Page 19 - The Beauty and Sorrow in Endodontics (Chapter 4 - Part 2)

Etiology: Cracked tooth?

P Discussed proposed treatment plan with the patient. Informed consent obtained to

proceed.
The patient was aware that root canal treatment will relieve the discomfort he has

been experiencing but cannot cure any cracks. In addition, minor cracks may not
even be visible and can propagate even with crown coverage. The patient was

aware that extraction of the tooth may be a possibility even with root canal

treatment.

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1) 16 Temp crown removal by referring dentist

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2) 16 Root canal treatment and assess presence of cracks
Rubber dam isolation. No cracks were observed under the microscope (Fig

46J). Access cavity prep completed and all canal orifices (including MB2) were

located (Fig 46K). Cleaning, shaping, and obturation of all canals completed;
still no cracks were observed under various magnifications and angles (Fig

46L). The author noticed a difference in tactile sensation when obturating the

palatal canal – the GP was not being compacted as densely as other canals. A
radiograph was taken for evaluation and showed a widened mid-palatal canal

space resembling the appearance of internal resorption (Fig 46M). The patient
reported no discomfort during obturation and consented to re-obturation. The

GP in the palatal canal was removed, the canal cleaned and shaped, and
obturated once again (Fig 46N). The newly obturated palatal canal on the

radiograph showed the typical appearance of a fractured root (Fig 46O). Coronal

seal was completed.
The patient and referring dentist were notified of the palatal root fracture.

The patient reported no pain or discomfort after treatment and therefore, does
not wish to proceed with extraction at this time., The temporary crown was

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recemented (Fig 46P) and the patient will have tooth 16 extracted and implant
placed with a sinus lift once it becomes symptomatic again.

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