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Anatomy of an Endodontic Failure

Terry Pannkuk, DDS, MScD – Recall Observations

Why does an endodontic treatment fail?

Patient: 38 year-old female with chronic myelogenous leukemia, taking Imatinib (antineoplastic agent, tyrosine kinase inhibitor)

Chief Complaint: Toothache on the left side

Dental History: Patient developed mild tooth pain of recent duration during chemotherapy. No recent dentistry had been performed and the mandibular left first molar had been restored with a full gold crown.

Significant Findings (#19): Slight percussion sensitivity was localized to tooth #19 which reproduced symptoms. Both teeth #’s 18 and 20 responded within normal limits to cold thermal stimulation while tooth #19 responded with a sharp, transient response. Periodontal findings were within normal limits. A periapical radiograph revealed periodontal ligament space widening at the mesial root periapex. Moderate diffuse calcification of the root canal system was also noted.

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2 comments

Commenting Guidelines Please make scholarly cited references or expert opinions suitable for publication. The comments can either be "pro" or "con" with references to the treatment philosophy. We encourage objectivity and detailed demonstration of knowledge/literature.
Kendel Garretson commented 7 years ago.

All cleared root end photos are of this case, correct?

Terrell Pannkuk commented 7 years ago.

Hi Kendel, All root ends are from that case which Craig Barrington cleared for me.

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