Fogorvosi szemle, 2004 (97. évfolyam, 1-6. szám)
2004-08-01 / 4. szám
155 FOGORVOSI SZEMLE ■ 97. évf. 4. sz. 2004. 32. Sanz M, Herrera D, van Winkelhoff AJ: The periodontal abscess. In: Lindhe J, Karring T, Lang NP(ed.): Clinical Periodontology and Implant Dentistry. 4lh ed. Blackwell-Munksgaard, Oxford, 2003; 260-268. 33. Suzuki JB, Delisle AL: Pulmonary actinomycosis of periodontal origin. J. Periodontol. 1984; 55: 581-584. 34. Topoll HH, Lange DE, Müller RF: Multiple periodontal abscesses after systemic antibiotic therapy. J. Clin. Periodontol., 1990; 17; 268-272. 35. Torabinejad M, Rick GM: Squamous cell carcinoma of the gingiva. JADA. 1980; 109:870-872. 36. VÁLYi P, Gorzó I: Short-term and long-term effect of subgingival curettage on patient with acute periodontal abscess. J. Dent. Res. 2003; 82: B226. (Abstract 1721) 37. Waerhaug J: Healing of the dento-epithelial junction following subgingival plaque control II: As observed on extracted teeth. J. Periodontol. 1978; 49: 119-134. 38. Yusof VZ, Ghazali MN: Multiple external root resorption. JADA. 1980; 118:453-455. Valyi P, Gorzó I: Periodontal abscess: etiology, diagnosis and treatment The periodontal abscess is an acute destructive process in the periodontium resulting in localized collections of pus communicating with the oral cavity through the gingival sulcus or other periodontal sites and not arising from the tooth pulp. The prevalence of periodontal abscess is relatively high and it affects the prognosis of the tooth. Periodontal abscesses can develop on the base of persisting periodontitis but can also occur in the absence of periodontitis. The cause of the development of periodontal abscess originating from chronic periodontitis is the marginal closure of a periodontal pocket, or the pocket lumen might be too tight to drain the increased suppuration due to changes in the composition of subgingival microflora, alteration of bacterial virulence or host defenses. Diagnosis of a periodontal abscess is based on medical and dental history as well as oral examination (pocket depth, swelling, suppuration, mobility, sensibility of the tooth). The most prevalent group of bacteria: P. gingivalis, P. intermedia, B. forsythus, F. nucleatum and P. micros. Previous studies have suggested that the complete therapy of the periodontitis patients with acute periodontal abscess has to do in two stages: the first stage is the management of acute lesions, then the second stage is the appropriate comprehensive treatment of the original and/or residual lesions. 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. Some authors recommend the incision or to establish drainage and irrigation, or a flap surgery, or even extraction of hopeless teeth. We recommend the use of systemic antibiotics as a preventive measure of systemic disease or in case of systemic symptoms. Keywords: periodontal abscess, definition, prevalence, etiology, diagnosis, differential diagnosis, microbiology, treatment
