Treatment of periodontal abscess

A periodontal abscess is a localized, purulent infection involving a greater dimension of the gum tissue, extending apically and adjacent to a periodontal pocket. Representing 6%–14% of all dental emergencies, the third-most common dental emergency is the periodontal abscess. Classification of periodontal abscesses depends on their course, location, number, and etiological criteria. The etiology of the periodontal abscess has been directly associated with periodontitis or sites without the previous existence of periodontitis. The presence of local and systemic factors makes the patient vulnerable to a periodontal abscess. It has been reported that microorganisms, primarily Gram-negative anaerobic rods, colonize the periodontal abscess. The usual clinical features of the periodontal abscess are the presence of generalized periodontal disease with pocket and bone loss, commonly related to the vital tooth, swollen and tender, sinus opening, or pus discharge through the periodontal pocket. The periodontal abscess should be ruled out from similar conditions and lesions as periapical abscess, gingival abscess, endo-perio lesion, perio-endo lesion, root fracture, and cracked tooth syndrome. The periodontal abscess diagnosis is based on the chief complaint and the history of the present illness, clinical findings, and investigations. Periodontal abscess management is a combination of three stages: immediate management, initial management, and definitive therapy. Early diagnosis and immediate treatment are crucially important for periodontal abscess management, to prevent the loss of an involved tooth. In this case report, all aspects of the periodontal abscess are described.