The periodontal abscess (I). Clinical and microbiological findings

Background/aims: Little information is available regarding the diagnosis an d microbiology of periodontal abscesses. The aim of this descriptive clinic al and microbiological study was to provide more information in order to he lp in the characterisation of the periodontal abscess associated to periodo ntitis. Method: 29 consecutive patients with a periodontal abscess were studied by the assessment of clinical variables, including both subjective (gain, edem a, redness and swelling) and objective (bleeding on probing, suppuration, p robing pocket depth, tooth mobility and cervical lymphadenopathy) parameter s. Microbiological samples were taken for anaerobic microbiology and proces sed by means of culture. Systemic involvement was also studied through the analysis of blood and urine samples using conventional laboratory standards . Results: 62% of the abscesses affected untreated periodontitis patients, an d 69% were associated with a molar tooth. More than 75% of the abscesses ha d moderate-severe scores related to edema, redness and swelling, and 90% of the patients reported pain. Bleeding occurred in all abscesses, while supp uration on sampling was detected in 66%. Mean associated pocket depth was 7 .28 mm, and 79% of teeth presented some degree of mobility Cervical lymphad enopathy was seen in 10% of patients, while elevated leucocyte counts were observed in 31.6%. The absolute number of neutrophils was elevated in 42% o f the patients. High prevalences of putative periodontal pathogens were fou nd, including Fusobacterium nucleatum, Peptostreptococcus micros, Porphyrom onas gingivalis, Prevotella intermedia and Bacteroides forsythus. Conclusions: The periodontal abscess has clear clinical characteristics and is usually associated with severe periodontal destruction. This condition may cause systemic involvement and the lesion generally has a large bacteri al mass with a high prevalence of well-recognised periodontal pathogens.