APICAL DISEASES
PULP NECROSIS >> APICAL PERIODONTITIS >> PERAPICAL ABSCESS >> PERIAPICAL GRANULOMA >> PERIAPICAL CYST

SYMPTOMATIC / ACUTE APICAL PERIODONTITIS
a. Intense pain, slight sensitivity-like feel on chewing.
b. TOP +ve
c. No radiographic changes seen
d. Vital AAP & non-vital AAP is differentiated only by pulp tests.

I. Vital AAP
o Post-restoration high point for 2 days
o TFO, bruxism, Pericoronitis
o Ortho PDL tear
o Abutment tooth in prostho FPD, RPD clasps, etc
o Treatment: simple occlusal adjustments only needed.

II. Non-Vital AAP
o Fully infected / necrosed pulp progression
o Over instrumentation in BMP ( piercing the PDL membranes beyond the apex >>> inflammation >>> post BMP pain
o GP extrusion post OBT pain

Nb: pulp vitality test…to know if endo treatment is req