Chronic apical abscess Peri-root granuloma Apical cyst

Pathological manifestations: Vascular dilation and congestion, serum oozing, infiltration of a small number of inflammatory cells, and tissue edema. Clinical manifestations: Occlusal pain Mild pain, persistent dull pain → The affected teeth have sensation of surfacing, early contact and chewing pain.

Pathological manifestations: 1. Early stage: Small abscesses are formed in the periodontal membrane near the root apical foramen 2. Acute alveolar abscess 3. Subperiosteal abscess 4. Soft tissue cellulitis 5. Break through the weak organizational structure

Clinical manifestations: 1. Early small abscess: spontaneous, persistent, and pulsating pain. 2. Acute alveolar abscess: The pain reaches its peak, accompanied by general discomfort, and enlarged lymph nodes in the drainage area. 3. Puss pierces the periosteum: the pain relieves. 4. The pus reaches the soft tissue and forms cellulitis: diffuse redness and swelling on the face, and the mouth opening is limited. 5. When pus penetrates the mucosa or skin: a fistula is formed.

Pimple discharge route: The pus forms a subperiosteal abscess through the alveolar bone on the buccal lip or lingual palatal side, which passes through the bone marrow cavity and breaks through the periosteum, mucosa or skin. The teeth with thick root canals and larger root apical holes are also discharged through caries Patients with severe periodontal pockets can also discharge pus through deep periodontal pockets. Penetrate the nasal mucosa Penetrate the maxillary sinus base

X-ray: The peri-radar space of the affected tooth increases, and the peri-radar bone plate may be unclear; if it is an acute attack of chronic inflammation, the alveolar bone will be absorbed

Due to the long-term slow stimulation of peri-apic pathogenic microorganisms and their metabolites, normal peri-apic tissue is absorbed and destroyed, and is gradually replaced by inflammatory granulation tissue

(I) Clinical characteristics

Epithelial source:

Outcomes of root apical granuloma

Epithelial apical granuloma can be transformed into peri-radar apical cyst:

Also known as chronic alveolar abscess, it can be directly transformed from acute apical periarthritis, or caused by the development of apical granuloma

(I) Clinical characteristics Most of them have no obvious symptoms, and some have patients who have received treatment due to small pustules in the gums Check for a tooth pain Common sinus openings X-ray: Transmissive images of different sizes in the root apical area

(II) Pathology There are purulent secretions around the root apical abscess, abscesses are formed in the periodontal membrane, central liquefaction and necrosis and neutrophils are surrounded by inflammatory granulation tissue, and the outer periphery is surrounded by fibrous connective tissue. Alveolar bone and cementum are absorbed in different degrees, and osteoclasts are abundant in the fossa.