Page 40 - The Beauty and Sorrow in Endodontics (Chapter 4 - Part 2)

the crown margins (Fig 49K, 49L) and a new crown was placed a week later

(Fig 49M, 49N, 49O).

4) Follow-up
1-year – The patient returned to the clinic for routine hygiene appointment and

reported no concerns functioning with 36. The dental hygienist had
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taken a bitewing for record (Fig 49P).

2-years –The patient returned to the clinic reporting occasional gingival

swelling around 36 (Fig 49Q). A bitewing radiograph revealed
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radiolucency around 36 furcation (Fig 49R). The patient reported
no effect on daily life and did not want any treatment.
5-years – The patient hadn’t returned until this date. He was still very happy

with 36 and all intraoral tests were normal except slight bleeding on
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probing at 36 straight buccal. The periapical radiograph revealed no
apical abnormality, however, a large furcal radiolucency was

observed (Fig 49S). The patient reported he had neglected his oral
hygiene for a while. He was informed that if the tooth develops

caries again, there will be no guarantee that the tooth can be restored
at that time.

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Note See “case 60” for discussion with the patient about treatment for the missing 47,
options:
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1) Ortho upright 48 and mesialize;
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2) 47 Implant; and
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3) 46-x- 48 bridge without uprighting 48 (not recommended).
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