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When a “J” Type Lesion on an X Ray Image, as well as Probing a “Deep Narrow Periodontal Pocket” Could Have Missled the Dental Practioner to Conclude the Presence of a Cracked Tooth.

April 8, 2011 By Dr Pierre Pizem Leave a Comment

 

Dental Operative Microscope and Retreatment, Dealing with Ledges and Apical Zip, Root Canal Treatment Pre-Therapy (1)Dental Operative Microscope and Retreatment, Dealing with Ledges and Apical Zip, Root Canal Treatment Per-Therapy (1)Dental Operative Microscope and Retreatment, Dealing with Ledges and Apical Zip, Root Canal Treatment Per-Therapy (2)Dental Operative Microscope and Retreatment, Dealing with Ledges and Apical Zip, Root Canal Treatment Per-Therapy (3)Dental Operative Microscope and Retreatment, Dealing with Ledges and Apical Zip, Root Canal Treatment Per-Therapy (4)Dental Operative Microscope and Retreatment, Dealing with Ledges and Apical Zip, Root Canal Treatment Post-Therapy (1)

This is a case where, based on the X ray image of a “J” type lesion in combination with a deep narrow periodontal probing, one could easily think of a cracked tooth. However, when observing under high magnification, no crack could be seen from within the root canal mesial wall. This J shaped radiolucency was in fact a narrow desmodontal sinus tract originating from an endodontic infection. Saving that tooth implied a retreatment, a ledge bypass and a few calcium hydroxide dressings replacements. As shown on those control post operative X ray images, a slow but complete periradicular tissues regeneration occured. In this case study, even a CBCT 3D imaging would have shown a deep narrow bony defect that could have misled the practionner to conclude the presence of a cracked tooth. Direct observation under a dental operative microscope showed us otherwise, proving once more how micro dentistry is elevating endodontic care to a higher level.

Filed Under: Dental operative microscope and retreatment, NEW CASES, Post endodontic treatment outcomes, Regeneration of the periradicular tissues, Dealing with ledges and apical zip

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