endo treatment after acute apical abscess?

[cavityhereIcome]

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Let's say a patient chose not to treat a necrotic tooth and it causes an acute apical abscess with severe pain down the road. at that point, would it be possible to do endo treatment for that tooth or does it have to be extracted? ( obviously after surgical draining of the pus)

 

[Blueshirts]

Is the tooth restorable or not?

 

[cmsmith85]

Let's say a patient chose not to treat a necrotic tooth and it causes an acute apical abscess with severe pain down the road. at that point, would it be possible to do endo treatment for that tooth or does it have to be extracted? ( obviously after surgical draining of the pus)

If the tooth is still restorable, then yes, it can still be treated endodontically. However, the bigger the periapical lesion gets, the lower the prognosis becomes.

 

[FutureDent020]

If the tooth is still restorable, then yes, it can still be treated endodontically. However, the bigger the periapical lesion gets, the lower the prognosis becomes.

Check the lit. This isn’t true. Toronto study (Friedman) and Ng have good studies about this. I’m sure there are others I can’t think of. This is only for previously treated teeth and surgically treated teeth. Lesions over 5mm associated with previous NSRCT are associated with lower success rates. Lesion size with necrotic teeth assuming no cracks, don’t have the same association. Presence of a pre op lesion vs no pre op lesion do effect the prognosis of NSRCT. But size wasn’t found to be a factor.

 

[cmsmith85]

Check the lit. This isn’t true. Toronto study (Friedman) and Ng have good studies about this. I’m sure there are others I can’t think of. This is only for previously treated teeth and surgically treated teeth. Lesions over 5mm associated with previous NSRCT are associated with lower success rates. Lesion size with necrotic teeth assuming no cracks, don’t have the same association. Presence of a pre op lesion vs no pre op lesion do effect the prognosis of NSRCT. But size wasn’t found to be a factor.

Ah, gotcha. I'm still a little endo newbie here trying to learn all those things! We just went over the outcomes and microbiology chapters and we talked about how the as the lesion increases in size, the number of different microbial species increases, which makes eliminating/reducing the amount of bacteria is more difficult. I understood that as decreasing the prognosis, but it looks like I may have misunderstood that.