Page 48 - The Beauty and Sorrow in Endodontics-Chapter 3

Rx: Clindamycin 300mg TID for 7 days

3) Follow-up

1-year – The patient reported disappearance of the abscess and no discomfort
during function on the tooth. Intraoral examination revealed normal

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response to percussion and palpation for 46 with probing depths
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~3-5mm. The lesion surrounding tooth 46 has almost completely
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healed (Fig 39O). However, tooth 47 was now sensitive to
percussion and the probing depths were ~5-6mm. The patient was
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urged to have a crown fabricated for cuspal protection on 46 and to
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remove the impacted 48.
4-years (Fig 39P, 39Q) – Adequate healing observed around the furcation area

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of tooth 46, demonstrating that with proper infection control of the
root canal system, the body’s natural healing mechanism can initiate

the healing process. This shows that the lesion was solely of

endodontic origin as it healed with only endodontic treatment.
Note 1 For more information on how implant therapy and endodontics can complement

each other, see “Chapter 4”.
2 These radiographs were taken by the patient’s family dentist.

3 These radiographs were taken at the consultation appointment.

4 For working length terminology and determination, see “Working Length”.
5 During the author’s training under Dr. Schilder, calcium hydroxide was rarely

used as an intracanal medication. The reason for this is that in a complex root canal
system, once the calcium hydroxide paste is placed, it becomes almost impossible

to remove in lateral canals, thereby interfering with the operator’s ability to clean

and seal them properly with warmed gutta percha.
6 During the author’s training at Boston University, removal of all existing

restorative material and reinforcement with a new restoration or copper band is
required to ensure adequate isolation. This also prevents dislodgement of small

fragments of amalgam or resin material that can cause blockage of the canals.
Nowadays, the author only operatives under microscopic aid and can remove

dislodged material in the canal if it happens. Thus, unless the existing restoration

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