Help interpreting dental xray

RE: Help interpreting dental xray

Evelyn Barbour-Hill — Wed, 06 Feb 2019 13:54:16 GMT

[quote user="GrooveJet"]Other than extraction, are there any other treatment options worth considering (apart from root canal treatment, which I have neither the facilities or the know-how, to attempt)?[/quote]

Not that I can think of. Apicectomy and root canal treatment perhaps.

I suspect that root is beyond endodontic treatment anyway, in practical terms – the apex is too destroyed. Perhaps something could be devised..... but why? Or you could divide the tooth, extract that root, and do endodontics on the other two to preserve them..... again, what would be the point? (I do occasionally divide that tooth, extract the mesial and palatal root for periodontal reasons and preserve the distal root; but that's a different situation altogether)

[quote user="GrooveJet"]If it is endodontic dz, any ideas what may have caused this?[/quote]

Pressure necrosis has been suggested by Geoff Lane. I'm very doubtful about that although 45 years ago it seemed a good hypothesis.

RE: Help interpreting dental xray

Miriam Lodewyks — Wed, 06 Feb 2019 09:59:11 GMT

Thanks for the help all.

I discussed it with owners and we have elected to re-xray in 6 months (sooner if becomes symptomatic).

If it is endodontic dz, any ideas what may have caused this? I examined the crowns carefully and they appeared sound, as did the surrounding gingiva....

Other than extraction, are there any other treatment options worth considering (apart from root canal treatment, which I have neither the facilities or the know-how, to attempt)?

RE: Help interpreting dental xray

Rob Davis — Wed, 06 Feb 2019 09:07:40 GMT

Did you manage to get the mesial roots on another picture? I would expect to see some periapical lucencies on them too. You could also try taking another picture from a slightly different angle to see if it looks the same. I agree that it looks suspiciously like there is endodontic disease.

Did you extract it? If so what did the root tip look like?

RE: Help interpreting dental xray

Evelyn Barbour-Hill — Tue, 05 Feb 2019 14:02:20 GMT

[quote user="GrooveJet"]Lots of recession in other places, 16 extractions so far.[/quote]

Then I'd extract this one as well!

RE: Help interpreting dental xray

Miriam Lodewyks — Tue, 05 Feb 2019 13:41:33 GMT

No clinical symptoms, crown and gingiva seem normal.

Lots of recession in other places, 16 extractions so far.

RE: Help interpreting dental xray

Evelyn Barbour-Hill — Tue, 05 Feb 2019 13:40:18 GMT

[quote user="GrooveJet"]Monitor, or extract? [/quote]

Well, answering the plain question with no other information: in most circumstances, I'd advise extraction.

Are there any symptoms? What does the crown look like? Any other teeth affected?

There's peri-apical lucency and considerable degeneration (external resorption) of the apical portion of the root. I'll lay there's endodontic disease going on.