DENT 267: LO6 LS1- Abscesses of the Periodontium: Gingival Abscesses

third most common dental emergency

-dental abscesses

abscess

-a localized circumscribed collection of pus surrounding a tooth (gingival, periodontal, periapical/endodontic)

purulent exudate

-pus

-WBCs, bacteria, necrotic tissue

abscess of the periodontium

-an acute infection involving a localized collection of pus within the gingival wall of the periodontal pocket

-circumscribed (confined to a specific site such as the facial surface of a single tooth)

suppuration

-pus (purulence) whitish-yellowish exudate consisting primarily of dead neutrophils, bacteria and cellular debris

-the process of forming pus

etiology of suppuration

-unknown but most lesions contain gram - and anaerobic microflora

characteristics of perio abscesses

-acute- constant localized pain

-chronic- no pain or dull pain

-difficulty masticating

-bad taste in mouth

-circumscribed localized swelling

-possible increase in tooth mobility

-loss of alveolar bone not involving tooth apex

-tooth usually has vital pulp

-elevated body temp when spreading throughout body

-may develop a sinus tract (fistula)

classification based on location: gingival

-limited to GM or IPs

classification based on location: periodontal

-affects deeper structures as well as GM

-occurs at site of pre-existing periodontitis

classification based on location: pericoronal

-involve tissues around crn or partially erupted tooth

-inflammation called pericoronitis

-flap of tissue covering tooth is called operculum

-may have trismus (limited opening)

-may have elevated temp

gingival abscesses

-affects marginal or interdental gingiva

-acute localized inflammatory reaction that develops through a break in the gingival tissue surface as a result of acute injury or localized infection of the gingiva

gingival abscess: etiology

-toothbrush bristles

-toothpicks

-popcorn husk

-peanut skin

-food impaction

-OH procedures or dental tx

gingival abscess: histopathology

-foreign body causes a break in epithelial tissue

-bacteria invade

-smooth, red, shiny surface

-pointed and pus may be released

gingival abscess: prognosis

-good prognosis

gingival abscess: tx

-incision and drainage usually done by dentist or periodontist

-incised, drained and irrigated w/ locally administered antimicrobials

-warm salt water rinses

-lesion may require excision

-debridement of the teeth in the area also recommended

-f/u to ensure healing