Clinical Case: How would you save this tooth with an open apex?
Dr. Sarah Abitbol, Endodontist, Coronation Dental Specialty Group with Dr. Ian Furst, Oral & Maxillofacial Surgeon, Coronation Dental Specialty Group
Here’s a case that involves regenerative endodontics. If you’re not sure what regenerative endodontics is or if you’d like a quick tutorial on the biologic basis for it, we’ve created an interactive backgrounder.
An 11 year old girl presents with swelling and pain in the left mandible and a fistula adjacent to tooth #3.5 for 3 days. Clinical exam reveals a deep development groove adjacent a talon cusp with occlusal decay. The tooth is tender to percussion but not palpation, has normal probing depths, a buccal sinus tract pointing to the apex of the tooth, and a non-vital response to cold testing when compared to control teeth.
Radiographically, you see deep occlusal decay, a blunderbuss apex, thin dental walls and a periapical radiolucency. The patient and her parents want to save the tooth.
What is your diagnosis, what treatment would you recommend and why?
See below for our video answer to this case or take part in the discussion through comments.
SPOILER ALERT: Our video solution to this clinical case.