Dentaltown January 2025 - 38
CASE
2
A U-shaped lesion
Tooth #30 presented with a diagnosis of
previously treated and symptomatic apical
periodontitis. The radiographic lesion
encompassed both sides of the mesial root, forming
a U-shaped lesion. Periodontal probing extended to
the apex. The prior endodontic root preparations were
relatively large, compared with the root canals on the
patient's other untreated teeth. Because the bone loss
associated with a U-shaped lesion encompasses both
sides of a root, it might be considered even more indicative
of a potential VRF than a J-shaped lesion.
This patient had been examined by an endodontist,
who recommended extraction because of a VRF.
Although multiple risk factors were identified, no fracture
was seen upon access, and this tooth was successfully
retained through nonsurgical retreatment.
Fig. 5: Preop PA.
Fig. 6: Preop CBCT.
Fig. 7: Recall PA.
Fig. 8: Recall CBCT.
Fig. 9: Preop PA.
Fig. 10: Preop CBCT.
CASE
3
A lateral lesion with a superficial crack
This patient presented for a second opinion after
an endodontist recommended extraction for
tooth #31 because of a VRF on its distal root. A
deep isolated probing defect, a cervical sinus tract, the
lateral position of the periradicular lesion and the prior
placement of a full crown because of cracks in the tooth's
distal enamel marginal ridge likely contributed to the prior
diagnosis of VRF.
A new diagnosis of previously treated and chronic
apical abscess was made, but the possibility of a VRF was
discussed with the patient. RCT was initiated. Internal
examination of the pulp chamber reassuringly revealed
that a crack on the distal wall of the pulp chamber did not
extend to the pulpal floor. Treatment was completed in
three visits using a calcium hydroxide intracanal medicament.
Treatment and postoperative radiographs revealed
a sharp dilaceration of the distal root, likely focusing the
bony lesion toward the distal surface, not toward the root
apex. Four months later, soft tissue and bony healing were
confirmed.
Fig. 11: Preop probe.
Fig. 12: Recall PA.
Fig. 13: Recall CBCT.
Fig. 14: Recall probe.
JANUARY 2025 | 38 | DENTALTOWN.COM
http://www.DENTALTOWN.COM
Dentaltown January 2025
Table of Contents for the Digital Edition of Dentaltown January 2025
Title
Office Visit: Dr. Conor Perrin
Simplifying Vertical Dimension - Dr. John Nosti
Don’t Jump to Extractions - Drs. Daniel Boehne and Shane White
High Visibility - Dr. David A. Wank
Howard Speaks: Orchestrating Success
Professional Courtesy: Future Focused
First Immediate Implant Case Advice Needed
Lost All Dignity Trying to Appease an Angry Patient
Online CE: Pediatric Dentistry
Poll: Sleep Dentistry
Ad Index
Dentaltown January 2025 - Intro
Dentaltown January 2025 - Cover1
Dentaltown January 2025 - Cover2
Dentaltown January 2025 - 1
Dentaltown January 2025 - 2
Dentaltown January 2025 - 3
Dentaltown January 2025 - 4
Dentaltown January 2025 - 5
Dentaltown January 2025 - Howard Speaks: Orchestrating Success
Dentaltown January 2025 - 7
Dentaltown January 2025 - Professional Courtesy: Future Focused
Dentaltown January 2025 - 9
Dentaltown January 2025 - Online CE: Pediatric Dentistry
Dentaltown January 2025 - Poll: Sleep Dentistry
Dentaltown January 2025 - 12
Dentaltown January 2025 - 13
Dentaltown January 2025 - First Immediate Implant Case Advice Needed
Dentaltown January 2025 - 15
Dentaltown January 2025 - 16
Dentaltown January 2025 - 17
Dentaltown January 2025 - Lost All Dignity Trying to Appease an Angry Patient
Dentaltown January 2025 - 19
Dentaltown January 2025 - 20
Dentaltown January 2025 - Ad Index
Dentaltown January 2025 - Office Visit: Dr. Conor Perrin
Dentaltown January 2025 - 23
Dentaltown January 2025 - 24
Dentaltown January 2025 - 25
Dentaltown January 2025 - 26
Dentaltown January 2025 - 27
Dentaltown January 2025 - 28
Dentaltown January 2025 - 29
Dentaltown January 2025 - Simplifying Vertical Dimension - Dr. John Nosti
Dentaltown January 2025 - 31
Dentaltown January 2025 - 32
Dentaltown January 2025 - 33
Dentaltown January 2025 - 34
Dentaltown January 2025 - 35
Dentaltown January 2025 - Don’t Jump to Extractions - Drs. Daniel Boehne and Shane White
Dentaltown January 2025 - 37
Dentaltown January 2025 - 38
Dentaltown January 2025 - 39
Dentaltown January 2025 - 40
Dentaltown January 2025 - 41
Dentaltown January 2025 - 42
Dentaltown January 2025 - 43
Dentaltown January 2025 - High Visibility - Dr. David A. Wank
Dentaltown January 2025 - 45
Dentaltown January 2025 - 46
Dentaltown January 2025 - 47
Dentaltown January 2025 - 48
Dentaltown January 2025 - Cover3
Dentaltown January 2025 - Cover4
Dentaltown January 2025 - ElitePractice
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