Periodontal VS Periapical Abscess

Periodontal Abscess

• A periodontal abscess is a localized purulent inflammation in the periodontal tissue.
• It is also known as lateral abscess or parietal abscess.
• Abscess localized in gingiva, caused by injury to the outer surface of the gingiva, and not involving the supporting structure are called gingival abscesses.

Clinical Features:

1. Smooth, shiny swelling of the gingiva
2. Painful, tender to palpation
3. Purulent exudate
4. Increased probing depth
5. Mobile and/or percussion sensitive
6. Tooth usually vital

Treatment:

1. Anesthesia
2. Establish drainage

• Via sulcus is the preferred method
• Surgical access for debridement
• Incision and drainage
• Extraction

Periapical Abscess

• Also known as dentoalveolar abscess, alveolar abscess
• It is an acute or chronic suppurative process of the of the periapical region 
• It is the sequelae of periapical granuloma
• Phoenix abscess is an acute exacerbation of chronic periapical lesion.
• Chronic abscess is an asymptomatic, well-circumscribed area of suppuration that shows little tendency to spread from local area

Clinical Features:

1. Swelling
2. Warmth
3. Erythema
4. Fluctuant mass that usually extends toward the buccal side of the gum and to the gingival-buccal reflection
5. Parulis or "gum boil" (a soft, solitary, reddish papule located facial and apical to a chronically abscessed tooth that occurs at the endpoint of a draining dental sinus tract
6. Initially- tenderness, which is relieved by application of pressure
7. Later- extreme pain & slight extrusion from socket
8. Rapid extension to adjacent marrow spaces may occur, resulting in osteomyelitis

Treatment:

Drainage must be establish

• Open pulp chamber
• Extract the tooth