Gingival Abscess — ORE Part 1 MCQ

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EasyPeriodontologyGingival AbscessORE Part 1

A 28-year-old patient presents with a localised acute gingival abscess on the labial aspect of the upper right canine. The tooth responds normally to pulp sensibility testing. There is no deep periodontal pocket or loss of attachment. What is the most likely aetiology?

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Correct answer: E — Foreign material impacted in the gingival sulcus

The most likely cause is foreign material impacted in the gingival sulcus. SDCEP states that a periodontal abscess may occur without periodontitis following impaction of food or another foreign body. The normal pulp sensibility response argues against a periapical source or infection communicating through a lateral canal. A combined endodontic-periodontal lesion would more typically show an altered or negative pulp response and deep periodontal pocketing. An acute periodontal abscess associated with established periodontitis would usually occur in a pre-existing periodontal pocket with attachment loss. A root crack can contribute to an endodontic-periodontal lesion, but the stem provides neither a deep narrow defect nor evidence of pulpal involvement. The key discriminators are a vital tooth, absence of attachment loss and localised gingival suppuration.

Reference: Scottish Dental Clinical Effectiveness Programme. Prevention and Treatment of Periodontal Diseases in Primary Care: Acute conditions, current online guidance. https://www.periodontalcare.sdcep.org.uk/guidance/managing-disease/other-periodontal-conditions/acute-conditions/