This patient came in today with a necrotic tooth #14. She had a draining sinus tract on the palatal and recounted a history of massive palatal swelling. Diagnostic tests found #14 Necrotic Pulp with Chronic Apical Abscess.
The tooth had a MO amalgam & O amalgam. Patient also has a history of bruxism with cuspal fractures on other teeth.
Upon access, a crack running down the distal wall and a crack running down the mesial wall both took a left turn and met across the pulpal floor. This tooth was then diagnosed as non-restorable and an extraction was recommended.
Had this tooth been crowned previously, it may have been saved. When patients exhibit severe patterns of occlusion with bruxism, I would recommend cuspal coverage at an earlier stage.
If you have difficulty making this recommendation to your patients, I would be glad to send you some pictures from my photographic collection called, "Teeth that might not have fractured if they had been crowned". You could make a nice picture book with these photos.
Hello Doc,
ReplyDeleteI would very much like to get some of your photos from your "Teeth that might not have fractured if they had been crowned" collection if possible. I started working just recently and still do not hve so many cases I could show to my patients. I am working at Zagreb, Croatia (Europe). My e-mail is borifilipovic@gmail.com
thnk you very much!