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Five Year Follow-Up of Heroic Anterior Tooth Save:UPDATE

Nov 18, 2019

UPDATE: Recurrent Endodontic Disease After Initial Healing, 4 years later

Patient: 52 year-old (2014) male in excellent health

Chief Complaint: Patient reported a bump on the gums above his front upper tooth

Dental History: Patient reported a history of prior orthodontics as a child and previous endodontic treatment performed on the maxillary left and right central incisors in 1970 (teeth #’s 8 and 9). Surgical endodontic treatment had been performed years ago after a recurrent infection associated with the maxillary left central incisor (tooth #9)

Gross Perforation Repair of Molar: 10 year Recall Exam

Aug 12, 2019

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.

Heroic Retreatment of a Retreatment: Puzzle Case Part 1

Feb 11, 2019

You make the call at the surprise decision point!

Patient: 52 year-old male in excellent health

Chief Complaint: Patient reported a bump on the gums above his front upper tooth

Dental History: Patient reported a history of prior orthodontics as a child and previous endodontic treatment performed on the maxillary left and right central incisors in 1970 (teeth #’s 8 and 9). Surgical endodontic treatment had been performed years ago after a recurrent infection associated with the maxillary left central incisor (tooth #9)

Significant Findings (teeth #’s 8 and 9): Percussion and palpation tests were within normal limits for both teeth. Periodontal probing depths were within normal limits for both teeth. A fistula with drainage was noted at the apical extent of the attached gingiva opposite tooth #9. Radiographic findings revealed slight PDL space widening with a slightly short root canal filling associated with tooth #8. Tooth #9 revealed a diffuse periapical radiolucency with a root filling filled 2-3 mm short of the radiographic terminus and a suspected “blunderbuss” apex.