What is the primary radiographic feature of a periapical abscess?

• A. Radiolucent lesion at the apex with possible lamina dura destruction and widening of the periodontal ligament space.
• B. Radiopaque halo around apex.
• C. No radiographic changes.
• D. Enlarged lamina dura without lesion.

Answer: (A)

Periapical abscess clearly shows bone destruction at the tooth tip as the infection spreads into the periapical tissues. The radiographic hallmark is a radiolucent lesion at the apex, representing the loss of surrounding bone. You’ll often also see disruption or loss of the lamina dura around the tooth and widening of the periodontal ligament space due to inflammatory edema and pressure from the infection. Early on, a radiograph might look normal, but as the abscess develops, the radiolucent area becomes evident. A radiopaque halo around the apex isn’t typical for an abscess, and an enlarged lamina dura without a lucent lesion doesn’t reflect the destructive periapical process.