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Post-Endodontic Flare-Up — NDEB AFK MCQ

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ModerateEndodonticsPost-Endodontic Flare-UpNDEB AFK

A patient presents 2 days after root canal treatment of tooth 46 with severe spontaneous pain and intraoral swelling. The obturation appears adequate on radiograph. What is the most likely diagnosis?

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Correct answer: A — Post-treatment flare-up (acute periapical abscess)

A post-treatment flare-up presenting with pain and swelling within 24-72 hours after RCT is most likely an acute exacerbation of periapical pathology. This occurs in 1-8% of cases and may be caused by extrusion of debris/bacteria beyond the apex or chemical irritation from irrigants or sealers. Management includes incision and drainage (if fluctuant), analgesics, and antibiotics if spreading infection with systemic signs.

Reference: Torabinejad – Endodontics: Principles and Practice, 6th ed., 2021