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Periapical AbscessAka: Apical Periodontitis, Apical Abscess
- See Also
- Pathophysiology
- Complication of Irreversible Pulpitis (Dental Caries)
- Symptoms
- Severe, persistent pain localized to affected tooth
- Signs
- Apical abscess may be present
- Fluctuant swelling at Buccal mucosa or palate
- Percussion with metal object elicits pain
- Regional Lymphadenopathy of the Head and Neck
- Apical abscess may be present
- Management
- Incision and Drainage if abscess is present
- Local Anesthesia to Gingiva (2% Lidocaine with Epinephrine)
- Small stab incision is sufficient
- Aim toward alveolar bone
- Insert through periosteum
- Probe space with Mosquito hemostat
- Irrigate abscess cavity
- Insert gauze packing or penrose drain if room
- Secure gauze or drain with Silk Suture 4-0
- Remove drain within 48 hours
- Patient should rinse with warm saline
- Root canal or tooth extraction by dentist
- Antibiotics not required in most cases
- Start if Periodontal Cellulitis suspected
- For Cellulitis, Augmentin or Clindamycin are recommended
- Incision and Drainage if abscess is present
- Complications
- References
- Amsterdam in Marx (2002) Rosen's Emergency Med, p. 897
- Douglass (2003) Am Fam Physician 67(3):511
Periapical Periodontitis (C0031030) | |
|---|---|
| Definition (MSH) | Inflammation of the PERIAPICAL TISSUE. It includes general, unspecified, or acute nonsuppurative inflammation. Chronic nonsuppurative inflammation is PERIAPICAL GRANULOMA. Suppurative inflammation is PERIAPICAL ABSCESS. |
| Concepts | Disease or Syndrome (T047) |
| ICD9 | 522.6 |
| MSH | D010485 |
| English | Apical Periodontitides, Apical periodontitis, Periapical Periodontitides, Periapical Periodontitis |
| Spanish | periodontitis apical |
| Parent Concepts | Periapical Diseases (C0031028), Periodontitis (C0031099) |
| Sources | MSH, MTHICD9, NDFRT, SCTSPA, SNOMEDCT Derived from the NIH UMLS (Unified Medical Language System) |
