Which treatment option is least appropriate for managing a periodontal abscess?

In managing a periodontal abscess, the least appropriate treatment option is the local delivery of antibiotics. This approach may not adequately address the immediate need for drainage and removal of pus that characterizes an abscess.

The primary goal in treating a periodontal abscess is to relieve pain and remove the source of infection, which often requires direct intervention such as incision and drainage to facilitate the outflow of purulent material. Local delivery of antibiotics might provide some targeted antimicrobial effect, but it does not resolve the underlying issue of necrotic tissue and infection, nor does it effectively alleviate the pressure and pain associated with the abscess.

Conversely, systemic antibiotics may be beneficial if there is a significant systemic involvement of infection or if the patient shows signs of systemic spread, such as fever or lymphadenopathy. However, while scaling and root planing can help in managing periodontal disease, it is typically performed after an abscess has been addressed to ensure proper healing and to minimize further complications.

Overall, while local delivery of antibiotics can be a useful adjunct in some cases of periodontal disease, it is the least effective standalone treatment when faced with an acute periodontal abscess, which requires prompt and direct measures to resolve the infection and pain.