Portfolio of Endodontics Cases

By: Sahil Arora

Class of 2014

Pt. 288026 M-67

Pt. Presents for class 4 anterior filling on #23. Large lesion leads to carious pulp exposure.

Pt. returns 6 months later with complaints of pain when eating #23

Pain on palpation, percussion, no response to ice testing, normal perio probings

Pulpal Diagnosis: Pulp Necrosis

Periapical Diagnosis: Acute Apical Periodontitis

Visits: 2

Reflection

Procedure was very straightforward

No complications

It was decided to not crown the tooth. Anterior composite would be sufficient.

Pt. 1117058 F-64

Pt. Presents to emergency with pain on previously crowned tooth #31 when chewing food.

Lingering pain to ice test, pain on percussion & palpation

Pulpal Diagnosis: Irreversible Pulpitis Periapical diagnosis: acute apical periodontitis

Visits: 3 (including emergency visit)

Reflection

We thought this was a unique one-canalled first molar, until Dr. Gluskin informed us that one-canalled first molars do not exist, and this is likely to be a second molar moved up (#31)

Pt. 1213210 M-45

Pt presented with lingering pain to cold drinks on tooth #13

Severe lingering pain to cold test for 10 seconds. Responds to palpation and percussion. Normal probing readings.

Pulpal Diagnosis: Irreversible Pulpitis Periapical Diagnosis: Acute apical periodontisis

Visits: 3

Reflection

Canal filed to a 35 per Dr. Fathi’s recommendation

Very straightforward case

No complications arose

Patient was brought in at a later time for buildup/prep/temp

Pt 1122055 M-74

Pt. Presented to ER with constant pain on #11

Findings included lingering pain to ice test, minor palpative pain, minor percussive pain

Pulpal Diagnosis: Irreversible pulpitis Periapical Diagnosis: Normal

Visits: 3 (Including ER)

Reflection

#11 was apart of a 6-unit bridge spanning canine to canine

Initially, it was thought to simply access through crown, but due to large decay, we chose to remove crown and all the decay with it

Patient had uncontrollable bleeding near apex when obturating, so canal was filled 1mm short of working length to prevent this

1115515 F-43

Patient presented to clinic with periapical lesion presented at apex of #11

Findings saw minor pain on percussion and palpation, negative thermal testing and normal probing depths

Pulpal diagnosis: Pulp Necrosis

Periapical diagnosis: chronic apical periodontisis

Visits: 2

Reflection

Very straightforward case

No complications arose

Lingual composite used as a final restoration

282279 F-46

Patient presented with pain on tooth #3. Tooth was previously filled 3 months prior, and base was placed due to proximity to the pulp

Due to consistent pain present after deep filling, Dr. Brown suggested endo therapy

Pulpal Diagnosis: Irreversible Pulpitis Periapical diagnosis: Normal

Visits: 6

Reflections

3 canals found initially, and MB-2 found at a alter time

Mb1 was opened to a size 40 after obturation was seen to be difficult at initial length

Pt 502933 F - 47

Special needs patient

Sister brought her in for an emergency visit, due to abscess located above tooth #13

Pulpal Diagnosis: NecrosisPeriapical diagnosis: chronic apical periodontitis

Visits: 3

Reflection

Minor difficulty conversing with special needs patient, which slowed the procedure down slightly

It was difficult to secure appropriate radiographs with the rubber dam in place with this patient, leading to a misleading master cone radiograph

Due to this, gutta percha was placed 2-3mm in excess of the apex.

Pt. 236084

Pt presents with lesion in root canal treated #19

RCT retreatment needed due to missed MB2 canal

Patient presented with no symptoms or swellings.

Visits: 4

Reflection

Post/core placed, and original crown preserved