Odontogenic infections represent a significant public health concern due to their high prevalence and potential for severe complications. These conditions commonly arise as a consequence of dental caries and periodontal disease, which remain leading causes of oral pathology worldwide.¹ In many cases, effective management requires an integrated approach combining pharmacological, dental, and surgical interventions², tailored to the specific clinical circumstances. The infection may originate within the dental structures or extend to the surrounding tissues. When the inflammatory process cannot be effectively controlled through antibiotic therapy, it may disseminate to the subcutaneous regions and, in severe cases, manifest extraorally.³ Such infections frequently present with pain and swelling in the orofacial region, often necessitating emergency endodontic intervention to alleviate symptoms and control the spread of infection.⁴ In patients exhibiting acute pain and clinical signs of facial swelling, endodontic management typically involves root canal treatment in conjunction with systemic antibiotic therapy.¹,²,³,⁴ Clinical Case: A 20-year-old male patient presented to the UABC Polyclinic in Mexicali with intense pain in the right submandibular region and noticeable right-sided facial asymmetry. Pulpal diagnosis: necrosis. Periapical diagnosis: acute periapical abscess affecting tooth #46. Endodontic treatment was initiated to achieve internal decompression, followed by completion using the crown-down biomechanical instrumentation technique, irrigation with 5.25% sodium hypochlorite (NaOCl), and obturation with MTA-Fillapex sealer. The clinical outcome was favorable, demonstrating complete resolution of the infection and absence of recurrence during follow-up.