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Percussion : Vertical root fracture
The opinions within this web page are not ours. Authors have been credited for the individual posts where they are
From: gary l. henkel d.d.s.
To: ROOTS
Sent: Tuesday, March 03, 2009 11:56 PM
Subject: [roots] interesting case

Last week, a middle aged w.m. presented with cc of a toothache urq.
Quickly found via radiograph and percussion that #2 was the culprit.
I was convinced that this was a vrf, and as the distal of the first
molar caught the mesial of the mandibular 2nd molar, patient and I
agreed removal was best option.   I routinely section roots, and
after routine removal, I found myself playing with a large 1.5x1 cm
soft mass through the well preserved interseptal bone.  I was able
to remove it in one nearly intact piece and two smaller ones through
the palatal root orifice.  Because it did not seem routine, we
submitted for histologic evaluation.  The report came back as an
odontogenic keratocyst.   This is unusual in that this was a maxillary
molar, most are found in the mandible.  Iíve attached a review of them.
We will monitor this patient carefully as ketatocysts have a high rate
of recurrence - Gary

Thanks for sharng Gary - Jose

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