Lectura 20.pdf

Observations made by recognised clini cians the aim

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observations made by recognised clini- cians. The aim of the present review was to critically evaluate the available litera- ture regarding the periodontal abscess. This condition has clinical implications, not only diagnostic, but also, prognostic and therapeutic in everyday periodontal practice. Definition Odontogenic infections have various possible sources, including pulp ne- crosis, periodontal infections, perico- ronitis, trauma or surgery (Gill & Scul- ly 1990). Odontogenic or dental ab- scesses have been defined according to their infection source, as endodontal or periapical abscess, periodontal abscess and pericoronal abscess (Van Winkel- hoff et al. 1985). This nomenclature, however, is somehow confusing, since abscesses of pulp necrosis origin have been referred both as dental or peri- apical or dentoalveolar abscesses (Gill & Scully 1988). Acute dentoalve- olar abscesses have been termed as the most frequent infection in dentistry which demand emergency treatment (Lewis et al. 1990). However, in order to render appropriate therapy, it is im- portant to distinguish among abscesses of endodontal and periodontal origin (Trope et al. 1988). The periodontal ab- scess has been defined as a lesion with an expressed periodontal breakdown,
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378 Herrera et al. occurring during a limited period of time, and with easily detectable clinical symptoms (Hafström et al. 1994), with a localised accumulation of pus (De- Witt et al. 1985, Carranza 1990), located within the gingival wall of the periodontal pocket (Carranza 1990). Prevalence The prevalence of periodontal abscesses has been studied in emergency dental clinics (Galego-Feal et al. 1996, Ahl et al. 1986), in general dental clinics (Lewis et al. 1990), in periodontitis pa- tients before and during periodontal treatment (Gray et al. 1994), and in periodontitis patients during peri- odontal maintenance (Kaldahl et al. 1996, McLeod et al. 1997). The peri- odontal abscess often requires emer- gency treatment, therefore, its preva- lence can be calculated from registrars of emergency dental clinics. Among all emergency dental conditions, peri- odontal abscesses represent approxi- mately 8% of all dental emergencies in Spain (Galego-Feal et al. 1996), and up to 14% in USA (Ahl et al. 1986). Data from a questionnaire of over 600 general practices in UK reported that periodontal abscesses were diag- nosed in 6–7‰ of all patients treated in 1 month (Lewis et al. 1990). The peri- odontal abscess was the third most prevalent emergency infection, after acute dento-alveolar abscesses (14– 25‰) and pericoronitis (10–11‰). Gray et al. (1994) reviewed the records from an army dental clinic studying peri- odontitis and abscess formation. From 5467 records, 203 patients suffered from periodontitis (3.7%). Amongst these, periodontal abscesses were diagnosed in 57 patients (27.5%). Patients under- going active periodontal treatment had a prevalence of a periodontal abscess of 13.5%, while untreated patients showed a higher figure, 59.7%. McLeod et al.
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