Page 31 - The Beauty and Sorrow in Endodontics-Chapter 1

(Fig 19P)

3-years post-op – The lamina dura around tooth
#36 has completely reformed and the extruded
sealer resorbed by the body, once again
exemplifying the concept that proper overfilling of

sealer does not inhibit healing.

+
S Age/Gender: 60 F
CC: “Swelling on my gum”
MH: Taking antibiotics for tooth pain

HCC: The patient reported tooth mobility with gingival swelling in the lower
left posterior for weeks. She has not been able to eat since. She had
seen several dentists for consultation and most of them had

recommended extraction of tooth 36 with plans for reconstruction after
#
healing. The patient had experienced similar pain and discomfort a few
years back in the lower right region and had some teeth extracted and
replaced with a removable partial denture, which she does not use

because it is uncomfortable. It was recommended to her that she
consults with an endodontist to discuss the feasibility of retaining the
tooth.

O I/O: Gingival erythema with suppuration upon palpation
#
36 Moderate attrition, M2, carious lesion in DO rest prep

#
Rad: 36 apical + furcal radiolucency (Fig 19A)
#
36 M root dilaceration (Fig 19B)
#
A Dx: 36
Pulpal: Necrosis
Periapical: Chronic apical abscess
P Discussed proposed treatment plan with patient, and consent was given to

#
proceed. Options for 36: 1) RCT treatment, 2) extraction, 3) no treatment,
given to patient and RBA explained.

#
1) 36 Root canal treatment
Appt 1: The access cavity was prepared without any anaesthetics. Pus

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