periapikale

Periapikale is a dental term used to describe the region around the apex of a tooth root. The periapical area includes the apical portion of the root, the surrounding periodontal ligament, the adjacent alveolar bone, and the apical cementum. In clinical practice, the term is commonly used when referring to diseases or processes that affect these tissues.

Periapical diseases typically originate from pulpal infection or necrosis, spreading to the periapical tissues. The main conditions include periapical abscess, periapical granuloma, and periapical cyst. These lesions may cause pain, swelling, tenderness to percussion, and sometimes facial swelling or systemic symptoms if infection spreads. Radiographic examination, often with periapical or cone-beam computed tomography imaging, reveals radiolucent areas around the tooth apex and changes in the lamina dura.

Diagnosis combines clinical examination, pulp vitality testing, and imaging. Treatment focuses on removing the infection source and promoting healing of the periapical tissues. The most common approach is endodontic therapy (root canal treatment) followed by restoration of the tooth. If nonsurgical treatment fails or is not feasible, surgical options such as apicoectomy (apical surgery) or extraction may be considered. Antibiotics are generally reserved for spreading infection or systemic involvement.

Prognosis varies with lesion type, size, and timely management. Many periapical lesions heal after effective root canal therapy, provided the tooth is adequately restored and future infection is prevented. Prevention emphasizes good oral hygiene, early management of caries and trauma, and prompt treatment of dental infections.