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Unresolved Symptoms for Years

May 15, 2017

Unresolved symptoms for years suggests a wrong diagnosis

Patient: 64 year-old female in good health

Chief Complaint: toothache and swelling in lower left back jaw

Dental History:

The patient reported having had root canal treatment on her mandibular left first molar (#19) 5 years prior to the author’s examination. Swelling had persisted and surgical endodontic retreatment had been performed a few months after the initial endodontic treatment. In 2013, the previous treating endodontist diagnosed a necrotic pulp and acute periradicular periodontitis associated with the mandibular left second molar (#18) and associated the continued swelling and non-healing of the #19 periapical bone to the pathosis of #18. The patient continued with a toothache and swelling until it worsened in 2017 and the patient sought the author for a second opinion.

Nonsurgical Retreatment Limited to the MB Root: CBCT-Aided

Dec 19, 2016

Learn to decide when to perform limited retreatment of a multirooted tooth

Patient: 35 years old female; in good general health condition

Chief Complaint: Palpation soreness on the cheek area while washing the face.

Dental History: The patient presented with good oral hygiene. Her dentition consisted of numerous intracoronal fillings and crowns. A crown restoration on tooth #16 was reportedly placed 5 years prior to the time of consultation at which time endodontic treatment had been performed. She reported no complaints associated with Tooth # 16 until recently (previous few weeks) The patient went to her dentist who took a periapical radiograph and diagnosed an apical periodontitis associated with Tooth #16, then referred the patient to the author for examination and treatment

Recall (6 Year): Retreatment of Missed DL Root

Feb 8, 2016

Access extension is important to discover previously ignored cracks and find missed canals during retreatment

Case: Patient presented with a recurrent abscess and a missed canal during previous root canal treatment

Patient: 61-year-old male in excellent health

Chief Complaint: asymptomatic (2006)

Dental History: The patient’s former dentist performed the initial root canal treatment in 2001 (he had claimed to treat it with a laser) and the patient’s new dentist referred the patient for endodontic examination before the construction of a new crown in 2006.