Page 24 - The Beauty and Sorrow in Endodontics-Chapter 2

she’s had any abscesses in the past.

DH (Fig 24A):
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# 26, 36 extracted
# 16, 46 root fragments (will need to be extracted)
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Obtaining a stable occlusion will be a major goal for orthodontic treatment. The
orthodontist reported radiolucency observed around the lower incisors and tooth

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# 12 , whether root canal treatment can successfully retain these teeth will dictate
his orthodontic treatment plan.
O I/O: Gen gingival inflammation (Fig 24B)

Multiple restorations
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31 STP (+), APT(+), PD WNL
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41 STP (+), APT(+), PD WNL
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42 STP (+), APT(+), PDWNL
Rad (Fig 24C, 24D):

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10x8mm radiolucency around the apices of teeth 42, 41 and 31 (epicenter
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at 41 apex)
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Large restorations on 42, 41, 31
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Discontinuous lamina dura around 42, 41, 31
Clear and straight main canals all the way from orifices to the apices on
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# 42, 41, 31
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A Dx: 41
Pre-Treatment Pulpal: Necrosis
Post-Treatment Pulpal (confirmed with cavity test): Necrosis
Periapical: Chronic apical abscess

Dx: 32, 42
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Pulpal (confirmed with cavity test): Normal
P Discussed proposed treatment plan with the patient and guardian. Informed

consent obtained from both to proceed.

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1) 41 Root canal treatment
Rubber dam placed. Microscopic examination of tooth 41 shows

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