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Abscess in 37 - Courtesy ROOTS

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From: Noemí Pascual
To: ROOTS
Sent: Wednesday, July 04, 2007 4:25 AM
Subject: [roots] Diagnostic CASE

First visit - This italian young female was referred for evaluation in 37.
Clinical examination revealed abscess in 37. The RCT was done
4 years before in Italy. No tenderness to percussion but painful to
palpation.She had pain to bit cotton. Perio probings were normal except
in one point 8 mm. I try to follow the access of the abscess with a
guttapercha and it arrived to the furca. Vertical fracture?
Second visit - I take off the metal ceramic corona and clean the gum.
Third visit - The abcess has disappeared and there is a clear sinus tract
more coronal than apical. I examined the sinus tract with a guttapercha and
it arrived again to the furca.

What´s your opinion??? - Noemí Pascual

Hi Noemi, why don't you try with a exploratory surgery???????? It's the classical presentation of a VRF. - SALUDOS I think the same Noemi....deep pocket at just one point looks like a VRF to me. - Sachin Hi Noemi, Have you tried to remove the filling, clean the pulp chamber and explore the floor? If there is a VF, sometimes you can see the fracture line. Regards, Carmen I am with Carmen. I would do this first. If I can not see a fracture line I would remove the whole RCT and check inside the canals. If that still looks fine I would go for Perio consult and exploratory surgery.- Thomas P.S Doesn't say much good about Italian endo and restorative....
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