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Second molar most sensitive to percussion - Courtesy ROOTS

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credited for the individual posts where they are - www.rxroots.com
From: Terry Pannkuk
Sent: Friday, February 19, 2010 9:27 AM
Subject: [roots] Orthognath Case

This is a 57 year old female patient who presented 12/07 for retreatment of #30.  She was having ortho and then
had a saggital split last year.  The crown on #30 was beaten up pretty good.  The second molar is the most
sensitive to percussion.  The one I treated 2 years ago is slightly percussion sensitive.  I don't particularly
like the PDL space widening at both apices of the tooth I treated.  The don't look like obvious lesions to me.
The fact that it was a retreatment, the patient just got her ortho bands off,  had recent orthognathic surgery,
and the roots apices seem to fenestrate through the buccal plate of bone, seems to suggest we should just
schedule her for a later recall.

Pretty wild how the one screw seems to be right on the mandibular canal.  The patient has no paresthesia.
I've been told by oral surgeons that these patients are informed to expect permanent paresthesia as a probably
outcome when the jaw is split.  Sometimes it amazes me how paranoid we are about certain risks while oral
surgeons and MD's treat the same risks as a cavalier accepted outcome - Terry

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