From Caries to Root Fracture

A 50-year-old lady had caries in #30 DO 6 years ago (Fig.1 *).  Carious removal results in pulpal exposure (Fig.2 *); note long roots of the neighboring teeth (premolars).  The affected tooth receives root canal therapy (RCT, Fig.3).  One year 10 month follow up reveals asymptomatic periapical radiolucency (Fig.4 ^).  The tooth develops large radiolucency (Fig.5*) and swelling and fistula (Fig.6 <) 3 years 11 months after RCT.  One year 5 months later, the distal root fractures (Fig.7).  Finally she agrees to have immediate implant because she has TMD on the right side.  Her husband reports that she bruxes at night.  Night guard will be fabricated after implant restoration.

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Xin Wei, DDS, PhD, MS 1st edition 10/07/2014, last revision 10/08/2014