Page 59 - The Beauty and Sorrow in Endodontics-Chapter 2

Fig 30P
4.5-years post-op – Healed lesion with no remaining

radiolucency; the resorption of most of the extruded
sealer allows for the sealed exits of the accessory
canals to be more visible on the radiograph (white
dots). This also confirms proper apical seal even

years after obturation.

+
S Age/Gender: 40 F
CC: “Swelling on my gum”

HCC: The patient reported swelling on the lower right buccal gingival that

started a month ago. She reported past swellings that would disappear
after she pokes it with a toothpick and uses mouthwash. However, that

did not work this time. She had been asking for advice on a few

different forums online and this clinic had been recommended to her.
#
DH: Periodontitis; Dental anxiety; 45 RCT completed 30 years ago
+
#
O I/O: 45 STP (slight +), APT (slight +), PD WNL, O Amalgam with marginal
leakage and tooth discolouration, crack lines along M/D/B tip

# 46 STP (+), APT (+), PD 5-7mm
#
47 STP (+), APT (+), PD 7-8mm
Rad: 45 root canal treated with inadequate obturation
#
#
45 periapical radiolucency (note J-shaped lesion towards M)
#
Bone loss around 47 (Fig 30A)
#
Sinogram with gutta percha cone points to 45 (Fig 30B)
The patient only consented to periapical radiographs for 45 even though a
#
panoramic was also recommended to allow for an overview assessment of her
1
dentition.
#
A Dx: 45
Pulpal: Previously treated
Periapical: Chronic apical abscess

57