THE ROLE OF DRAINAGE AND IMMEDIATE CHEMICAL-MECHANICAL PREPARATION IN THE MANAGEMENT OF ACUTE PERIAPICAL ABSCESS: A LITERATURE REVIEW

Abstract

The understanding of the pathophysiology and microbiology of acute periapical abscess is essential for the understanding of the evolution of endodontic infection and for the definition of effective therapeutic strategies in the management of this clinical condition. In this context, drainage associated with chemomechanical preparation stands out as an effective measure in the reduction of microbial load and tissue pressure, presenting greater effectiveness than isolated systemic therapy in emergency care. This is a literature review with a qualitative and descriptive approach, carried out through searches in the PubMed, SciELO and Google Scholar databases, including scientific articles and reference works published between 1996 and 2026. The results evidenced that drainage promotes a rapid reduction of tissue hydrostatic pressure, while endodontic instrumentation and irrigation act directly in the decrease of intraradicular infection. In contrast, it was observed that systemic therapy presents limitations when used in isolation, without prior local clinical intervention. Thus, it is concluded that the association between drainage and chemomechanical preparation represents the most effective therapeutic approach for the reduction of microbial infection, pain control and the greater predictability of the treatment of acute periapical abscess.