Periapical lucency (TPL)

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  • Defining characteristics:
    A pathologic periapical lucency can appear as a widening of the periodontal ligament space in the apical region, loss of lamina dura at the apex, or diffuse/irregular radiolucency at the apex. It should be differentiated from a benign lucency such as a chevron lucency.  A radiolucent area has been detected at the apex of a tooth root and most likely represents a pathologic process

  • Common differential diagnoses:
    Abscess, cyst, inflammatory disease

  • Helpful additional data:
    Is there any swelling on the face?  Has the patient been reluctant to eat?  Is there a foul odor in the mouth?  Has there been excessive drooling or salivation

  • Commonly associated diagnostics:
    Consider CBC (r/o infection). Consider FeLV/FIV snap (feline), consider Parvo snap (feline)

  • Commonly associated treatments:
    Consider extracting the tooth or root canal therapy, analgesics, and antibiotic therapy

  • Commonly associated home care:
    Depending on the tooth removed, consider soft food for 1-2 weeks