inflammation is more common, but exacerbation is more active in the clinical sense.

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Acute apical periodontitis

Symptoms:

Constant intense pain in the area of the infected tooth and periodontium.

• Intoxication:
  • the pain is localized, intensifies when eating, pressing on the tooth, the affected area is clearly indicated by the patient himself.
  • the face is swollen, the swelling is asymmetrical.
  • the mouth opens freely, jaw movements are not limited.
  • the mucous membrane is hyperemic.
  • there is a carious cavity or the process is developing under an old filling.
  • Palpation of the gums and percussion of the tooth cause pain.
• Exudation:
  • accumulation of simple exudate causes constant pain.
  • The accumulation of purulent exudate provokes throbbing pain.
  • purulent exudate provokes pain radiating to the trigeminal nerve.
  • the discharge of exudate relieves pain and reduces swelling of the face and gums.
  • the tooth is loose.
  • percussion causes severe pain in the entire affected periodontal area.
  • the cavity of the tooth is often closed - either by a filling or by growing fibrous tissue.
  • the mucous membrane is edematous.
  • body temperature is elevated.
  • Often the accumulation of exudate leads to collateral edema in the tissue of the jaw and cheek.
  • the transition from the serous phase of exudation to the purulent phase takes on average from 14 to 20 days.

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Chronic apical periodontitis

Chronic apical periodontitis in the initial stage proceeds without any signs and symptoms. This process can last for years, simultaneously infecting the entire body as a whole due to the presence of a constant chronic bacterial focus. The chronic apical form of the disease is divided into three main types:

1. Fibrous periodontitis.
2. Granulating periodontitis.
3. Granulomatous periodontitis.

Each of the types can be connected to each other by a pathogenetic mechanism, however, recently, cases have increasingly been recorded where granulomas develop independently under the influence of as yet unexplained, unspecified factors, obviously of an infectious nature.

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Treatment of apical periodontitis

Despite the fact that acute apical periodontitis is more severe in terms of pain, it is treated more successfully and faster, the chronic form of periodontal inflammation is a difficult therapeutic task due to the neglect of the process and its combination with other diseases of the oral cavity.