PERIAPICAL PATHOLOGY + VITAL PULP
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From: Roberto Cristescu
Sent: Tue 3/29/2005 15:54
Subject: [roots] PERIAPICAL PATHOLOGY + VITAL PULP
Thought this might be interesting...I know it may happend from time to
time, that's why it is so important to accurately make all the
This 33 y.old male was reffered to me for chronic apical periodontitis
because the other doc saw a big decay, the radiotransparency on the
X-ray and the pt told him that it hurts when he eats on this tooth (47
international, 31 USA).
The vitality test with pulp tester showed me a value of 48 and the
tooth 37 (18 USA) was 45 on electric pulp tester. I saw on the X-ray
that on the mesial the pulp might pe open....
Made him one articaine and one mepivacaine and started to remove all
the decay, and yes, the pulp was discovered :-)))..it was vital and
not bleeding but..unfortunately still hurting when I gently tocuhed it
with the explorer....I had to temporise, which I really hate MOST !
I rescheduled the pt, and I'll go with ibuprofen premedication and who
knows what kind of anesthsia so that I'll be able to make the
pulpectomy safe and without pain ! The patient have had in 2002
hepatitis B :-)))
It's so sad to see on myself that the authors that are writing about
the high failure rates of SPix anesthesia for endo on lower molars
are damn right :-(((((
All the best regards, - ROBERTO
Ledermix paste is great in cases such as this. Settles things down so that
the LA works ok for pulp extirpation at the next visit. - Stephen Day.
This is a similar case.MY left cetral and lateral incisal.
apical lesion was noted over 6 years,
no color change almost no symptom , sometimes feel a little sensitive
I ask my friend to do the endo ,but when he use the high speed I feel
very very sensitive. So I think it is vital.
And decide to follow up. What should I do ,keep follow up or endo?
please give me some suggestion, thinks. - Shih wu hsien
Take more x-rays form different angles. Do thermal and electric pulp
testing. - DanS