PHOENIX ABSCESS

This condition is an inflammatory reaction superimposed on an existing asymptomatic apical periodontitis.

CAUSES

• Noxious stimuli from a diseased pulp can cause acute inflammatory response.
• Irritation during root canal instrumentation may trigger this reaction.
• Influx of toxins from root canal.

SYMPTOMS

• Tender on palpation.
• Tooth gets elevated from its socket and becomes sensitive.
  
• Red and swollen mucosa over the radicular area.

DIAGNOSIS

• Radiograph shows a well defined periradicular lesion.
• Patient may give a history of trauma or postoperative pain that might have subsided by then.
• Lack of response to vitality tests indicates a necrotic pulp.

HISTOPATHOLOGY

• Areas of liquefaction with disintegrating PMN's
• Presence of macrophages, lymphocytes and plasma cells around the cellular debris.

TREATMENT

• Incision and drainage
• Antibiotics
• Needle aspiration 
• Trephination and decompression

PROGNOSIS

The prognosis of the tooth is good once the symptoms have subsided.