Classification
Symptomatic Apical Periodontitis
Inflammation of periapical tissues with clinical symptoms; may or may not have radiographic changes
- • Percussion sensitivity (often exquisite)
- • Biting pain
- • Tooth feels 'long' or 'extruded'
- • May or may not have periapical radiolucency
Acute Apical Abscess
Purulent inflammation with pus collection at apex; spreading potential
- • Severe throbbing pain
- • Marked percussion sensitivity
- • Soft tissue swelling (fluctuant)
- • Fever and malaise possible
- • Radiolucency may or may not be present
Phoenix Abscess
Acute exacerbation of pre-existing chronic periapical lesion
- • Sudden acute symptoms on previously asymptomatic chronic lesion
- • Large periapical radiolucency already present
- • Rapid swelling development
- • Root canal treated teeth commonly affected
Traumatic Occlusal Periodontitis
AAP from occlusal trauma; vital pulp; no infection
- • Percussion sensitivity
- • Recently placed high restoration
- • Normal radiograph or slight widening
- • Resolves after occlusal adjustment