Bone loss one year after VRF revealing (by Ilya Mer)

Русская версия

The initial RCT was done 10 years before by resorcinol pulpotomy. It was quite during  10 years and got exacerbation a month ago. That moment two doctors had tried to retreat it but didn’t succeed due to massive resorcinol obliteration of pulp chamber and coronal third. Patient was told about perforation in mesial root. The patient was sent to my office to consult, in fact to confirm that only extraction was possible. Patient came with pain and buccal swelling around #36. After two hours of archaeological digging I succeeded to struggle through the reparative dentin and got pus from ML. Perforation was also found in middle third of ML. Root canals were cleaned and application of Ca(OH)2 placed for two weeks. Next visit I was going to complete the obturation. Patient sad that he breathed freely after the anesthesia gone and the tooth didn’t hurt him during 10 days but 3 days ago  lingual swelling appeared. After opening I immediately saw fracture starting from perforation and rising up. IMHO I couldn’t see it last appointment, color is to bright, is it mean a fresh fracture? So, it’s very sad situation. Any way I completed the obturation but I said the patient the tooth should be go out. By any reason the patient held that tooth unextracted and got acute abscess one year later

Preop X-ray
After the canals were negotiated pus came out
After cleaning and shaping procedure were completed calcium hydroxide was placed
VRF was revealed
Red arrow points to perf
Obturation was completed but extraction recommended
the situation one year later, significant bone loss

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