Page 24 - The Beauty and Sorrow in Endodontics-Chapter 4 - Part 1

the crown.

The crown, along with the fiberpost and resin core, had dislodged after

ultrasonic vibration (Fig 42L). Rubber dam isolation. No cracks were
observed, however, new DL caries were seen. Photos were taken to show the

patient and he was urged to return to his restoring dentist for a new crown
with better marginal seal. The patient declined and wished to proceed with

recementation of the original crown due to his age, acknowledging the risk

of possible re-infection in the future. The post space was irrigated with
5.25% NaOCl solution and carious lesions removed. The crown and

fiberpost were disinfected as well and recemented with dual cure resin
cement (Fig 42M). Reinforced oral hygiene and remineralization products

such as MI Mousse, MI Paste, or RECALDENT were recommended.

5) Follow-up

3-years – The follow-up radiograph showed complete healing of the apical
#
#
lesions surrounding teeth 32- 41, however, slight widening of the
PDL can be seen (possibly due to occlusal trauma) (Fig 42N).
Upon careful examination, a white-in-white dot can be seen at 41
#
mid-root, which corresponds with the sinus tract opening before

treatment (Fig 42O).
The patient also complained of chewing discomfort around the two implants.

A panoramic radiograph revealed a radiopaque entity that was
thought to have been calculus at the implant-crown interface at

# 46 (Fig 42P). However, an updated periapical radiograph

revealed a small fracture of the implant body (Fig 42Q). It is yet
unknown whether this is a result of manufacturer error or

parafunction. The patient was urged to return to the implant
surgeon for evaluation.

Note For information on one-visit RCTs, see “Chapter 8”

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