Case Studies


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21 Year Recall: Internal Perforation Repair with Amalgam

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)


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Puzzle Case: Silver Point Retreatment Part 1 and Part 2 (Conclusion)


What is your diagnosis, prognosis and treatment plan?

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Gross Perforation Repair of Molar: 10 year Recall Exam


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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Perforation Management

Dec 4, 2017

"Quick" Emergency Visit to an Endodontist

May 16, 2016