Apical periodontitis - Diagnosis

Apical periodontitis, together with pulpitis, is the most common endodontic diagnosis. Unlike pulpitis, apical periodontitis usually is quite easy to diagnose: the pulp is necrotic and periapical (sometimes lateral) bone destruction can be seen in the radiograph.

About 80 - 90 % of teeth with apical periodontitis are free of symptoms. In a minority of cases symptoms such as pain, swelling, tenderness to percussion, abscess formation or a patent sinus tract are present. Fistulas usually track and open close to the apical area of the tooth, but sometimes the opening of the fistula (ie, sinus tract) may be found far from the involved tooth, even on the skin. Apical periodontitis always requires treatment, either root canal therapy or extraction.

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