Periapical granuloma

Periapical granuloma

· Sequalae of acute periapical periodontitis

· Ultimate resault of chronic periapical periodontitis-due to acute inflammation that has been inadequately drained and incompletely resolved.

· tooth is usually non vital

· First recognized as rounded area of radiolucency at the apex of the tooth-usually 5mm in diameter and well defined margins.

· Interprited as early cyst formation.

· Chronic periodontitis is typical chronic inflamation characterized by lymphocytes,plasma cells and macrophages.

· Infection is confined by inflammatory cells and granulation tissue surrounds the area.the granulation tissue grows into rounded mass forming granuloma.

· Osteoclasts resorb the bone to accomadate it.

· Spontaneous healing is absent due to tunnel of continuous infection in the root canal

· Variable degrees of proliferation of the epithelial rests of Malaassez in a periapical granuloma at the apex of the dead tooth are common.

Epithelial proliferation may be sufficient to lead ultimately to cyst formation