Caries, pulp and periodontal disease: combined endodontic-periodontal lesion: practice question

A Dentistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dentistry · Caries, pulp and periodontal disease: combined endodontic-periodontal lesion

Sample item

A 40-year-old has a lower molar with a deep, narrow, isolated 9-mm probing defect and a radiolucency from the furcation to the apex. The tooth does not respond to cold or the electric pulp test, and the rest of the mouth has pockets of 3 mm or less. What is the best sequence of treatment?

ARoot canal treatment first, then reassess the periodontal defectBPeriodontal flap surgery with bone graft firstCImmediate extractionDScaling and root planing alone

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Root canal treatment first, then reassess the periodontal defect

A necrotic pulp with a single deep pocket indicates a lesion of endodontic origin draining through the periodontium. Root canal treatment is done first and the pocket often heals, with periodontal therapy only for what remains.

Option by option

A. Root canal treatment first, then reassess the periodontal defect (correct)
Correct. Treating the infected canal is the first step.
B. Periodontal flap surgery with bone graft first
Surgery before removing the pulpal source risks failure.
C. Immediate extraction
The tooth is restorable and extraction is not needed at this stage.
D. Scaling and root planing alone
Scaling alone does not address the necrotic pulp.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Dentistry question

What is the answer to this Dentistry question?

The best answer is A, Root canal treatment first, then reassess the periodontal defect. A necrotic pulp with a single deep pocket indicates a lesion of endodontic origin draining through the periodontium.

Why is "Periodontal flap surgery with bone graft first" not the answer?

Surgery before removing the pulpal source risks failure.

Why is "Immediate extraction" not the answer?

The tooth is restorable and extraction is not needed at this stage.

Why is "Scaling and root planing alone" not the answer?

Scaling alone does not address the necrotic pulp.

What concept does this question test?

It tests Caries, pulp and periodontal disease: combined endodontic-periodontal lesion in Dentistry. Root canal treatment is done first and the pocket often heals, with periodontal therapy only for what remains.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Caries, pulp and periodontal disease: combined endodontic-periodontal lesion?

Learn the dental formula, eruption ages and tooth structure once, as tables. Then use the flashcards and the other Dentistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.