ENDODONTICS, ORTHODONTICS, AND ORAL SURGERY

ENDODONTICS, ORTHODONTICS, AND ORAL SURGERY…

This 13 yo healing male was referred to our office for management of an anticipated carious pulp exposure on tooth #31. The boy’s chief complaint included pain on chewing due to food entrapment within the carious defect and sensitivity to temperature (cold/hot) and sweets. Additionally, this tooth was mesially inclined significantly and was treatment planned for molar uprighting by an orthodontist. The upper left represents the pre-operative radiograph (we apologize for the blurriness as this boy had a slight issue with his gag reflex on this particular day). The upper right depicts the post-operative radiograph where we performed apexogenesis using Brasseler Root Repair Material and glass ionomer as a permanent restoration. The lower left depicts the 1 year recall where the patient remained asymptomatic and we have evidence of continued root development. At this time, the patient had already initiated orthodontic treatment. The final radiograph on the lower right represents 1 year, 6 month recall. We can see that the root has completely developed at this time with significant calcification of the canal system. This may be impactful in the future should the tooth become infected as it would make endodontic treatment very difficult. Additionally, the tooth has been significantly uprighted. The tooth is now primed for full coronal restoration. We have included Oral Surgery in the discussion due to the partial soft tissue impacted 3rd molar (#32) which is slightly visible in all radiographs. We have recommended that an evaluation be made pre-prosthetically to have the 3rd molars removed to aid in restoration of #31. Additionally, the roots have not fully developed yet so extractions would be made easier at this time (panoramic radiograph not included above).