May 15, 2011
From the ROOTS forum
patient was referred for consultation and treatment of #25 and #26. They
presented with pain in the upper right quadrant and swelling in the area of the
#25 and #26. The referring dentist had prepared both teeth for PFMs and they
were provisionalized. Percussion of both teeth was very painful, mobility
(2-3+). There was a deep pocket (approximately 11-12mm) between molar and
premolar. Vitality testing was positive for molar and negative for
premolar. Preoperative X-rays showed
periradicular bone resorption and pocket depth, checked by guttapercha point.
debridement and disinfection procedures were completed, calcium hydroxide
dressing was placed for 4 weeks and it’s filling quality checked by x-ray.
4 weeks there were no signs of pain or
swelling. 26 still has positive reaction for cold test. Normal mobility
of molar, premolar has 1-2 grade of mobility. During final obturation a small
lateral canal was filled, perhaps this one caused periradicular bone
destruction and join two microbiotas – endo and perio one. Elimination of the endodontic infection led
to partial healing but for my view periodontal treatment is needed for the
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Best regards, Ilya Mer
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