Question

A 12-year-old patient undergoing active, full band edgewise orthodontic treatment develops pulpal necrosis with acute apical periodontitis in a maxillary lateral incisor. The tooth had been restored with a large Class III composite before banding. This problem is best managed by

A. opening the tooth for drainage and leaving it open until the band is removed.
B. performing root canal therapy without interrupting orthodontic treatment.
C. prescribing antibiotics until orthodontic treatment is completed, then performing root canal therapy.
D. removing the archwire and discontinuing orthodontic treatment until root canal therapy can be performed.

Answer 1

The best management for a 12-year-old patient with pulpal necrosis and acute apical periodontitis undergoing orthodontic treatment is to perform root canal therapy without interrupting the orthodontic process, ensuring both the dental health and orthodontic goals are maintained.

Step-by-step explanation:

Management of Pulpal Necrosis in Orthodontic Treatment:

A 12-year-old patient undergoing active, full band edgewise orthodontic treatment develops pulpal necrosis with acute apical periodontitis in a maxillary lateral incisor that had previously been restored with a large Class III composite. When considering the management of this dental issue the recommended approach is to prioritize the health of the tooth while maintaining the progress of the orthodontic treatment. Therefore the best option is performing root canal therapy without interrupting the orthodontic process. This choice allows for immediate care of the infected tooth while preserving the alignment goals of the orthodontic treatment.

Other options such as delaying treatment, could lead to further complications or setbacks in dental health and orthodontic progress. Once the root canal therapy is completed the orthodontic treatment can continue without further affecting the patient's dental health.