Periapical bone loss configuration in sub-Saudi patients afflicted with periapical abscesses: A 3D cone-beam computed tomography analysis

Abstract Introduction: Periradicular tissue can react to pulpal infection and necrosis by developing acute apical abscess (AAA) and/or chronic apical abscess (CAA). Both of these diseases display distinct clinical manifestations. The causes for the differing reactions remain unclear. The purpose of this study was to identify and analyze bone loss patterns in AAA and CAA within the Saudi subpopulation using cone-beam computed tomography (CBCT) imaging. Materials and Methods: The bony defect pattern of 84 CBCT scans for patients diagnosed to have AAA or CAA was assessed. The pattern of bone loss was recorded and assessed using a Chi-square test with the significance level set at P < 0.05 using SPSS software. Results: Out of 41 cases of AAA, 58.5% showed cortical fenestration, 19.5% showed corticated border, and 21.9% had fascial space infection. Out of 43 cases of CAA, 100% showed cortical fenestration, and 39.5% showed a corticated border. A significant difference ( P < 0.05) in cortical fenestration was seen in AAA compared to CAA. The highest occurrence of cortical fenestration in both AAA and CAA was found in the apical third area. Conclusions: Cortical fenestration is crucial for CAA development. Periradicular lesions lacking clear cortical fenestration can still induce AAA and fascial space involvement.