Case Studies

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Treatment of a Gross Perforation

Jul 1, 2020

Proper treatment of a gross perforation with a bioactive material can lead to remarkable healing.

Treatment Plan: Nonsurgical Endodontic Therapy and internal perforation repair (#26)

Special Considerations of Performed Treatment:
The first important consideration was elimination of pain which required palliative treatment (Ibuprofen and Acetaminophen), pulp extirpation, and management of the inflamed periradicular perforation site.

UPDATE 1 year Recall: Mandibular First Molar Presumed Split, but not.

Nov 11, 2019

Not all teeth that look split are split; expect the unexpected!

Patient: 49-year-old male with controlled hypertension and hypercholesterolemia

Chief Complaint: Swelling on the cheek-side of his right lower molar

Dental History: The patient reported having had a bonded resin filling material having been placed in his mandibular right first molar approximately 6-12 months prior to the time of examination. His dentist had reported a crown fracture and on a recent cleaning visit buccal swelling was noted with a 12 mm sulcular defect communicating with the buccal furcation. The dentist was certain the tooth was split and referred the patient to the author because the patient insisted upon wanting to see if the tooth could be saved.

21 Year Recall: Internal Perforation Repair with Amalgam

Nov 4, 2019

Long-term recall of internal perforation repair with amalgam

Patient: 38 year-old male in excellent health (1994)

Chief Complaint: Severe tooth ache

Dental History: The patient presented to the author in 1994 having had previous endodontic therapy on the maxillary right first molar (tooth #3) in 1990. Severe tooth pain had developed localized to the tooth 1 ½ weeks prior to the author examining the patient at which time the patient’s dentist had attempted endodontic retreatment. The attempted nonsurgical endodontic retreatment procedure failed to relieve the patient’s pain and the general dentist had performed an emergency surgical flap procedure. Antibiotics and narcotic analgesics had been prescribed and the patient was referred for endodontic consultation (1994)