Clinical Reports
Knowledge based on two cases that were difficult to diagnose
2018 Volume 39 Issue 3 Pages 142-146
Details
2018 Volume 39 Issue 3 Pages 142-146
Abstract : Two clinical cases whose endodontic condition was very difficult to diagnose are described. Based on this experience, the importance of diagnosis prior to root canal treatment and complications related to the treatment are described.
Case #1 : Mandibular second molar with acute apical periodontitis and fractured instrument in the apical third is described. The patient’s chief complaint was swelling and sinus tract. This tooth had been treated and built up with a metal core by a general dentist more than 20 years ago. The root canal configuration (anatomy) was C-shaped and the isthmus between the mesial and distal canal was infected. Therefore, the canal was shaped with ultrasonic tips and the metal fragment in the apical third was removed. After treatment, both complaints resolved and the prognosis was assessed as good. The tooth remains asymptomatic after more than one year.
Case #2 : The patient’s chief complaint was pain in the maxillary second premolar. After complete examination, a diagnosis of a trigeminal neuralgia was made. Shortly afterwards the patient was referred to the neurosurgery department and underwent a MRI exam. The final diagnosis rendered was acoustic neuroma.
