Alveolar Periostitis

• A more virulent infection into the alveolus produces alveolar periostitis.
• Infection spreads from pulp or from gingivitis to produce the periostitis.
• This may then break out of the alveolus into the bone causing osteomyelitis.
  • Seen in infection of carnassial teeth in dogs as chronic sinus discharging below eye. So called 'malar' abscess.
• Only treated by removal of tooth.
• Abscess may break through into maxillary sinus. If drained will get recovery.
  • Other maxillary cheek teeth can be involved in pyaemic infection with sinus formation.
• Hard to evaluate on mandible, may produce fistula that also needs tooth removal.