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Head and Neck Imaging

Abscess, dental

purulent collection within the alveolar bone of the jaws. An acute periapical abscess most frequently arises when inflammatory degradation products from an infected tooth pulp penetrate the apical periodontal ligament and pass into the periapical tissues, causing tissue death and pus formation. Radiographically, widening of the periodontal ligament space is seen. If left untreated, it may progress to osteomyelitis, cellulitis of the surrounding tissues or soft tissue abscess, or it may create a fistula to the oral cavity or skin (see masticator space (VI:2), Fig. 1).

An acute dental abscess may evolve into a chronic dental abscess, if the infection is of low virulence or the resistance of the host is high. The radiographic appearance of a chronic dental abscess varies from a widened periodontal ligament space, to an appearance very similar to a periapical granuloma (see odontogenic cysts); sclerotic bone may be seen surrounding the radiolucent lesion.