Which statement best defines a periapical inflammatory lesion?

• A. Inflammation confined to gingival tissues.
• B. Initial inflammation is a necrotic pulp and the bony lesion is restricted to the region of the tooth.
• C. Inflammation of the periodontal ligament without pulpal involvement.
• D. Systemic bone infection unrelated to the tooth.

Answer: (B)

Periapical inflammatory lesions are driven by an infection that begins in the dental pulp, typically from pulp necrosis, and then irritates the surrounding periapical bone. The key point is that the inflammation starts in the pulp and the resulting bony lesion is confined to the region around the tooth’s apex. This matches the statement that the initial inflammation is a necrotic pulp and the bone change is restricted to the tooth’s region. Inflammation limited to the gingival soft tissues, a periodontal ligament issue without pulp involvement, or a systemic bone infection not related to the tooth do not describe a periapical lesion.