Abstract

Periodontal abscesses represent a localized purulent infection within the tissues supporting the teeth, characterized by rapid onset, swelling, pain, and eventual tissue destruction if left untreated. These abscesses are one of the most common dental emergencies and present significant challenges for both diagnosis and management, particularly due to their potential to mimic other types of orofacial infections and their complex etiopathogenesis. This paper provides a detailed overview of the causes, clinical features, diagnostic considerations, and current management strategies of periodontal abscesses. Etiologically, periodontal abscesses are often associated with preexisting periodontal pockets, poor oral hygiene, foreign body impaction, trauma, or obstruction of the pocket opening. The involvement of pathogenic bacteria, particularly anaerobic species such as Porphyromonas gingivalis and Fusobacterium nucleatum, plays a central role in the pathogenesis. Diagnosis involves a careful clinical examination, supported by radiographic imaging and microbiological assessments when necessary. Differentiating periodontal abscesses from periapical abscesses is crucial for targeted treatment. Management includes both immediate interventions to control infection and long-term strategies to address the underlying periodontal condition. Drainage of the abscess, debridement, antibiotic therapy when indicated, and patient education form the foundation of acute management. Long-term care may involve scaling and root planing, surgical intervention, and maintenance therapy. Emerging approaches such as local antimicrobial delivery systems and host modulation therapy are also being explored. Understanding the multifactorial etiology and evolving treatment modalities is vital for dental professionals to manage periodontal abscesses effectively and prevent recurrence. This review aims to consolidate existing knowledge and recent advancements in the field to assist clinicians in evidence-based decision-making.