patient have during recurrent normal check he had (diffirent sense) on percussion on his tooth and x_ray widening lamina dura apical 3rd?
- A- chronic apical priodontitis.
- B- acute apical periodontitis.
- C- chronic abcess.
Based on the information provided, the most likely answer is: A. Chronic apical periodontitis
Here's why:
- Symptoms:
The patient experiencing "different sense" on percussion (tapping) of the tooth suggests sensitivity or discomfort. This is a common symptom of apical periodontitis, both chronic and acute.
- X-ray findings:
The widening of the lamina dura around the apex of the third tooth is a classic radiographic sign of chronic apical periodontitis. The lamina dura is a thin, hard layer of bone surrounding the tooth root, and its widening indicates inflammation and bone loss in the area.
Other Options:
Here's a breakdown of the other options and why they are less likely:
B. Acute apical periodontitis:
This is a more severe form of apical periodontitis with sudden and intense pain, often accompanied by swelling, fever, and malaise. While the X-ray finding of widened lamina dura can be present in both acute and chronic cases, the lack of mention of other acute symptoms makes chronic apical periodontitis more likely.
C. Chronic abscess:
This is a localized collection of pus that forms as a result of chronic inflammation. While it can occur in association with apical periodontitis, it wouldn't necessarily be indicated by just the widening of the lamina dura. Additional symptoms like swelling, drainage, or bad taste in the mouth would be more suggestive of an abscess.
Therefore, based on the available information, chronic apical periodontitis is the most likely diagnosis for this patient.
Additional Details:
Here are some additional details that could help confirm the diagnosis:
- History of previous dental work on the tooth:
Chronic apical periodontitis often develops after a deep filling, trauma, or other procedures that damage the pulp (inner part) of the tooth.
- Other X-ray findings:
Additional radiographic signs of chronic apical periodontitis may include loss of bone around the apex, radiolucency (darker area) at the tip of the root, or thickening of the periodontal ligament (space around the tooth).
- Pulp testing:
Testing the tooth's response to heat or cold can help determine if the pulp is still alive. A dead pulp is a strong indicator of apical periodontitis.
It's important to note that I am not a medical professional and this information should not be taken as a substitute for professional diagnosis and treatment. If you have any concerns about your dental health, please consult with a dentist.
