{"id":17056,"date":"2021-10-19T11:11:46","date_gmt":"2021-10-19T09:11:46","guid":{"rendered":"https:\/\/www.bmscience.net\/blog\/?p=17056"},"modified":"2024-01-22T21:37:08","modified_gmt":"2024-01-22T20:37:08","slug":"la-parodontite-apicale","status":"publish","type":"post","link":"https:\/\/bmscience.net\/blog\/la-parodontite-apicale\/","title":{"rendered":"La parodontite apicale"},"content":{"rendered":"<div class=\"wp-block-image\">\n<figure class=\"alignright size-large is-resized\"><a href=\"https:\/\/amzn.to\/42a8n0H\" target=\"_blank\" rel=\"noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"707\" height=\"1024\" src=\"https:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/81Afos-9tgL._SL1500_-707x1024.jpg\" alt=\"\" class=\"wp-image-18555\" style=\"width:141px;height:auto\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/81Afos-9tgL._SL1500_-707x1024.jpg 707w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/81Afos-9tgL._SL1500_-207x300.jpg 207w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/81Afos-9tgL._SL1500_-768x1113.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/81Afos-9tgL._SL1500_-1024x1484.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2024\/01\/81Afos-9tgL._SL1500_.jpg 1035w\" sizes=\"auto, (max-width: 707px) 100vw, 707px\" \/><\/a><figcaption class=\"wp-element-caption\"><strong><a href=\"https:\/\/amzn.to\/42a8n0H\" target=\"_blank\" rel=\"noreferrer noopener\">Acquista ora<\/a><\/strong><\/figcaption><\/figure>\n<\/div>\n\n\n<p>La <strong>parodontite apicale<\/strong> \u00e8 un processo infiammatorio del parodonto che circonda la porzione terminale della radice del dente, quindi il parodonto apicale. Pu\u00f2 essere <u>acuta e cronica<\/u>, e pu\u00f2 avere diverse eziopatogenesi:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>evoluzione della necrosi pulpare del dente;<\/li>\n\n\n\n<li>iatrogena, quando la terapia canalare va oltre l\u2019apice;<\/li>\n\n\n\n<li>processo infiammatorio del parodonto oltre l\u2019apice;<\/li>\n\n\n\n<li>da processo traumatico (tipico degli elettricisti e delle sarte che &#8220;strappavano&#8221; i fili con gli incisivi provocando continui microtraumi);<\/li>\n\n\n\n<li>per via ematica.<\/li>\n<\/ul>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><img loading=\"lazy\" decoding=\"async\" width=\"207\" height=\"271\" src=\"http:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2021\/10\/Parodontite-apicale.jpg\" alt=\"\" class=\"wp-image-17057\"\/><\/figure>\n<\/div>\n\n\n<p>La <strong>parodontite <u>apicale acuta sierosa<\/u><\/strong> presenta i tipici segni dell\u2019infiammazione sierosa a livello apicale.<br>Si ha iperemia vasale attiva e successivamente passiva, formazione di microtrombi, fuoriuscita di essudato dai vasi e lieve infiltrazione leucocitaria. Tutto ci\u00f2 \u00e8 associato con dolore localizzato, non sensibile allo sbalzo termico.<br>Il paziente riferisce una sensazione di <strong>dolore<\/strong> localizzato e \u201cdente allungato\u201d specie al mattino, perch\u00e9 l\u2019infiltrato infiammatorio spinge il dente verso l\u2019alto (o verso il basso, nel caso dell&#8217;arcata superiore) che si solleva di 2-3 mm dall\u2019osso alveolare. Anche con la pressione verticale del dente sul focolaio infiammatorio durante la masticazione si sente dolore.<\/p>\n\n\n\n<p>La parodontite apicale acuta sierosa, senza opportuna terapia, pu\u00f2 evolvere nella <strong><u>forma purulenta<\/u><\/strong> con un mutamento, quindi, delle caratteristiche istopatologiche del parodonto apicale. \u00c8 presente una sintomatologia accentuata, con dolore pi\u00f9 intenso e pulsante.<\/p>\n\n\n<div id=\"bmscience2623025177\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><a href=\"https:\/\/amzn.to\/45Jgkha\" target=\"_blank\" aria-label=\"Version 1.0.0\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/d3f60ba2-e5d1-4c20-807b-fc7463b5ddff.jpg\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/d3f60ba2-e5d1-4c20-807b-fc7463b5ddff.jpg 1940w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/d3f60ba2-e5d1-4c20-807b-fc7463b5ddff-300x77.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/d3f60ba2-e5d1-4c20-807b-fc7463b5ddff-1024x264.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/d3f60ba2-e5d1-4c20-807b-fc7463b5ddff-768x198.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/d3f60ba2-e5d1-4c20-807b-fc7463b5ddff-1536x396.jpg 1536w\" sizes=\"auto, (max-width: 1940px) 100vw, 1940px\" width=\"1940\" height=\"500\"  style=\"display: inline-block;\" \/><\/a><\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"alignright is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"435\" height=\"280\" src=\"http:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2021\/10\/Ascesso.jpg\" alt=\"\" class=\"wp-image-17058\" style=\"width:274px;height:auto\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2021\/10\/Ascesso.jpg 435w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2021\/10\/Ascesso-300x193.jpg 300w\" sizes=\"auto, (max-width: 435px) 100vw, 435px\" \/><\/figure>\n<\/div>\n\n\n<p>La parodontite apicale acuta pu\u00f2:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>guarire (spontaneamente o con terapia);<\/li>\n\n\n\n<li>formare un <strong>ascesso<\/strong> (se coinvolge il periostio);<\/li>\n\n\n\n<li>dare <strong>osteomielite<\/strong>, se \u00e8 coinvolta la compagine ossea;<\/li>\n\n\n\n<li>dare <strong>parodontite profonda<\/strong> (distruzione del parodonto) con mobilizzazione del dente;<\/li>\n\n\n\n<li>evolvere in <strong>parodontite <em><u>apicale cronica <\/u><\/em><\/strong><strong><em><u>(granuloma apicale<\/u><\/em><\/strong><strong><em><u>).<\/u><\/em><\/strong> All\u2019apice del dente si forma <strong>tessuto di granulazione<\/strong>, che pu\u00f2 guarire (raramente), riacutizzare, o pu\u00f2 evolvere in una <strong>cisti radicolare<\/strong>. Il granuloma apicale pu\u00f2 insorgere anche <em>ab initio<\/em>. Non si ha dolore, tranne che alla pressione sulla zona apicale e non si ha la sensazione di &#8220;dente allungato&#8221;.<br>Se il granuloma \u00e8 presente su due denti, per sapere quale ha causato il processo e sapere su quale agire bisogna vedere quale \u00e8 in necrosi e controllare la vitalit\u00e0 degli stessi. Alla radiografia si vede radiotrasparenza apicalmente.<br>La <u>terapia<\/u> della parodontite apicale cronica \u00e8 di tre tipi: <strong>endodonzia<\/strong>, <strong>apicectomia pi\u00f9 endodonzia<\/strong> (quando non si riesce a fare un\u2019otturazione e una terapia endodontica tradizionale), o <strong>estrazione<\/strong>.<\/li>\n<\/ul>\n\n\n<div class=\"wp-block-image wp-image-17059 size-full\">\n<figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"576\" height=\"386\" src=\"http:\/\/www.bmscience.net\/blog\/wp-content\/uploads\/2021\/10\/Radiografia-di-parodontite-apicale.jpg\" alt=\"\" class=\"wp-image-17059\" srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2021\/10\/Radiografia-di-parodontite-apicale.jpg 576w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2021\/10\/Radiografia-di-parodontite-apicale-300x201.jpg 300w\" sizes=\"auto, (max-width: 576px) 100vw, 576px\" \/><figcaption class=\"wp-element-caption\">Le difese dell\u2019ospite delimitano la zona infiammatoria con tessuto di granulazione che pu\u00f2 essere apprezzato, ad un esame radiografico, come un\u2019area di <strong>radiotrasparenza periapicale<\/strong> come nel caso di questo premolare superiore trattato endodonticamente in modo inadeguato.<\/figcaption><\/figure>\n<\/div>\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>Fonte: <a href=\"https:\/\/amzn.to\/47Ke5HN\" target=\"_blank\" rel=\"noreferrer noopener\">Principi di clinica odontostomatologica<\/a>.<\/p>\n<\/blockquote>\n\n\n<div id=\"bmscience1608695409\" style=\"margin-top: 15px;margin-bottom: 15px;margin-left: auto;margin-right: auto;text-align: center;\"><a href=\"https:\/\/amzn.to\/4kIYBeg\" target=\"_blank\" aria-label=\"81RH6rhG+0L._SX3000_\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/81RH6rhG0L._SX3000_.jpg\" alt=\"\"  srcset=\"https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/81RH6rhG0L._SX3000_.jpg 2188w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/81RH6rhG0L._SX3000_-300x69.jpg 300w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/81RH6rhG0L._SX3000_-1024x234.jpg 1024w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/81RH6rhG0L._SX3000_-768x176.jpg 768w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/81RH6rhG0L._SX3000_-1536x351.jpg 1536w, https:\/\/bmscience.net\/blog\/wp-content\/uploads\/2025\/06\/81RH6rhG0L._SX3000_-2048x468.jpg 2048w\" sizes=\"auto, (max-width: 2188px) 100vw, 2188px\" width=\"2188\" height=\"500\"  style=\"display: inline-block;\" \/><\/a><\/div>","protected":false},"excerpt":{"rendered":"<p>La parodontite apicale \u00e8 un processo infiammatorio del parodonto che circonda la porzione terminale della radice del dente, quindi il parodonto apicale. Pu\u00f2 essere acuta e cronica, e pu\u00f2 avere diverse eziopatogenesi: La parodontite apicale acuta sierosa presenta i tipici segni dell\u2019infiammazione sierosa a livello apicale.Si ha iperemia vasale attiva e successivamente passiva, formazione di&hellip;<\/p>\n<p class=\"more\"><a class=\"more-link\" href=\"https:\/\/bmscience.net\/blog\/la-parodontite-apicale\/\">Continue reading <span class=\"screen-reader-text\">La parodontite apicale<\/span><\/a><\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advgb_blocks_editor_width":"","advgb_blocks_columns_visual_guide":"","footnotes":""},"categories":[14],"tags":[778,1677,2217,2218,2749,2974,3650,5109,5436,5443,5534,5535,5537,5538,5539,5540,5541,5542],"class_list":["post-17056","post","type-post","status-publish","format-standard","hentry","category-odontoiatria","tag-ascesso","tag-cisti-radicolare","tag-dente","tag-dente-allungato","tag-endodonzia","tag-estrazione","tag-granuloma-apicale","tag-necrosi-pulpare","tag-osso-alveolare","tag-osteomielite","tag-parodontite","tag-parodontite-apicale","tag-parodontite-apicale-acuta-sierosa","tag-parodontite-apicale-cronica","tag-parodontite-apicale-purulenta","tag-parodontite-profonda","tag-parodonto","tag-parodonto-apicale","entry"],"author_meta":{"display_name":"Raffo Coco","author_link":"https:\/\/bmscience.net\/blog\/author\/raffo\/"},"featured_img":null,"coauthors":[],"tax_additional":{"categories":{"linked":["<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">Odontoiatria<\/a>"],"unlinked":["<span class=\"advgb-post-tax-term\">Odontoiatria<\/span>"]},"tags":{"linked":["<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">ascesso<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">cisti radicolare<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">dente<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">dente allungato<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">endodonzia<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">estrazione<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">granuloma apicale<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">necrosi pulpare<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">osso alveolare<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">osteomielite<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">parodontite<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">parodontite apicale<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">parodontite apicale acuta sierosa<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">parodontite apicale cronica<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">parodontite apicale purulenta<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">parodontite profonda<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">parodonto<\/a>","<a href=\"https:\/\/bmscience.net\/blog\/category\/medicina\/odontoiatria\/\" class=\"advgb-post-tax-term\">parodonto apicale<\/a>"],"unlinked":["<span class=\"advgb-post-tax-term\">ascesso<\/span>","<span class=\"advgb-post-tax-term\">cisti radicolare<\/span>","<span class=\"advgb-post-tax-term\">dente<\/span>","<span class=\"advgb-post-tax-term\">dente allungato<\/span>","<span class=\"advgb-post-tax-term\">endodonzia<\/span>","<span class=\"advgb-post-tax-term\">estrazione<\/span>","<span class=\"advgb-post-tax-term\">granuloma apicale<\/span>","<span class=\"advgb-post-tax-term\">necrosi pulpare<\/span>","<span class=\"advgb-post-tax-term\">osso alveolare<\/span>","<span class=\"advgb-post-tax-term\">osteomielite<\/span>","<span class=\"advgb-post-tax-term\">parodontite<\/span>","<span class=\"advgb-post-tax-term\">parodontite apicale<\/span>","<span class=\"advgb-post-tax-term\">parodontite apicale acuta sierosa<\/span>","<span class=\"advgb-post-tax-term\">parodontite apicale cronica<\/span>","<span class=\"advgb-post-tax-term\">parodontite apicale purulenta<\/span>","<span class=\"advgb-post-tax-term\">parodontite profonda<\/span>","<span class=\"advgb-post-tax-term\">parodonto<\/span>","<span class=\"advgb-post-tax-term\">parodonto apicale<\/span>"]}},"comment_count":"0","relative_dates":{"created":"Pubblicato 4 anni fa","modified":"Aggiornato 2 anni fa"},"absolute_dates":{"created":"Pubblicato il 19\/10\/2021","modified":"Aggiornato il 22\/01\/2024"},"absolute_dates_time":{"created":"Pubblicato il 19\/10\/2021 11:11","modified":"Aggiornato il 22\/01\/2024 21:37"},"featured_img_caption":"","series_order":"","_links":{"self":[{"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/posts\/17056","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/comments?post=17056"}],"version-history":[{"count":0,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/posts\/17056\/revisions"}],"wp:attachment":[{"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/media?parent=17056"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/categories?post=17056"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bmscience.net\/blog\/wp-json\/wp\/v2\/tags?post=17056"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}