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Pulpal and periapical diseases #neet2025 Dental caries involving the enamel dentine pulp supporting perodontal region and finally leading to either an abscess or a dental cyst cares in enamel is seen clinically as a discoloration or a catch is felt on the enamel surface on probing radiographic changes are not evident patient is also asymptomatic from the enamel if the carries proceed to the dentine patient will experience sever sens it on probing or on exposure to hot or cold due to Expossed dentinal tubules radiograph will show radiolucency involving enamel and dentine involvement of Pulp leading to inflammation is called as pulpitis palpus can occur as a seally of Progressive Dental carries iatrogenically due to placement of respiration accidental exposure of Pulp during cavity preparation trauma of the tooth leading to fracture of ground exposing the pulp and the pulp undergoing Cress which is called as a nonvital tooth clinically the signs and symptoms vary between acute and chronic pulpitis pain is acute continuous lancinating increasing on lying posture aggravated on heat and cold in acute pulpus radaph shows radi lucency involving the pulp with no periapical changes on the contrary the in chronic pulpitis clinically and radiographically there is a wide open carious lesion with dull intermittent pain once the inflammation and the infection crosses the AAL foramen and involves the surrounding periapical region it is called as periapical parodontitis in acute periapical parodontitis there is pain and probing tender on percussion of the tooth and palpation over the alular mucosa the tooth is slightly extruded from the the socket with an accompanying Regional lymp fitis radaph shows radiolucency involving the P along with the widening of perodontal liment space separation in the periapical region following a periapical parodontitis leads to accumulation of pus which is called a synapsis if there is a collection of p in the periapical region with a mild bulge over the alular mucosa it is periapical absis if it is a localized intraoral or an extraoral swelling it is a DA absis or a dent alular absis if it is a diffuse extraoral swelling it is called a cellulitis however radiograph of all the three are more or less similar with radiolucency involving the P widening of pontal liin space loss of lamura with or without a periapical radiolucent leion so far we have seen the acute SE of events if the vent of the organism is decreased and the immunity of the individual is high there could be a long-standing intraoral swelling with the sinus opening and a p star which is called as a chronic periapical absis a tooth with a white carious leion without any clinical signs and symptoms but radiographically showing well circumscribed periapical radiolucency of less than5 CM it is termed as a periapical granuloma long-standing periapical Gran Loma or a periapical absis could undergo transformation to a fluid fill pathological cavity which is called as a radicular cyst or a dental syy patient will have a slow expansile bony heart swelling in relation to the carious tooth or the nonvital tooth radiograph of the inval tooth will show a well circumscribed radial lucency measuring more than 1.5 CM surrounded by a radio op border to recapt youate this flowchart depicts the events that occurs in both the acute phase and in The Chronic phase following a pulpitis another possibility which can occur as a squally of palpal and periapical infection is the inflammation of the soft tissue components of the bone which is called as osteomylitis clinical features of osteomylitis includes intraoral or extraoral swelling severe bone pain mobility of the involed tooth draining sinuses parasthesia of the lips radiography it shows altered tracular pattern presence of sequestrum and motheaten appearance severe long-standing cases can lead to a pathological fracture treatment of ostomy includes broadspectrum antibiotics like clamy and penicillin followed by a surgical curou inflammation of the pericoronal tissue surrounding an erupting tooth is called as a pericoronitis the term pericoronitis is used synonymously with an erupting upper and lower third molar it usually occurs between 17 to 30 years of age patient will have an inflam bicoronal flap with food accumulation separation beneath the flap Regional lymphadenitis trismus or pass accumulation leading to an extraoral swelling which is called as a pericoronal abscess.