Endodontics · single question
A patient presents with a periapical abscess on tooth #30. The tooth is restorable. What is the DEFINITIVE treatment?
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Correct answer: A. Root canal treatment (RCT)
- A. CORRECT. The definitive treatment for a periapical abscess from a necrotic tooth is ELIMINATION OF THE SOURCE — which is the infected pulp. Root canal treatment removes the necrotic pulp, debrides the root canals, and seals the system, allowing periapical healing. If the tooth is restorable, RCT is preferred over extraction.
- B. Extraction eliminates the source but sacrifices the tooth. When the tooth is restorable, RCT is the appropriate conservative option.
- C. Antibiotics manage spreading infection systemically but do not penetrate the avascular necrotic pulp — they cannot eradicate the source. Antibiotics are adjuncts when systemic signs of infection exist, not definitive treatment.
- D. Incision and drainage is an ADJUNCTIVE procedure that provides pain relief by releasing pus when a fluctuant swelling is present. It does not eliminate the pulpal source of infection. I&D alone will not resolve a periapical abscess.