Advertisement
Clinical Research| Volume 45, ISSUE 9, P1114-1118, September 2019

Dynamics of Bone Loss in Cases with Acute or Chronic Apical Abscess

      Abstract

      Introduction

      Acute and chronic apical abscesses are 2 dramatic ways that periradicular tissues may react to pulpal infection and necrosis. Although both of these clinical states are the response to pulpal infection, their clinical manifestations are significantly different. It is not clear why the body responds to root canal infection in one way or another. The objective of this study was to evaluate the size and pattern of bone loss in patients with acute apical abscess (AAA) and chronic apical abscess (CAA) using cone-beam computed tomographic images.

      Methods

      Twenty-three cone-beam computed tomographic images of cases with AAA and 25 cases with CAA were selected and evaluated. The presence and location of fenestration and the volume and pattern of the periradicular lesions were recorded and compared between the 2 groups using the Fisher exact and Mann-Whitney U tests.

      Results

      One hundred percent of cases with CAA had cortical fenestration, but only 47% of cases with AAA had cortical fenestration (P < .05). The median volume of the lesions was 233 mm3 in the CAA group and 109 mm3 in the AAA group (P > .05). CAA cases, in comparison with the AAA group, had a relatively larger cortical disruptions.

      Conclusions

      Cortical fenestration is fundamental for the development of CAA. However, periradicular lesions without evident cortical fenestration can still cause AAA and fascial space involvement.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Endodontics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Gupta R.
        • Hasselgren G.
        Prevalence of odontogenic sinus tracts in patients referred for endodontic therapy.
        J Endod. 2003; 29: 798-800
        • Glickman G.
        • Schweitzer J.
        Endodontic diagnosis. Endodontics: Colleagues for Excellence.
        American Association of Endodontists, Chicago2013
        • Barnett C.W.
        • Glickman G.N.
        • Umorin M.
        • Jalali P.
        Interobserver and intraobserver reliability of cone-beam computed tomography in identification of apical periodontitis.
        J Endod. 2018; 44: 938-940
        • Liang Y.H.
        • Jiang L.
        • Gao X.J.
        • et al.
        Detection and measurement of artificial periapical lesions by cone-beam computed tomography.
        Int Endod J. 2014; 47: 332-338
        • Pak J.G.
        • Fayazi S.
        • White S.N.
        Prevalence of periapical radiolucency and root canal treatment: a systematic review of cross-sectional studies.
        J Endod. 2012; 38: 1170-1176
        • Bauer W.H.
        Maxillary sinusitis of dental origin.
        Am J Orthod Dentofac Orthop. 1943; 29: B133-B151
        • Simon D.
        • Faustini F.
        • Kleyer A.
        • et al.
        In vivo visualization of cortical microchannels in metacarpal bones in patients with cutaneous psoriasis by high resolution peripheral computed tomography-detecting cortical pathologies before the clinical onset of psoriatic-arthritis: 1892.
        Arthritis Rheumatol. 2014; 66: S832-S833
        • White S.C.
        • Pharoah M.J.
        Oral Radiology Principles and Interpretation.
        7th ed. Elsevier, St Louis, MO2014
        • Jalali P.
        • Hasselgren G.
        Endodontic inter-appointment flare-ups: an example of chaos?.
        Dent Hypotheses. 2015; 6: 44-48
        • Seely A.J.
        • Christou N.V.
        Multiple organ dysfunction syndrome: exploring the paradigm of complex nonlinear systems.
        Crit Care Med. 2000; 28: 2193-2200