Periapical Abnormality

Periapical abnormality or disease refers to pathology around the apex of a tooth root or roots. This will be taken to infer the disease to be inflammatory, usually as a result of pulp necrosis. Many different conditions may present as radiolucencies or radiopacities in the periapical region of teeth. The most common periapical lesions are a direct result of infection of the root canal system but this can only be determined with a thorough history, an examination, clinical tests and radiographs. In order to accurately diagnose periapical diseases, it is important to understand the dynamics of the disease processes that occur within the pulp and periapical tissues, and also the interactions between the different disease entities. Signs and symptoms will vary at different stages of the disease process as will the treatment required. Periapical conditions must be diagnosed in conjunction with a diagnosis of the status of the pulp and the rootcanal of the affected tooth. The cause of the presenting conditions must also be assessed and then the appropriate treatment will become obvious. If such an approach is followed, then the treatment is more likely to have a favorable outcome.