A tooth with a periapical radiolucency that is tender to percussion is indicative of which condition?

• A. Asymptomatic apical periodontitis
• B. Symptomatic apical periodontitis
• C. Dental abscess
• D. Pulpitis

Answer: (B)

A tooth exhibiting a periapical radiolucency that is tender to percussion is indicative of symptomatic apical periodontitis. This condition arises due to inflammation of the pulp and is often a response to infection or trauma. The tenderness to percussion suggests that there is an active inflammatory process at the apex of the tooth, which is consistent with symptomatic apical periodontitis.

Radiographically, the periapical radiolucency indicates that there is bone loss around the root tip, which can occur as a result of the inflammatory response to pulpal disease. In symptomatic apical periodontitis, the patient typically experiences pain, especially when the tooth is tapped or subjected to pressure, reflecting the inflammation and possible infection extending to the periapical tissues.

Understanding the nuances of periapical conditions can help differentiate among various diagnoses. Asymptomatic apical periodontitis, for example, would not present with tenderness, as there are typically no symptoms; while other conditions like dental abscess or pulpitis might manifest differently in terms of symptoms or radiographic appearance.