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CBCT Scan: Perforation of bicuspid

This patient presented with pain and discomfort on the buccal aspect of tooth 28.  She had root canal treatment on this tooth about one year ago and it was always uncomfortable to the touch. Vitality tests including palpation, percussion, biting down tests were performed. A radiograph was taken but the diagnosis was unclear.                                                  

 

 A cone beam Ct data set of the mandible was acquired and reconstructed. The resultant axial, coronal, and sagittal reconstructions were examined. The findings show an object protruding from the buccal aspect of this tooth.Treatment consisted of removal of the object followed by conventional root canal therapy followed by a repair using MTA. Normally MTA would discolor a tooth if it combines with blood from tissue outside of the tooth.  In this case, there is a metal crown in place so discoloration is not an issue.

 Also note, it is easy for the operator to lose orientation when accessing the canal of a mandibular bicuspid. Note the angle the root compared to the angle of the post. 

 If you have any cases that need an extended diagnosis available through CT scans, send them to us. We are looking forward to working with you. Thank you for your support. 

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