There are three types: O Gingival abscess O Pericoronal abscess O Periodontal abscess. 5. O Among all the abscesses of the periodontium. “Regional” enlargements refer to involvement of gingiva around three or more . Histopathological examination of gingival/periodontal/pericoronal abscess may. The periodontal abscess is an acute destructive process in the periodontium the gingival sulcus or other periodontal sites and not arising from the tooth pulp.
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Primary oral tuberculous lesions are very rare, but when zbses occur they are usually seen in younger age. Maroteaux-Lamy syndrome[ 27 ]. Anderson-Fabry disease[ 2930 ]. The most serious condition associated with gingival enlargement in this category would be acute myeloid leukemia.
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When infected secondarily, there is increase in the size of existing enlargement and adds characteristic features of inflammatory enlargement. Contemporary oral and maxillofacial surgery 5th ed. Since the management of a periodontal abscess is different from a periapical abscess, this differentiation is important to make see Dental abscess Diagnostic approach For example, root canal therapy is unnecessary and has no impact on pain in a periodontal abscess.
Klippel-Trenaunay syndrome[ 33 ]. The main symptom is pain, which often suddenly appears, and is made worse by gingivw on the involved tooth, which may feel raised and prominent in the bite. The management of acute lesions includes establishing drainage via pocket lumen, subgingival scaling and root planing, curettage of the lining pocket epithelia and seriously inflamed connective tissue, compressing pocket wall to underlying tooth and periodontal support, and maintaining tissue contact.
Usual allergens known to be associated with this lesion could be, e. Systemic immune factors such as diabetes can predispose a person to the formation of periodontal gingifa.
Amelogenesis imperfecta associated with dental follicular-like hamartomas and generalised gingival enlargement. World J Clin Cases.
Before pus has formed, the lesion will not be fluctuant, and there will be no purulent discharge. Typical multiple interproximal enlargements in a pregnant patient.
An expeditious diagnosis can be made by a simple full blood count. Cross syndrome[ 23 ]. The prevalence of giniva abscess is relatively high and it affects the prognosis of the tooth.
How Do I Manage a Patient with Periodontal Abscess? | jcda
Apart from gingival enlargement other associated features could be oral ulceration, spontaneous gingival bleeding, petechiae, mucosal pallor, herpetic infections and candidiasis. Differential diagnosis of gingival enlargement requires thorough dental and medical history, careful evaluation of the type, nature and extent of enlargement and identification of etiologic or predisposing factors.
Presents in adults as smooth surfaced mass, often ulcerated and grows from beneath the gingival margin. Jones syndrome[ 21 ]. Histopathology and electron and immunofluorescence microscopy of gingivitis granulomatosa associated with glossitis and cheilitis in a case of Anderson-Fabry disease.
There still could be some lesions which may present in an unusual manner and make the diagnosis challenging. Hurler syndrome[ 26 ]. Report of a rare case.
Among these, diagnostic points are discussed for the more commonly occurring lesions and the very rare and unusual presentation are listed as per the category to which they belong. It usually ahses with the eruption of the primary or permanent dentition.
The enlargement may reduce spontaneously after the delivery, gijgiva complete elimination may require the removal of all local irritants and additional surgical intervention of any fibrotic remnants. Patients usually complain about burning sensation on eating hot and spicy food. Gingival enlargement unveiling sarcoidosis: Furthermore, primary tuberculosis manifesting solely as gingival enlargement is extremely rare which can be diagnosed based on history of fever, weakness, loss of appetite and weight loss[ 47 ].
Food packing may also obstruct a periodontal pocket. There are no specific tests for sarcoidosis. Cowden syndrome[ 31 ]. Pertinent management gingivq on precisely diagnosing the origin of enlargement. Oral lesions as gigiva first clinical sign of microscopic polyangiitis: There may be systemic upset, with an gingivw of malaise and pyrexia. Malignant tumors could be squamous cell carcinoma or melanoma.
A customized decision tree is designed, which will help clinicians to keep a broad view when formulating a differential diagnosis of localized isolated, discrete, regional or generalized gingival enlargement and arrive at a particular diagnosis is an easy and systematic manner. A diagnostic feature of this type of enlargement would be presence of significant enlargement in maxillary and mandibular anterior regions and no involvement of posteriors. D ICD –