Endodontics · single question
A tooth has a history of an anterior bridge (5 years ago) and root canal therapy (2 years ago), now presents with pain to percussion, no response to cold, and an intermittent draining sinus tract (parulis) on the gingiva. What is the most likely apical diagnosis?
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Correct answer: B. Chronic apical abscess (a long-standing infection draining intermittently via a sinus tract)
The presence of an intraoral sinus tract/parulis indicates a chronic, low-grade, intermittently draining infection — the hallmark of chronic apical abscess. Acute apical abscess instead presents with rapid onset, significant swelling/pain, and typically no sinus tract (since there hasn't been time for one to form).