Etiology, Evaluation, and Treatment of Pericoronitis

Abstract

Pericoronitis is the medical term for an oral inflammatory condition brought on by an infection of the soft tissues in proximity to the crown of an immature tooth, including gingiva and dental follicle. It is believed that microbial entry into the follicular area begins the infection once the tooth's follicle establishes contact with the oral cavity. Pericoronitis's microbiota primarily consists of anaerobes. It is commonly accepted that the build-up of food particles close to the opercula and the occlusal injuries caused by the opposing tooth to the tissues present pericoronally both accelerate this process. Third molars that are oriented vertically are more frequently affected by pericoronitis than those that are oriented horizontally, which had a lower incidence of the condition. Pericoronitis may be more likely to develop in patients with impaired immune systems, such as those with uncontrolled diabetes or immunodeficiency diseases. Patients with acute pericoronitis exhibit regional erythema, edema, purulence, and intense throbbing pain radiating to the ear, throat, floor of the mouth, temporomandibular joint, and posterior submandibular region during intraoral physical examination. Advanced cases including those developing into cellulitis, Ludwig's angina and peritonsillar abscesses may necessitate immediate attention including surgical intervention. It is advised to utilize only localized treatment measures for patients with localized pain and edema involving the pericoronal tissues and are free of local or systemic symptoms. Antimicrobial therapy is advised if the patient is displaying regional or systemic manifestations in as well as local pain and edema. Surgery is advised only when there have been two or more incidences of pericoronitis or other pathological conditions which maybe potentially be complicated by the presence of partially erupted tooth.