Abscesses Of The Periodontium Question And Answers

Abscesses Of The Periodontium 

• An abscess is the consolidation of suppurative infection secondary to tissue breakdown during a limited period of time.
• Localized abscesses of periodontal origin can be basically classified as being one of 2 types.

1. 1. Gingival abscess
   2. Periodontal abscess

Read And Learn More: Periodontology Important Question And Answers

Question 1. Discuss gingival abscess and its management.
Answer:

Gingival Abscess

• The gingival abscess is a localized purulent infection that involves the marginal gingiva and interdental papilla.
• It is characterized by acute onset, usually provoked by traumatic injury and impregnation of the gingival tissue with a foreign body such as a toothbrush bristle or fish bone.
• Pain may sometimes be present and the teeth immediately adjacent to the abscess may be sensitive to percussion.
• Gingival abscesses rarely extend to involve the supporting periodontal tissues and usually do not have any prognostic significance as they may regress spontaneously without treatment.

Treatment of Gingival Abscesses

• Treatment ideally consists of the removal of foreign objects and the establishment of drainage by pressure or an incision.
• Supportive therapy such as warm saline gargle, and topical anesthetic application may be prescribed. Antibiotic therapy may be occasionally required.

Question 2. Discuss periodontal abscess and its management.
Answer:

Periodontal Abscess: The periodontal abscess has been defined as a localized purulent infection within the tissue adjacent to the periodontal pocket that may lead to the destruction of the periodontal ligament and alveolar bone.

Periodontal Abscess Etiology

• The periodontal abscess is always associated with a periodontal pocket, complex pockets are more prone for abscess formation.
• It may also develop in simple pockets if there is no drainage through the margin as a result of either blockage due to inflmmatory shrinkage or due to calculus deposit pushed into the gingiva. Furcation areas are also prone for abscess formation.

Periodontal Abscess Clinical Features

• A periodontal abscess presents as a diffuse swelling along the lateral aspect of the tooth.
• Located in the attached or marginal gingiva, it is present either as soft fluctuant swelling or as a sinus tract opening with purulent discharge.
• The involved tooth may be tender on lateral percussion and there may be localized lymphadenitis.

Treatment of Periodontal Abscesses

• Incision and Drainage: The first line of therapy consists of incision and drainage of the abscess. This may be achieved either by

1. The external incision on the most fluctuant part of the abscess or
2. Drainage through the pocket.

• Supplemental therapy includes the use of antibiotics and analgesics. The antibiotics commonly prescribed are amoxicillin, metronidazole, or a combination of both.
• Multiple periodontal abscess are a feature of diabetes mellitus and this must be considered before incision and drainage is attempted.
• The underlying periodontal pocket is then evaluated and appropriate therapy is instituted.

Periodontal Abscess Conclusion

• Abscesses of the periodontium are associated with pain and require immediate attention.
• It is necessary to differentiate between abscess of pulpal and periodontal origin so that proper treatment can be instituted at the earliest.