Marian Diana, Constantin George Dumitru, Stana Ademir Horia, Lile Ioana Elena, Hajaj Tareq, Gag Stana Otilia Lavinia
Department of Dentistry, Faculty of Dentistry, "Vasile Goldiș" Western University of Arad, 94-96 Revolutiei Blvd., 310025 Arad, Romania.
Discipline of Clinical Practical Skills, Department I Nursing, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Diagnostics (Basel). 2025 Aug 29;15(17):2195. doi: 10.3390/diagnostics15172195.
Palatal abscesses of endodontic origin are rarer than buccal ones due to maxillary anatomy. Their clinical appearance may resemble that of other palatal illnesses, complicating diagnosis and treatment. Prevention of problems requires early detection and endodontic treatment. A 26-year-old female patient presented with a 2 cm diameter palatal abscess, significant pulsatile discomfort, fever, and enlargement of the anterior hard palate. Clinical examination showed grade 1 mobility of the central and lateral incisors, percussion discomfort, and negative pulp vitality in the case of the lateral incisor. Cone-beam computed tomography (CBCT) showed two radiolucent lesions: a posterior cystic lesion near the first molar and an anterior lesion near the upper left lateral incisor. Palatal cortical bone puncture and soft tissue extension indicated the abscess origin. According to the clinical and imaging evaluation, the upper left lateral incisor had a persistent periapical lesion of endodontic origin that a palatal abscess with cortical bone perforation had exacerbated.
由于上颌骨的解剖结构,牙髓源性腭部脓肿比颊部脓肿少见。其临床表现可能与其他腭部疾病相似,使诊断和治疗变得复杂。预防问题需要早期发现和进行牙髓治疗。一名26岁女性患者出现直径2厘米的腭部脓肿,伴有明显的搏动性不适、发热以及前硬腭肿大。临床检查显示中切牙和侧切牙有1级松动、叩诊不适,侧切牙牙髓活力阴性。锥形束计算机断层扫描(CBCT)显示两个透射性病变:一个位于第一磨牙附近的后部囊性病变和一个位于左上侧切牙附近的前部病变。腭部皮质骨穿刺及软组织延伸显示了脓肿的起源。根据临床和影像学评估,左上侧切牙存在牙髓源性根尖周持续性病变,伴有皮质骨穿孔的腭部脓肿使其病情加重。