Apical periodontitis

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

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

[1], [2], [3]

Acute apical periodontitis

Symptoms:

Constant intense pain in the area affected by infection of the tooth and periodontal disease.

• Intoxication:
  • pain is localized, increases with food intake, pressure on the tooth, the affected area is clearly indicated by the patient himself.
  • the person is edematous, the swelling is asymmetric.
  • the mouth opens freely, the movements of the jaw are not limited.
  • the mucosa is hyperemic.
  • there is a carious cavity or the process develops under the old filling.
  • palpation of the gums, percussion of the tooth cause pain.
• Exudation:
  • the accumulation of simple exudate causes constant pain.
  • accumulation of purulent exudate provokes throbbing pain.
  • purulent exudate provokes irradiating in a trigeminal nerve pain.
  • the expiration of exudate relieves pain, reduces swelling of the face, gums.
  • the tooth is mobile.
  • percussion causes severe pain in the entire affected periodontal zone.
  • The tooth cavity is often closed - either by a filling, or by an increasing fibrous tissue.
  • the mucous is edematous.
  • body temperature increased.
  • often accumulation of exudate leads to collateral swelling in the jaw tissue, cheeks.
  • the transition of the serous phase of exudation to purulent on average takes from 14 to 20 days.

[4], [5], [6]

Chronic apical periodontitis

Chronic apical periodontitis in the initial stage proceeds without any signs and symptoms. Such a course of the process can last for years, simultaneously exposing the whole organism to infection because of the presence of a chronic 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 species can be linked to each other by a pathogenetic mechanism, but cases have recently become more frequent where granulomas develop independently under the influence of undetermined, unspecified factors, obviously of an infectious nature.

[7], [8],

Treatment of apical periodontitis

Despite the fact that acute apical periodontitis proceeds more heavily in the sense 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.