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Concept
Periapical periodontitis
Summary
Periapical periodontitis or apical periodontitis (AP) is an acute or chronic inflammatory lesion around the apex of a tooth root, most commonly caused by bacterial invasion of the pulp of the tooth. It is a likely outcome of untreated dental caries (tooth decay), and in such cases it can be considered a sequela in the natural history of tooth decay, irreversible pulpitis and pulpal necrosis. Other causes can include occlusal trauma due to 'high spots' after restoration work, extrusion from the tooth of root filling material, or bacterial invasion and infection from the gums. Periapical periodontitis may develop into a periapical abscess, where a collection of pus forms at the end of the root, the consequence of spread of infection from the tooth pulp (odontogenic infection), or into a periapical cyst, where an epithelial lined, fluid-filled structure forms.
Etymologically, the name refers to inflammation (Latin, -itis) around (peri- ) the root tip or apex (-apical) of the tooth (-odont-). Periradicular periodontitis is an alternative term.
The radiographic features of periapical inflammatory lesions vary depending on the time course of the lesion. Because very early lesions
may not show any radiographic changes, diagnosis of these lesions relies solely on the clinical symptoms. More chronic lesions may show lytic (radiolucent) or sclerotic (radiopaque) changes, or both.
Classification of periapical periodontitis is usually based on whether the process is acute/symptomatic or chronic/asymptomatic.
(Note: alternative names for periapical periodontitis include 'apical periodontitis' and 'periradicular periodontitis'.)
Acute (or symptomatic) periapical periodontitis....
Malaise throbbing pain due to
Inflammation within periodontal ligament
Chronic (or asymptomatic) periapical periodontitis.
In addition to periapical abscesses, periapical periodontitis can give rise to various related lesions, including periapical granulomas and cysts.
Official source
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