Clinical Approach In Acute Apical Abscessed Teeth: 3 Case Reports
Zeynep Yağmur Özdemir Tekin1, Salihanur Sarı1, Gülsen Kiraz1, Arzu Kaya Mumcu1
1 Kutahya Health Science University, Faculty Of Dentistry
Aim: Acute apical abscess is the most common form of dental abscess and results from infection
of the root canal. It is usually localized intraorally but can sometimes cause serious
complications. This case report aims to present the diagnostic and treatment approaches of
different teeth with intraoral and extraoral abscesses. Case Description 1: A 21-week pregnant
patient who applied to our clinic with complaints of pain and swelling was observed to have an
abscess in the right buccal region during clinical examination, and sensitivity to percussion was
observed in tooth number 46. Acute apical abscess was diagnosed, and root canal treatment was
applied. After the intraoral drainage was stopped, calcium hydroxide was applied. Two weeks
later, the root canals were obturated with bioceramic-based root canal sealer and adhesive
restoration was completed. Case Description 2: A systemically healthy 27-year-old female
patient applied to our clinic with complaints of severe pain and swelling. According to
radiographic examinations; a periapical lesion was observed in tooth number 26, and according
to clinical examination; sensitivity to percussion and swelling in the palatal region were
observed. Root canal treatment was started for the tooth diagnosed with acute apical abscess
and intraoral incision was made after drainage could not be provided. Two weeks after the
calcium hydroxide was applied, the canal filling was completed and adhesive restoration was
performed. Case Description 3: A systemically healthy 49-year-old female patient applied to
our clinic with complaints of severe pain, swelling and paresthesia. Sensitivity to percussion
and swelling in the buccal region were observed in tooth number 45. Root canal treatment was
applied and after no drainage was observed, a drain was placed by making an intraoral incision.
After applying calcium hydroxide, root canals were filled with bioceramic-based root canal
sealer and adhesive restorations were applied. The patient was prescribed vitamin B12 due to
paresthesia symptoms. Results: In the 1st, 3rd and 6th month controls, it was observed that the
teeth were asymptomatic in all three cases. In the third patient, it was observed that the
paresthesia in the relevant region disappeared in the 6-month controls. Conclusion: In addition
to endodontic approaches, surgical methods can also be used in the treatment of patients
diagnosed with acute apical abscess. Successful treatment will eliminate the patient's symptoms
and prevent serious complications.
Keywords: Acute apical abscess; Palatal abscess; Endodontic treatment