Question

A patient schedules an appointment because he says he is having "a problem." Examination reveals a purulent discharge distal to the first molar, which the patient states has been present for the past week. Radiographs reveal considerable loss of bone on the distal of this tooth. The remainder of the mouth is periodontally sound. Pulp tests indicate a nonvital pulp. Proper management of this case is to

A. extract the tooth.
B. refer the patient to a periodontist.
C. complete endodontic therapy and immediately resect the distal root.
D. complete endodontic therapy and recall the patient for evaluation of healing.

Answer 1

The patient is experiencing a dental abscess caused by caries. The proper management of this case is complete endodontic therapy, followed by evaluation of healing.

Step-by-step explanation:

The patient's symptoms and radiographic findings suggest a dental infection known as an abscess. An abscess can occur when caries (tooth decay) reaches the innermost pulp, leading to an infection that spreads to the surrounding tissues. In this case, the tooth affected is the first molar, as seen from the radiographs showing significant bone loss on the distal side of the tooth.

The proper management of this case would involve complete endodontic therapy, which refers to the removal of the infected pulp and cleaning and shaping of the root canal system. This is followed by filling the root canal with a biocompatible material and placing a protective dental restoration, such as a crown, to protect the tooth.

After the completion of endodontic therapy, the patient should be recalled for evaluation of healing. Monitoring the healing process through regular follow-up visits allows the dentist to assess the success of the treatment and ensure that any further intervention is done if necessary.