Periapical periodontitis

Periapical periodontitis
Other names	Apical periodontitis, periradicular periodontitis
Periapical dental radiograph showing chronic periapical periodontitis on the root of the left maxillary second premolar. Note large restoration present in the tooth, which will have undergone pulpal necrosis at some point before the development of this lesion.
Specialty	Dentistry

Periapical periodontitis or apical periodontitis

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.

Diagnosis

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

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 periapical periodontitis

Acute (or symptomatic) periapical periodontitis.... Malaise throbbing pain due to Inflammation within periodontal ligament

Chronic periapical periodontitis

Chronic (or asymptomatic) periapical periodontitis.

Related lesions

In addition to

Periapical periodontitis of some form is a very common condition. The prevalence of periapical periodontitis is generally reported to vary according to age group, e.g. 33% in those aged 20–30, 40% in 30- to 40-year-olds, 48% in 40- to 50-year-olds, 57% in 50- to 60-year-olds and 62% in those over the age of 60.[5] Most epidemiologic data has been generated in European countries, especially Scandinavia. While millions of root canal treatments are carried out in the United States alone each year, total numbers of such cases do not provide reliable indicators of frequency, even for symptomatic periapical periodontitis (given that root canal treatment is not always indicated or complied with, and may also be performed in the absence of periapacial periodontitis).

References