Which procedure should be conducted if a tooth shows signs of pulpal necrosis with associated periapical radiolucent lesions?

• A. Extraction
• B. Endodontic treatment
• C. Periodontal surgery
• D. Restorative treatment

Answer: (B)

When a tooth exhibits signs of pulpal necrosis alongside periapical radiolucent lesions, the most appropriate procedure is endodontic treatment. This intervention addresses the underlying issue of necrotic pulp tissue, which can lead to infection and subsequent bone loss evident through radiographic changes.

Endodontic treatment, or root canal therapy, involves the removal of the infected or necrotic pulp tissue from within the tooth, followed by cleaning, shaping, and filling the root canals to prevent further infection and resolve any associated periapical pathology. This approach aims to preserve the tooth, alleviate pain, and promote healing in the surrounding bone.

In contrast, extraction would remove the tooth entirely rather than addressing the underlying disease process. Periodontal surgery focuses on issues related to gum health and would not treat the pulpal condition directly. Restorative treatment is designed to repair the tooth structure but does not resolve the infection or necrosis present in the pulp. Thus, endodontic treatment is the correct choice for managing pulpal necrosis with periapical lesions, as it directly targets the source of the problem and aims to retain the tooth.