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Huge lesion from 44-47

From: Marga Ree To: ROOTS Sent: Tuesday, May 18, 2010 5:45 AM Subject: [roots] Huge lesion from 44-47 This 18 year old boy was referred for a huge lesion, associated with 46. In november 2008, I started retreatment of 46, I stripped off the gutta-percha, obtained patency. No drainage. Applied CaOH. He got a flare-up after 3 days and because I was abroad for a few days, he ended up in the office of an OS. The OS did an I&D procedure and applied a drain, consisting of a piece of sterile glove, attached with a suture. After 2 days I removed the drain. I had him returned to my practice every day, and there was a never ending flow of pus each day. Finally, I decided to leave the tooth open, and after a few days, there was still pus seeping out of the canals, the sulcus, and the old incision. In addition, patient mentioned a numb feeling on the right side of his lower jaw.... I referred him to an OS who I trust, and asked him to do a biopsy, and not touch the root tips. There was still CaOH in the tooth. The OS raised a flap, and found a lesion extending from 47-44, he found what he called a periodontal defect between 46 and 45 of over 15 mm, buccal bone plate was intact, the lesion was so big that the mental nerve was visible, but intact. Biopsy revealed the presence of a cyst. I decided to change CaOH till there were signs of healing. This took 5 months. I finished treatment in May 2009 One year follow-up shows remarkable resolution of this huge lesion - Marga

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