Is this a radiolucency?

[Mo24078]

Hello there Dentistry Forum community,

I have had a periodontal abscess between teeth 18 and 19 for the past couple of months and today my dentist took a few bitewings and periapical X-rays to see what is going on. The good doctor wasn't able make a final determination and suggested a consult with an endodontist. He said he wasn't sure if the inflammation was only periodontically involved or if it was endodontically involved as well. He said if the endodontist determined that root wasn't involved, then I should go to a periodontist to resolve this. He said the abscess is currently draining on it's own.
So here I am querying the forum's hive mind. Specifically, in the X-ray below, do you believe there is a radiolucency at the root apex? Do you believe there is endodontic involvement here?

Thanks in advance.

 

[MattKW]

The RCT isn't the best quality, and an endodontist could certainly improve that, but it's not clear if that would resolve the abscess. Another possibility is that there is a distal crack in the tooth. If so, then an extraction is the only option - a periodontist can't fix a crack either. So go to the endodontist, and they should not only assess the quality of the RCT, but also check to see if you have a crack.