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erupting or partially erupted tooth with breach of the follicle (OR) Pericoronitis is a red
swelling of the tissues that surround the crown of a tooth that has only partially erupted
Synonyms :
1. Operculitis.
2. Folliculitis.
Pericoronitis was first reported by Gunnel in 1844 as painful affection. Previously in early
20 century it was known as Folliculitis, later KAY changed it as Pericoronitis. It can occur in
relation to any tooth but mandibular third molar is often most commonly involved. Pericoronitis
is the third common odontogenic infection and is also, one of the common cause for removal of
Impacted third molar. Generally ever teeth while erupting under normal conditions develop local
inflammation and tissue degeneration and this condition is termed as Supracoronitis.
Predisposing Factors :
Emotional Stress
Fatigue
Menstruation
Pathogenesis : Food debris and bacteria may become entrapped between the retromolar pad and
the tooth, resulting in acute infection and extreme pain. It usually occurs within 17 to 24 years of
age.
Chronic pericoronitis may be the etiology for the development of paradental cyst, an
inflammatory odentogenic cyst. The swelling ranges from soft to firm and progress to a knob
like mass of tissue that is very painful when you chew, open or close the mouth. It is a result of
bacterial infection caused either by Staphylococcal or Streptococcal bacteria or both.
Clinical Features :
Acute Pain :
Leucocytosis
Malaise
Increase in pulse
Halitosis.
Subacute Phase :
Jaw stiffness
Regional lymphadenopathy
Chronic Phase :
Dull pain and discomfort with unpleasent taste in the oral cavity
Halitosis
Histologic Features :
Increased vascularity
Differential diagnosis :
Pulpitis
Periodontitis
Trismus
Tonsilitis
Management :
Pericoronitis can spread rapidly and develops into cellulitis, so it is important to treat it as
soon as possible. General Management :
Appropriate antibiotic therapy should be given. Pencillins are the drug of choice,
Metronidazole can also be used as resonable alternative.
Local Treatment :
Antibiotics and analgesics should be prescribed which helps to relive the symptoms and
also to prevent the further spread of infection to the adjacent tissue spaces.
Patient is adviced not to apply heat externally since it promots the spread of infction on to
the facial skin.
Folliculitis, impacted teeth problem, impacted third molar, Operculitis, pain near the third molar,
swelling around the third molar.
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