Case of the week

I chose this case because the root canal turned out beautifully and it was an unusual diagnosis, resorption of a molar.  I take great pride in completely finishing upper molar root canals, ie finding and cleaning the fourth canal.  Many of the “specialists” in our area do not EVER do this and it drives me crazy.  It basically ensures the patient will have ongoing pain and the tooth will eventually fail.  Due to my extra training and purchasing of the correct equipment I am able to find and treat the fourth canal in 80% of my patients that I see in Wheaton.  I keep the stats and photos here.  If you look at the literature that falls in line with the number that are present in most populations.

George came in complaining of pain whenever he drank coffee in the morning.  Pain to hot is an occasional symptom of a dead tooth that has gotten infected.  However, when I tested these teeth with cold, a symptom dead teeth do not feel, all teeth were alive.  I also tested the teeth to heat and none tested abnormal, in fact all tests were normal.  The xray appeared to show something black (circled) under the metal filling.  I advised him that I was strongly suspicious that his pain was coming from that tooth but wouldn’t know until I removed the metal filling to see what was under it.  Well, as soon as I removed the filling a hole into the nerve opened up and I knew we had the problem solved.  Completed the root canal as I usually do and he was out of pain the next day!

Upon hitting the amalgam with a bur the cusp and amalgam flew out and a cavernous hole into pulp was exposed