📌 POINTS TO PONDER 

🔹A periodontal abscess is defined as suppurative lesion associated with periodontal breakdown and localized accumulation of pus within the gingival wall of a periodontal pocket.

📣 CLASSIFICATION :

1. Depending on the location of the lesion : 

🔺Periapical abscess 

🔺Periodontal abscess 

🔺Pericoronal abscess

2. Depending on the course of lesion : 

🔺 Acute abscess 

🔺Chronic abscess 

3. Depending on the tissue involved : 

🔺Gingival abscess 

🔺Periodontal abscess 

🔺 Pericoronal abscess

4. Depending on the cause of the acute infectious process, two types of periodontal abscess may occur : 

🔺Periodontitis-related abscess 

🔺 Non-periodontitis-related abscess

5. Depending on the number of abscess :

🔺 Single 

🔺Multiple

🔹Multiple periodontal abscesses are seen in diabetes mellitus. 

🔹Periodontitis associated abscess: It is the result of acute infection emerging from a biofilm present in a deepened periodontal pocket. 

🔹Post-scaling periodontal abscess: This type of abscess develops due to migration of small fragments of calculus into the deep and previously noninflamed portion of the periodontal tissues.

🔹Postsurgery periodontal abscess: Such type of abscess occurs due to incomplete removal of subgingival calculus or to the presence of foreign bodies in the  periodontal tissues, such as sutures, regenerative devices or periodontal pack. 

🔹Post-antibiotic periodontal abscess: In patients with advanced periodontitis administration of systemic antibiotics without subgingival debridement may lead to abscess formation.

⭐ Acute periodontal abscess is associated with: 

🔸Pain 

🔸Tenderness 

🔸Sensitivity to palpation 

🔸Suppuration upon gentle pressure 

⭐ Chronic abscess is associated with : 

🔸Sinus tract 

🔸Usually asymptomatic

📌 VIVA VOCE 

💡 Name the drugs of choice for periodontal abscess. 

Ans. Antibiotics-amoxicillin and metronidazole, are the drugs of choice for periodontal abscess. 

💡 What is Gingival abscess and its etiology? 

Ans. Gingival abscess is a localized painful, rapidly expanding lesion usually of sudden onset. It is generally limited to the marginal gingiva or interdental papilla. Etiology: Irritation from foreign substances, toothbrush bristle; apple core; lobster shell forcefully embedding into the gingiva. 

Q3. In which systemic disease multiple periodontal abscesses are seen? 

Ans. Diabetes mellitus. 

Q4. Why incomplete removal of subgingival plaque and calculus from the depths of pocket leads to abscess formation? 

Ans. Frequently after scaling there is a tightening of the gingival cuff which occludes pocket containing bacteria which leads to abscess formation. 

Q5. What is the nature of pain of periodontal abscess? 

Ans. In acute periodontal abscess, the pain is throbbing and radiating, whereas in chronic periodontal abscess, pain is dull and gnawing. 

Q6. What are the various complications of periodontal abscess? 

Ans. Tooth loss, cellulitis, subcutaneous infection, phlegmon and mediastinitis 

Q7. What is the nature of pain of periapical abscess? 

Ans. Severe and throbbing pain. 

Q8. Name microorganisms mainly present in periodontal abscesses? 

Ans. Gram-positive bacterial species mainly Peptostreptococcus micros and Actinomyces spp. 

Q9. What is the radiographic feature of periapical abscess? 

Ans. Apical radiolucency. 

Q10. What is the radiographic feature of chronic periodontal abscess? 

Ans. Lateral radiolucency with alveolar crest bone loss, angular bone defects and furcation involvement.

📌 MULTIPLE CHOICE QUESTIONS MCQs

💡Most abundant cells in the inflammatory exudates of an acute periodontal abscess are:

A. Lymphocytes

B. Neutrophils

C. Monocytes

D. Basophil

Answer :B

💡 A young adult shows non –fluctuant, tender and redswelling in the marginal gingiva:

A. Periapical abscess

B. Periodontal abscess

C. Periapical sinus

D. Gingival abscess

Answer : D