The following case represent interesting diagnostic dilemma.
The patient was referred to smile clinic, dental surgery London for the management of chronic problem and the fit of dental implants and teeth whitening. He was attended by Dr Firas Daoudi, the specialist and cosmetic dentist. The patient has been complaining of vague discomfort on the right side of the face.
The pain lasted for few months and radiated to upper and lower teeth, TMJ and the right ear. At one stage there was suspension of trigeminal neuralgia.
Antibiotics were prescribed on many occasions with little improvements.
Recording careful history of the patient’s complaint has lead to the correct diagnosis.
Careful examination resulted in positive response to the use of tooth slooth with LR7.
Lower molars are the most common teeth to be affected by tooth crack syndrome.
In addition, radiographic examination showed the presence of an apical radiolucency associated with this tooth. The patient was given the option of saving the tooth, or the fit of dental implants (Fig 1).
The presence of the crack was confirmed clinically. After the administration of local anaesthesia, rubber dam was used to isolate the tooth. The use of magnification and intense lightening (curing light in this case) helped confirming the presence of the mesio-distal crack (Fig 2).
Root canal treatment was completed in single visit and adhesive provisional restoration was provided (Fig 3).
The patient was asked to return to the referring dentist for the provision of a crown as soon as possible. This will help with the long-term prognosis of the provided treatment. Should the tooth need future extraction, dental implants was recommended.
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