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The periodontal abscess is the third most frequent dental emergency,
representing 7–14% of all dental emergencies. Numerous etiologies are
possible: exacerbations of the existing disease, post-therapy abscesses,
impaction of foreign objects, factors altering root morphology, etc. The
diagnosis should take into account the analysis of signs and symptoms.
The microflora related with periodontal abscesses doesn’t seem to be
specific and is dominated by gram-negative strict anaerobe, rods. A
tooth suffering from a periodontal abscess has a worse prognosis and is
at a higher risk of being lost. The treatment of the periodontal abscess
has been a challenge for many years. In the past, the periodontal
abscess in periodontal diseased teeth was the main reason for tooth
extraction. There is not enough scientific evidence in the literature to
provide a unique treatment regime for periodontal abscesses. Today,
three therapeutic approaches have been discussed, including: drainage
and debridement; systemic antibiotics and periodontal surgery procedures
applied in chronic phase of disease. The localization of the acute
periodontal abscess and the possibility of obtaining drainage are
essential considerations for successful treatment. Antibiotics should be
prescribed in case of general symptoms or if complications can be
suspected. Metronidazole, tetracyclines and clindamycin are drugs of
choice. Penicillin was traditionally the drug of choice and its
importance should not be neglected. Proper mechanical debridment and
local antiseptic irrigation should be carried out after resolution of
the acute inflammatory phase. In the case of chronic periodontal abscess
periodontal surgery procedures should be considered.
Key words:
periodontal abscess, drainage, antibiotics, periodontal surgery
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