Gross Perforation Repair of Molar: 10 year Recall Exam

Terry Pannkuk, DDS, MScD Complications: Advanced Management, Perforations, Retreatment Strategies, Dismantling, Gutta Percha Removal, Recall Observations

Repair of gross perforation defects can result in long-term successful treatment

Patient: 23 year old female in excellent health

Chief Complaint: ”tooth feels swollen”

Dental History: The patient reported having had the previous root canal treatment, build-up, and crown performed by her previous dentist in Salt Lake City, Utah, 6 years prior (1994)

Significant Findings: The patient presented with severe percussion sensitivity, fluctuant swelling, Class 1 mobility, a 4mm sulcular mesiolingual defect which bled upon probing, and the following radiographic observations associated with the mandibular left first molar (tooth #19):

  1. Previous root filling with weak apical radiodensity and filled short of the radiographic terminus.
  2. Missed canals were suspected in each root.
  3. Three previous posts were placed in each root and suspected to be perforating the furcation.
  4. The periapical radiolucency was noted circumscribing the mesial root measuring 5.5mm in greatest
    diameter and a periapical radiolucency circumscribing the distal root measuring 3.5mm in greatest diameter.
  5. A large radiolucency involving the furcation.

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