Case Studies

Surgical Exploration

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Inflammation of the Marginal Gingiva and Recalcitrant Endodontic Disease

What are the common causes of a sinus tract near the marginal gingiva?

Patient: 61 year-old female with hypothyroidism (2010)

Chief Complaint: gum swelling with drainage (2010)

Dental History: The patient reported a history of temporomandibular joint disease and a recent draining fistula associated with the buccal marginal gingiva of the right mandibular first molar (tooth #30). No recent restorative dentistry had been performed in the sextant and the PFM crown on tooth #30 had been placed before the year 2000.

Surgical Exploration

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Maloccluded Symptomatic Maxillary Canine having a Necrotic Pulp

Surgical Exploration

Learn how to manage a complicated case with combined nonsurgical and endodontic therapy: Patient presenting with deficient supporting bone and endodontic swelling

*Patient:** 53 year-old female in excellent health

Chief Complaint: The patient reported pain and swelling associated with her right maxillary canine for the previous 2 weeks.

Dental History: The patient reported a history of periodontal problems and multiple teeth having been extracted. The existing bridge had been made 5 to 10 years earlier.

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Aggressive Interproximal Lesion

Surgical Exploration

Learn how to manage a treatment resistant periodontal defect

Case: Patient returned on recall examination with an abscessed aggressive interproximal bone defect after having endodontic treatment on both adjacent teeth

Patient: 30-year-old female in excellent health

Chief Complaint: Aching pain around the gums (teeth #’s 2 and 3)

Dental History: The patient had a history of endodontic treatment on the maxillary right second molar in 1998 (treated by the author with the pulp being vital, caries exposure) and the maxillary first molar in 2010 (retreatment performed by author’s partner, original endodontic treatment by unknown dentist during the interim). At the time of treatment of #3, tooth #2 had normal periodontal findings and no pain (2010). A year later the patient started developing a gum infection in the area then having pain that required her to seek an endodontic examination. Her periodontist had noted a deep pocket between teeth #’s 2 and 3.

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Recall Series (3 years): Treatment Resistant Lesion

Surgical Exploration
Dec 7, 2015