Page 17 - The Beauty and Sorrow in Endodontics-Chapter 2

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S Age/Gender: 40 M
CC: “Swelling on my gum”
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HCC: The patient points to the abscess at the center of his lower jaw. 32 had
been pulpectomied by the referring dentist.

O I/O: Gingival abscess on the buccal gingiva of lower anterior teeth
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Rad: Sinogram with gutta percha cone points to 32 (Fig 23A)
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A Dx: 32
Pulpal: Previously initiated
Periapical: Chronic apical abscess

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

to proceed.

1) 32 Root canal treatment
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32 root canal treatment completed in one appointment as the patient
travels far for treatment. In the post-obturation radiograph, it can be seen
that the apical constriction had been destroyed from the infection, and a

sealer puff is present from overfilling of the material (Fig 23B).

2) Follow-up

6-months – The follow-up radiograph shows that the sealer puff has been
slowly resorbed by the surrounding structures; healing of the

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apical lesion is evident (Fig 23C). Since the apex of 31 is located
at the epicenter of the lesion, regular monitoring of its pulpal

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status is required. Electric pulp test (EPT) of tooth 31 showed an
abnormal reading at this appointment and a cavity test was
recommended.

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3) 31 Cavity Test
With the consent from the patient, a cavity test was performed without

anaesthetics. Once the drill passed the dentinoenamel junction, the patient
reported sensitivity, the cavity test was subsequently terminated, and a glass

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