Prognosis
Prognosis
Acute apical periodontitis without abscess has an excellent prognosis following root canal treatment. Small periapical lesions (< 5mm on CT) resolve completely in 85–95% of cases within 6–24 months. Large lesions (cysts vs. granulomas) may require apical surgery if non-resolving at 2-year review.
Acute apical abscess with appropriate drainage and endodontic treatment carries an excellent short-term prognosis for resolution of the acute episode. Long-term tooth retention depends on restorability and periapical healing status.
Spreading infections treated promptly carry good prognosis. Delayed treatment of spreading dental infections can be fatal: Ludwig's angina, descending mediastinitis, and septicemia from dental origin carry mortality rates of 10–40% even with aggressive treatment. Time to diagnosis and appropriate treatment is the critical prognostic factor.