Oral Surgery · single question
A lower left second molar presents with a deep distal pocket depth, emergence of inflammatory exudate, and associated lower left third molar. Patient has no fever and no systemic infection signs. What is the most likely diagnosis?
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Correct answer: C. Pericoronitis
Deep distal pocket + inflammatory exudate on the lower left SECOND molar in the presence of the THIRD molar = PERICORONITIS. The partially erupted or erupting third molar creates a pericoronary flap that harbors bacteria, causing local infection/inflammation manifesting as a deep distal pocket on the adjacent second molar with exudate. The absence of fever and systemic signs confirms it is a localized pericoronitis, not a spreading infection.
- A. INCORRECT. Traumatic occlusion causes PDL changes and mobility but not exudate from a pocket — infection is not the primary feature.
- B. INCORRECT. External root resorption causes a specific radiographic defect — not typically associated with exudate from a pocket in this pattern.
- C. CORRECT. Pericoronitis occurs when the gingival flap (operculum) over a partially erupted third molar becomes infected. This creates a deep pocket distal to the second molar, with exudate, erythema, and local pain. No systemic signs indicates localized pericoronitis.
- D. INCORRECT. Acute apical abscess involves pulpal necrosis with a periapical pathway — the presentation here points to a pericoronary (pericoronal) origin associated with the third molar.