PERICORONITIS

• Incomplete eruption of a wisdom tooth

produces an opening through the overlying
gum but often the greater part of crown of
tooth remains covered by soft tissue. This
pocket, which forms a large stagnation area,
can easily become infected through the
opening causing pericoronitis.
• Aetiology and aggravating factors:

• 1. Impaction of food under gum flap

• - and accumulation of plaque encourages
multiplication of bacteria
• 2. Biting on the gum flap by an upper tooth
• - Laceration of flap leads to infection and
increases swelling
3. Ulcero-membranous gingivitis
A pericoronal pocket may act as a focus from
which infection can originate but usually
becomes involved secondarily by backward
spread of infection
4. Diminished resistance due to systemic disease
This is a rare factor
• Clinical features

• Young adults affected

• Main symptoms are:
• -soreness and tenderness around partially
erupted tooth
• -quickly goes on to pain, swelling and difficulty
in opening mouth
• -regional lymph nodes enlarged
• -slight fever
• -in severe case- suppuration and abscess
formation
• Management

• Uncomplicated case
• 1. Mouth should be cleaned and food debris
removed from under the gum flap by syringing
• 2. Radiograph taken to show position of
affected tooth
• 3. Frequent use of hot mouth wash is effective
• Recurrences may occur until stagnatiion area is
removed by further eruption, operculectomy or
extraction
• 5. If radiograph shows third molar is impacted or
carious it should be extracted

• Complicated case
• When infection is severe antibiotics should be
given
• Spread of infection ( cellulitis or osteomyelitis)
may follow extraction of the tooth while
infection is still acute