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):
- Previous root filling with weak apical radiodensity and filled short of the radiographic terminus.
- Missed canals were suspected in each root.
- Three previous posts were placed in each root and suspected to be perforating the furcation.
- 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.
- A large radiolucency involving the furcation.