Apical periodontitis

- inflammation of the tissues surrounding the tip of the root of the tooth.

Etiology: infection (Staphylococcus, Streptococcus, anaerobes), mechanical trauma, including microtrauma (biting thread, grabbing nails with teeth, etc.), chemical.

Pathogenesis . Spread of the inflammatory process from the pulp through the apical opening. Reaction to contact with necrotic pulp, strong drugs and damage to endocanal instruments. Microbial and drug sensitization is important.

Symptoms, course.Acute periodontitis is manifested by sharp pain in the area of the tooth, which increases from touching it. Swelling of the lips, cheeks. The gums are swollen, hyperemic, and infiltrated. The tooth is pathologically mobile. Submandibular lymph nodes are enlarged, painful on palpation, body temperature 37-37. 5 ° C. There may be complications in the form of a parotid abscess, osteomyelitis of the jaw.

When a submandibular abscess is formed, the severity of symptoms decreases.


The chronic process is sluggish: there is a feeling of awkwardness when eating, bad breath, sometimes fistulas on the gums, less often on the skin of the face. Periodically, periodontitis worsens. In the affected tooth-a carious cavity or a filling. The pulp is necrotic. In case of traumatic origin of the process, the crown of the tooth is intact.

Different forms are differentiated by radiography. The disease can lead to the formation of a jaw cyst. It is a source of streptococcal sensitization of the body.

Treatment.The acute process requires urgent intervention – creating an outflow of exudate from the apical region, which is achieved by passing the root canal with an endodontic tool and opening the apical opening.

The subcostal abscess is opened. With pronounced General phenomena, antibiotics are prescribed.

In the chronic process, the root canals are expanded, their antimicrobial treatment is performed, and the inflammatory focus is affected by drugs or physical methods (electrophoresis, UHF therapy, etc.). the Treatment is completed by filling the root canals. Surgical methods of treatment are also used – tooth extraction, root tip resection, tooth replantation, and hemisection.