Page 10 - The Beauty and Sorrow in Endodontics-Chapter 2

S Age/Gender: 20F
CC: “Swelling on my gum”
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HCC: The patient pointed to the abscess between 35 and 36.
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O I/O: Gingival abscess on buccal gingiva between 35 and 36
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35 Temporary restoration
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36 Large class II amalgam restoration with M(R) caries
Rad: Sinogram with gutta percha cone points to 35 (Fig 21A)
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Periapical radiolucency between 35 and 36 (Fig 21B)
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Cavity Test: 35 (-)
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A Dx: 35
Pulpal: Necrosis

Periapical: Chronic apical abscess

P Discussed proposed treatment plan with the patient. Informed consent obtained
to proceed.

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1) 35 Root canal treatment
# 35 root canal treatment completed in one visit. Access opening without

local anaesthetics with no discomfort to the patient that was confirmed pulp
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necrosis on 35.
2) Follow-up
2-weeks – The gingival abscess has disappeared. Overfilled sealer can be

seen at the apex in the post-obturation radiograph (Fig 21C).
With consent from the patient, the old amalgam restoration on

# 36 was removed without anaesthetics, and the pulpal status was

normal, thus a new composite resin restoration was completed
after caries removal.

6-weeks – The follow-up radiograph of 35 showed gradual healing of the
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apical lesion and reappearance of the lamina dura around the
tooth (Fig 21D). The patient was advised to have a crown

fabricated to restore the tooth and idealize occlusion. However,
due to financial constraints, the patient opted for only an

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