What is the primary management approach for periapical abscesses, granulomas, and cysts?

• A. Remove the source of infection via root canal therapy or extraction
• B. Antibiotics alone
• C. Immediate extraction of all teeth
• D. Wait and watch

Answer: (A)

The main idea is to remove the source of infection at the tooth apex. Periapical abscesses, granulomas, and cysts all arise from bacterial infection of the pulp that extends into periapical tissues. The definitive management is to eliminate that source—usually by root canal therapy to clean, disinfect, and seal the canal, or by extracting the tooth if it cannot be saved. Antibiotics alone don’t cure these lesions because they don’t remove the infected tissue or establish drainage, so they’re only an adjunct in specific situations (like systemic involvement). Periapical abscesses require drainage and debridement, and granulomas or cysts tend to heal once the irritant is removed and the canal is properly treated. Options like extracting all teeth or simply waiting are not appropriate strategies.