If X-rays show many well-demarcated periapical lucencies, what is the next step?

When X-rays reveal many well-demarcated periapical lucencies, the presence of these lucencies often indicates the possibility of inflammatory processes or periapical lesions, which may be due to pulp necrosis or infection. The best initial step in this scenario is to conduct pulp tests on the affected teeth.

Pulp testing helps determine the vitality of the pulp tissue within the tooth. If the pulp is necrotic, it may indicate that the tooth requires endodontic treatment, such as a root canal. Conversely, if the pulp is still vital, alternative management options may be more appropriate, depending on the specific clinical findings.

This diagnostic approach allows for a better understanding of the underlying condition of each tooth before proceeding with any invasive treatments like extraction or root canal therapy. Thus, pulp testing provides critical information that guides the subsequent steps in treatment planning and ensures that the intervention matches the specific needs of the tooth and the surrounding bone structure.