A patient with incomplete periodontal therapy presents with pain at #29, heavy bleeding, abundant calculus, deep bone loss, and a draining abscess. The most likely diagnosis is:

Correct answer: A. Combined periodontal-endodontic lesion

• A. Correct. Long-standing periodontal disease with bone loss plus a pulpal/periapical component produces a combined perio-endo lesion.
• B. A purely endodontic abscess would not feature the heavy calculus and chronic periodontal bone loss described.
• C. Gingivitis is reversible inflammation without attachment/bone loss.
• D. Pericoronitis affects soft tissue over a partially erupted tooth (usually third molars).