A Pt present in severe pain. The periapical area over the involved tooth is inflamed and swollen.
The tooth is mobile and depressible in its socket with a diffused radiolucency. The diagnosis is:
- a. Acute apical periodontitis.
- b. Chronic apical periodontitis.
- c. Acute exacerbation of chronic apical periodontitis.
- d. Abscess.***
The most likely diagnosis for the presented symptoms is d. Abscess.
Here's why:
- Severe pain:
This is a characteristic symptom of an abscess, which is a localized collection of pus caused by an infection.
- Periapical inflammation and swelling:
This indicates inflammation of the tissues surrounding the tooth's apex, which is a common finding in an abscess.
- Mobile and depressible tooth:
This suggests that the infection has weakened the bone supporting the tooth, causing it to become loose.
- Diffused radiolucency:
This is a dark area on an x-ray that indicates bone loss around the tooth's apex, another characteristic sign of an abscess.
While the other options listed also involve inflammation and radiolucency around the tooth's apex, they lack the key symptom of an abscess: severe pain.
Here's a breakdown of the other options:
a. Acute apical periodontitis:
This is an inflammatory condition that affects the tissues surrounding the tooth's apex. While it can cause pain, it is usually not as severe as the pain associated with an abscess.
b. Chronic apical periodontitis:
This is a long-term inflammation of the tissues surrounding the tooth's apex. It can cause minimal or no pain, and there may not be significant swelling or mobility of the tooth.
c. Acute exacerbation of chronic apical periodontitis:
This is a sudden worsening of symptoms in a chronic case of apical periodontitis. It may involve an increase in pain and swelling, but it is still less likely to present with the severe pain described in the scenario.
Therefore, considering the presence of all the key symptoms, abscess is the most likely diagnosis for this patient.
