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  Syndrome case: tooth #37

The opinions and photographs within this web page are not ours. Authors have been credited for the individual posts where they are. - www.rxroots.com Photos courtesy of Noemi Pascual
From: Noemi Pascual
Sent: Tuesday, September 18, 2007 3:40 AM
Subject: [roots] What would you do?

Coming back from my holidays...I have post-holiday Syndrome!!!!

A 26 year old female was referred for endodontic therapy for tooth 37. The patient was assymptomatic. 3 canals were
located. 2 visits with calcium hydroxide as intracanal medication for 4 weeks.Notice the separated file in the ML. I was
not able to retire the separated file but I could by-pass it (it was my post-holiday syndrome????).

The obturation was carried out using the cold lateral condensation with GP and AhPlus for the apical third and accesory
points with guttacondensor for the other two thirds.  - Noemí Pascual

Hi Noemí., Tooth 4.7 (lower R third molar) has a wicked root pattern and apparent close proximity to the inferior alveolar dental nerve. Considering the patient's age (26 years), are there plans to do anything with that unerupted tooth? - Michael Moran. Dear Michael, She has her first visit with the oral surgeon so by the moment I am not sure which is the treatment option they are going to take. What would you recommend in this case? - Noemí Pascual Hi Naomi, I'd leave it to the oral surgeon to make the call. Personally, I'd be thinking if the roots weren't so close to the inferior alveolar dental nerve it might be a reasonable surgical risk, even if the distal root were to break off and be left behind, due to the tooth's vital status. Perhaps a CT scan would be indicated to assess the risks. If it were left to me I'd probably say leave the tooth where it is due to the absence of pathology to date, and radiographically monitor it annually. - Michael Moran.
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