• Journal of Oral Medicine and Pain
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• v.38 no.2
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• pp.143-147
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• 2013

Mouth opening limitation is generally caused by masticatory muscle or temporomandibular joint pain, disc dislocation without reduction, adhesion or ankylosis of the temporomandibular joint, and muscle contracture. But otorhinolaryngologic disease, neurologic and vascular disease, tumor, inflammation and infection may cause pain and mouth opening limitation which mimics temporomandibular disorders. Re-evaluation for possibilities of inflammation, infection and tumor should be in cases that do not show symptom improvement or appear with continuous aggravation despite of proper treatment. In this case, we report of medial pterygoid muscle pain and mouth opening limitation caused by periapical abscess of third molar spread to the pterygomandibular space.

• Restorative Dentistry and Endodontics
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• v.16 no.1
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• pp.236-244
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• 1991

Numerous studies have been focused on the immunologic aspects of inflamed pulp and periapical tissues. The purpose of this study was to evaluate levels of serum IgG and IgM in patients of acute pulpitis and acute apical abscess using Enzyme-Linked Immunosorbent Assay. Streptococcus mutans, Streptococcus sanguis, Bacteroides intermedius and Bacteroides gingivalis were grown for use as antigen and they were harvested by centrifugation. The patients were divided into 3 groups; patients of acute apical abecess, acute pulpitis and normal control 5 patients of each group were selected and their blood was obtained via intravenous puncture. Sera were prepared by centrifugation of each blood samples. Then serum antibodies were measured by modified ELISA. The following results were obtained; 1. Serum IgM levels of patients with acute pulpitis and acute apical abscess seemed to be slightly higher than those of normal control 2. Serum IgG levels of patients with acute apical abscess were slightly higher than those of normal control 3. Serum IgG and IgM levels of acute apical abscess patients and serum IgM levels of acute pulpitis were highest to Bacteroides gingivalis.

• Restorative Dentistry and Endodontics
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• v.25 no.4
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• pp.509-526
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• 2000

It is known that injuries to the dentin have a corresponding inflammatory effect on the pulp and these inflammatory effects frequently result in pulpal pathoses due to progressive degradation of pulpal connective tissue. It was supposed that the tissue degradation in different inflammatory process was controlled by proteinase activity and antiproteinase activity. Therefore, the purpose of this study was to examine the pulp and periapical pathoses in terms of the activities of proteinase and proteinase inhibitor, 37 pulpal tissues were divided by clinical diagnostic criteria into normal pulp, acute inflamed pulp, and chronic inflamed pulp, and then those groups were subdivided by histopathological findings into 5 pulpal pathoses groups, i.e. normal pulp (P1, n=8), chronic pulpitis with fibrotic change (P2, n=2), chronic pulpitis with dystrophic calcification (P3, n=11), chronic pulpitis with pulp abscess (P4, n=7), acute pulpitis with necrotic change (P5, n=4), 26 periapical tissues were also divided by ordinary histopathological findings into 3 periapical pathoses group, i.e., granuloma (A1, n=17), cyst (A2, n=2) and abscess (A3, n=7). The activities of proteinases (cathepsin G, MMP-3) and proteinase inhibitors (${\alpha}1$-AT, TIMP-1 and, SLPI) were evaluated by RT-PCR and immunohistochemical methods. The results were as follows. 1. Generally, the intensity of immunohistochemical staining of proteinases and proteinase inhibitors increased in P2 and P5 groups compared to P1 group. 2. The immunohistochemical stain of proteinases and proteinase inhibitors was intensely detected in P2 group, showing low inflammatory reaction and low tissue degradation, but it was reduced in P3 and P4 groups, showing severe tissue degradation. 3. The distribution of proteinases and proteinase inhibitors in pulpal pathoses was consistently presented by immunohistochemical staining, while the expression of proteinase and/or proteinase inhibitors mRNAs in pulpal pathoses was occasionally detected by RT-PCR methods. 4. RT-PCR of proteinase and proteinase inhibitors was usually positive in P2, showing rare tissue degradation, but it was almost negative in P3 and P4, showing severe tissue degradation. 5. We presume that the reason why the level of proteinase and proteinase inhibitors was so sparse in RT-PCR method is due to the abrupt decrease of mRNA synthesis or degradation of synthesized mRNA of proteinase and/or proteinase inhibitors depend on the inflammatory reaction and/or on the degradation of pulp tissues(P3, P4). 6. Pulpal pathoses groups showed significant lower RT-PCR detection of proteinases and proteinase inhibitors than the periapical pathoses group(p<0.05), and there is no significant difference among the periapical pathoses groups(p>0.05).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.2
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• pp.174-178
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• 2006

Brain abscess is a rare, extremely aggressive, life-threatening infection. It may occur following : infection of contiguous structure, hematogenous spread, or cranial trauma/surgery. Dental pathology and/or treatment have been linked to a small number of brain abscesses as possible source of infection. 50-year-old male patient was presented with a brain abscess caused by Streptococcus viridans. In the case presented, the significant oral findings were chronic periapical and periodontal infection due to root remnant of lower right 3rd molar. A case history and brief literature review of brain abscess related odontogenic infection was presented after successful treatment with antibiotics and craniotomy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.2
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• pp.135-140
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• 2021

Since the first report of a nasal septal abscess (NSA) from a dental origin (1920), six articles have been published in the English literature to date. The most common cause of NSA is an infection of the nasal septal hematoma after trauma. This is a report of an uncommon cause of NSA with a dental origin. A PubMed search performed regardless of year and country using the terms ("nasal septal abscess") OR ("nasal septum abscess") initially yielded 229 articles. After screening, seven articles (eight patients) were selected. Addition of two related articles produced a total of nine articles (10 patients) to be included. The age of the included patients ranged from 7 to 69 years (mean, 32.82 years; standard deviation, ±23.86 years). The sex composition was as followed: males (n=7; 63.6%), females (n=4; 36.4%). Dental histories were various: periapical lesions, caries, extraction, endodontic therapy, and cystic lesions. The maxillary incisor dominated as the tooth of origin. Early diagnosis and treatment of NSAs are important to avoid not only facial deformity, but also severe complications (e.g., intracranial infection). If NSA is suspected in patients without facial trauma, the possibility of a dental origin, especially from the maxillary incisor area, should be considered.

• Journal of Veterinary Clinics
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• v.25 no.6
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• pp.533-536
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• 2008

The patient, two-year-old female Maltese dog with recurrent facial cellulitis below the left eye was referred for further investigation to the Veterinary Medical Center, Chungbuk National University. There were no visible dental problems, but extraoral radiographs showed periapical bone lyses on the left maxillary third and fourth premolars. Affected teeth were extracted by closed extraction and communication between some extraction sockets and the facial lesion was confirmed using a periodontal explorer. The facial lesion was treated as open wound. During a followup of 3 weeks, the extraction site and lesion reveal normal healing. In this case, the dog was young and had no clinically significant dental problems, like gingivitis or periodontal pocket. This case suggests that the carnassial abscess occurred secondary to cellulitis.

• Restorative Dentistry and Endodontics
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• v.11 no.1
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• pp.63-75
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• 1985

This study was designed to identify lymphocytes and to compare the lymphocyte distribution in endoodontically treated periapical lesions with that in endodontically untreated periapical lesions by way of immunohistochemical staining. Twenty-one human dental periapical lesions were obtained, frozened, serially sectioned to $4-5{\mu}$, and stained using the three-stage indirect immunoperoxidase technique and monoclonal antibodies for detecting the presence of B,T lymphocyte and T suppressor cell. Following results were obtained; 1. All of the examined periapical lesions had positive staining for B,T lymphocyte and T suppressor cell. 2. The concentration of T lymphocytes in 18 lesions diagnosed as periapical cyst and granuloma in both groups was greater than that of B lymphocytes and 2 periapical lesions identified as abscess in treated lesions had more positive B lymphocytes than positive T lymphocytes. 3. The average numbers of T,B lymphocytes and T suppressor cells in Endodontically treated lesions were lower than those of untreated lesions, but no statistically significant difference was noted. 4. When the distribution ratios of T lymphocytes to B lymphocytes and T suppressor cells to T lymphocytes were compared in Endodontically treated lesions by the histological aspects of the lesions and at the intervals of the duration after Endodontic treatment, a statistically significant change was not found. 5. The mean values of T lymphocytes, B lymphocytes and T suppressor cells in Endodontically treated lesions were markedly decreased in the specimens obtained at 3 month after Endodontic treatment, but no statistically significant difference was found.

• Restorative Dentistry and Endodontics
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• v.42 no.2
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• pp.111-117
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• 2017

Objectives: Periapical lesions, including periapical cyst (PC), periapical granuloma (PG), and periapical abscess (PA), are frequently affected by chemical/physical damage during root canal treatment or severe bacterial infection, and thus, the differential diagnosis of periapical lesions may be difficult due to the presence of severe inflammatory reaction. The aim of this study was to make differential diagnosis among PC, PG, and PA under polarizing microscope. Materials and Methods: The collagen birefringence patterns of 319 cases of PC (n = 122), PG (n = 158), and PA (n = 39) obtained using a polarizing microscope were compared. In addition, 6 cases of periodontal fibroma (PF) were used as positive controls. Results: Collagen birefringence was condensed with a thick, linear band-like pattern in PC, but was short and irregularly scattered in PG, and scarce or absent in PA. PF showed intense collagen birefringence with a short, palisading pattern but no continuous band-like pattern. The linear band-like birefringence in PC was ascribed to pre-existing expansile tensile stress of the cyst wall. Conclusions: In this study all PCs (n = 122) were distinguishable from PGs and PAs by their characteristic birefringence, despite the absence of lining epithelium (n = 20). Therefore, the authors suggest that the presence of linear band-like collagen birefringence of the cyst wall aids the diagnostic differentiation of PC from PG and PA.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.4
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• pp.421-426
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• 2011

Most of the intraoral infections origin in odontogenic infection. Odontogenic infection spreads out along the least resistant path. In maxilla, the thickness between periapical area and cortical bone is narrower on the buccal side than the palatal side. So infection usually spreads out along the buccal side rather than the palatal side. The failure of root canal treatment more frequently occurs on the buccal root compared to the palatal root. So the palatal abscess is rarer than the buccal abscess. It is difficult to differential diagnosis palatal abscess from salivary gland tumors, benign neural tumors and cysts on the palate. Therefore, when the palatal swelling is observed in children, you need to prevent the systemic spread of infection by early diagnosis of the odontogenic palatal abscess. In these cases, the patient who complained of the pain in deciduous teeth and the palatal swelling was diagnosed with odontogenic palatal abscess. The patient was treated with extraction and antibiotic medication. The palatal abscess was resolved, and we report after treatments.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.1
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• pp.180-186
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• 1990

This is a case report of first branchial cleft cyst in 56 year old male patient, which was tentatively diagnosed as acute right submandibular abscess resulted from the periapical lesion of the lower right second molar. The results are as follows, 1. The accompanying ipsilateral inflammatory swelling resulted from the periapical lesion of lower right second molar tooth makes the diagnosis difficult. 2. The onset of this case was very late in comparison to the mean discovering age of branchial cleft cysts. 3. The plain radiography using contrast media is helpful for the diagnosis of cystic lesions within soft tissues. 4. This case in a first branchial cleft cyst(Type I) which occurs less than 1% of all branchial cleft anomalies.