Diagnosis and Classification - Radiographic features vary depending on the time course of the lesion - Early lesions may not show radiographic changes, relying on clinical symptoms for diagnosis - Chronic lesions may show lytic or sclerotic changes, or both - Diagnosis is based on the presence of clinical symptoms and radiographic findings - Other diagnostic tools such as vitality tests and cone-beam computed tomography (CBCT) may be used - Periapical periodontitis can be classified as acute/symptomatic or chronic/asymptomatic - Acute periapical periodontitis is characterised by throbbing pain and inflammation within the periodontal ligament - Chronic periapical periodontitis is typically asymptomatic - Other names for periapical periodontitis include apical periodontitis and periradicular periodontitis - Classification is important for determining appropriate treatment strategies

Related Lesions - Periapical periodontitis can give rise to periapical abscesses, periapical granulomas, and cysts - Periapical granuloma is a mass of chronically inflamed granulation tissue at the apex of a nonvital tooth - Periapical granuloma may lack granulomatous inflammation, but the term is widely accepted - Other related lesions include radicular cysts and apical periodontal cysts - These lesions may require different treatment approaches compared to periapical periodontitis

Treatment - Treatment options for periapical periodontitis include antibiotic therapy, root canal therapy, and extraction - Antibiotic therapy is usually used in the short term and may be augmented by chewing gum - Root canal therapy involves removing the infected pulp and filling the root canal - Extraction may be necessary if the tooth cannot be saved or if there are complications - The choice of treatment depends on factors such as the severity of the infection and the patient's overall oral health

Epidemiology - Periapical periodontitis is a common condition - Prevalence varies according to age group, with higher rates in older individuals - Epidemiologic data is mainly generated in European countries, particularly Scandinavia - The total number of root canal treatments performed does not accurately reflect the frequency of periapical periodontitis - Root canal treatment may be performed for reasons other than periapical periodontitis, leading to potential underestimation of its prevalence

Miscellaneous - Other names for periapical periodontitis include apical periodontitis and periradicular periodontitis - Other diagnostic tools such as vitality tests and cone-beam computed tomography (CBCT) may be used - The severity of the infection and the patient's overall oral health are factors in determining treatment options