Page 31 - The Beauty and Sorrow in Endodontics-Chapter 2

Raised, hypervascular mucosal lesion between the apices of teeth 25 and
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# 26 (Fig 25A)
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# 25 STP (+), APT (+), PD WNL, worn central cusp (Fig 25B)
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Rad: Sinogram with gutta percha cone points to 25 (Fig 25C)
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25 discontinuous lamina dura with a larger canal compared to tooth 24
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and 26 (Fig 25D).
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A Dx: 25
Pulpal: Necrosis
Periapical: Chronic apical abscess

P Discussed proposed treatment plan with the patient. Informed consent obtained
to proceed. The patient was aware of possibly needing apical surgery if healing

is inadequate following root canal treatment.

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3) 25 Root canal treatment and assess for presence of cracks
Rubber dam isolation. Microscopic examination revealed a
hypervascular papillary entity (Fig 25E) with no evidence of cracks on tooth

# 25 (Fig 25F). Access completed without local anaesthetics with no

discomfort to the patient. Cleaning and shaping of the coronal and middle
thirds were completed utilizing the envelope of motion along with 5.25%

NaOCl. Once the irrigating solution showed limited debris, 1% NaOCl was
then used with a small ISO #10 file to peek through the RT to check patency

of the canal. Cleaning and shaping of the canal were completed and a master
cone fit radiograph taken (Fig 25G). The cone was then disinfected. Final

irrigation then the canal was dried with paper points while simultaneously

conducting the paper point test to verify working length. Warm vertical
compaction obturation (Fig 25H). Fiberpost with resin core (Fig 25I, 25J,

25K, 25L). Occlusion adjusted and final radiograph taken (Fig 25M).
Rx: Clindamycin 300mg TID for 7 days

4) Follow-up
10-days– The patient called the office to report the disappearance of the

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