COMPROMISED TEETH:

Here is a 79yo healthy female with non-remarkable medical history. She presented with a history of massive palatal swelling due to perforation of the palatal root from attempted retreatment by her dentist. As you can see, a part of the previous casted post remains in the palatal root. We have identified the perforation on 2D imaging and confirmed with CBCT (we area aware of an untreated MB2 canal; however, there is no evidence of periapical pathology and retreatment will not be attempted until we can confirm that we have rectifed the palatal pathology). We have decided to attempt repairing the perforation defect through a palatal access. The factors involved in our treatment decision included: age of patient, existing restorations on adjacent teeth, maxillary sinus proximity, finances, Through the sequence of images, we show the radiogrpahic images involved in diagnosis and the sequence of surgical events in order to address this case. A membrane was used after bone graft was placed but there is no picture to show it. We are pretty happy with the result given the considerations that we had to work with! Stay tuned for follow-up and potential retreatment of the buccal roots…