PHOTO READING STATION

30th November 2021

SPV ADVISOR:
dr. Irma Darinafitri, Sp.Rad(K)
dr. Farah Nurdiana, Sp.Rad(K)

dr. NEL – dr. ARI - dr. VEN

1
 CASE 1

Mr. A/ 41 DENTAL -
years old Panoramic

Radix
11520232 gangrene +
pulpitis
 CONCLUSION
• Periapical lucency 45,47 suspected ec periapical granuloma
• Dental caries 46
 CASE 2

Mrs. K/ 34 DENTAL -
years old Panoramic

dental
11521581 gangrene +
gingivitis
 CONCLUSION
• Dental periapical cyst 35
THANK YOU
Theory
ANATOMY
Pathology
Periapical disease is an inflammation of the root originating from a necrotic pulp

Periodontitis
apikalis

Periapical
granuloma
Various
Periapical
Diseases
Radicular cyst

Apical abscess
 Apical periodontitis
• Apical periodontitis: An inflammation of the periapical tissue, namely the periodontal ligament
(PDL) and the alveolar bone, causing a lesion in the apical region of the tooth.
 Radiolucency
of the pulp
(perforated
caries),
widening of
the PDL
A. Acute apical periodontitis
B. Periapical abscess
Abses Periapikal

• Ill-defined borders typically

suggest an acute process
(abscess), particularly
when accompanied by pain
• The presence of
inflammatory changes in
the bone marrow and
adjacent soft tissues
strongly suggests periapical
abscess,particularly when
associated with pain, fever,
and swelling
Periapikal Granuloma
 A small round or oval
lucency surrounding the
apex of the tooth with a
clear and indistinct border
 Radicular Cyst
Is an epithelial sac filled with fluid. Occurs at the site of the periapical granuloma.

periapical cyst is typically larger A periapical lucency larger than 200 mm3 on
radiographs is characterized as a cyst. Periapical cysts appear as round or
pear-shaped and well-defined radiolucent lesions with sclerotic borders
around the tooth root,
The various radiographic appearances of infection and inflammation in the apical tissues.
(A) Normal.
(B) Early apical change – widening of the radiolucent periodontal ligament space (acute apical periodontitis ) (arrowed).
(C) Early apical change – loss of the radiopaque lamina dura (early periapical abscess ) (arrowed).
(D) Extensive destructive acute inflammation – diffuse, ill-defined area of radiolucency at the apex (periapical abscess ).
(E) Longstanding chronic inflammation – well-defined area of radiolucency surrounded by dense sclerotic bone (periapical granuloma or radicular cyst ).
(F) Low-grade chronic inflammation – diffuse radiopaque area at the apex (sclerosing osteitis ).
Periapicals showing examples of inflammatory changes in the periapical tissues.
(A) Early apical change on showing widening of the periodontal ligament space and thinning of the lamina dura (acute apical periodontitis ) (arrowed).
(B) Same patient 6 months later – the area of bone destruction at the apex has increased considerably (open arrows) and there is now early apical change associated with the mesial root
(solid arrows).
(C) Large, diffuse area of bone destruction associated with and a smaller area associated with (black arrows) (periapical abscess ). shows evidence of a dens-in-dente (invaginated odontome)
(open white arrow).
(D) Reasonably well-defined area of bone destruction (arrowed) associated with (periapical abscess, granuloma or cyst ).
(E) Large area of bone destruction associated with (periapical abscess ). Note: with deciduous molars, bone destruction is typically intra-radicular (arrowed) rather than around the apices
CASE 1
CASE 2