This month’s case highlights a simple but restoratively challenging one. Patient presented with a fractured #4, pain and sensitivity to cold.

Patient Presentation

The patient was referred to HTX Endodontics for the evaluation & treatment of Tooth #4

Fractured palatal cusp #4

Clinical findings:

• • H/O fracturing the tooth while eating food
• • Sharp sensitivity to cold
• • Lingering pain
• • No pain on percussion

Radiographic findings:

• • No periapical radiolucency
• • Intact PDL

Pre Op PA #4

Bite wing #4 showing fracture line extending to pulp

Diagnosis – Symptomatic irreversible pulpitis/ Normal Apical Tissues. Endodontic Prognosis – Favourable

Treatment Options Discussed

We discussed all possible choices with the patient:

• Nonsurgical Root Canal Treatment

• Extraction

• No treatment

The patient wanted to save the natural tooth and chose root canal treatment, which is a very reliable and long-lasting option.

Treatment Provided

We completed the root canal in a single visit.

Access Cavity Prep

What we did:

● Cleaned and shaped two canals

● Removed infected and inflamed tissue

● Filled the tooth with gutta-percha and bioceramic sealer

Obturation & Post Placement #4

● Placed a post and core as requested by the referring dentist

Post placement

The patient handled the procedure very well, and everything went smoothly. We shared pre-op and post-op radiographs with the referring dentist for their records.Patient headed straight to the dentists office for a crown.

Final PA#4 after post & core

A warm thank-you to the referring dentists for trusting us with this case. Working closely with our referring dentists helps us deliver the best care possible. If you ever have questions about a case or need support managing a patient with tooth pain, we’re always here to help.

HTX Endodontics – Memorial City & Uptown/Galleria

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