Dental abscess

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

Right-sided facial swelling over mandible; previous teeth abscesses in the past. Very poor dentition and pain over the right back mandibular molar.

Patient Data

Age: 28 years
Gender: Male

CT Neck

ct

There is a fluid collection eroding the alveolus of the first right inferior molar tooth and opening into the adjacent soft tissues at the external cortical face of the mandible and showing marginal enhancement. Enlarged right level II lymph node is likely reactive. There is poor dentition with multiple decays. 

Case Discussion

This case spots how well-defined a dental abscess margins are. This diagnosis could be achieved with a panoramic radiographic (OPG), but the referring doctor was concerned for extensive soft tissue extension based on the clinical presentation. The abscess bulges the gum soft tissues and was estimated with a volume of ~2 ml. 

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