Patient: (60-year-old female) Tooth Involved: Maxillary right 1st premolar (#14) Main Complaint: Persistent pain and sensitivity in the upper right premolar

Clinical Examination

Patient visited our clinic with pain in her upper right premolar. Upon examination, tooth #14 was:

  • Rotated (palato -mesially positioned)
  • Severely abraded, exposing underlying dentin and even pulp
  • Showing signs of chronic pulpitis

Diagnosis

After thorough clinical and radiographic evaluation, the diagnosis was:

  • Chronic Pulpitis due to mechanical trauma and wear
  • Severe occlusal abrasion with pulp exposure
  • No periapical radiolucency (early intervention was timely)

Treatment Plan

We aimed to save the natural tooth using a conservative yet effective approach:

  1. Root Canal Therapy (RCT) to eliminate pain and remove infected pulp
  2. Direct Composite Restoration to rebuild the lost tooth structure and restore aesthetics and function.

Step-by-Step TreatmentStep 

1: Root Canal Treatment

  • Access cavity prepared through the rotated crown
  • Canals located and cleaned using rotary endodontic files
  • Irrigation with NaOCl and EDTA to disinfect canals
  • Obturation done with gutta-percha and sealer
  • Temporary filling placed until full healing

Step 2: Composite Build-Up

  • Rubber dam isolation ensured a moisture-free field
  • Tooth cleaned and conditioned
  • Bonding agent applied, followed by incremental composite layering
  • Tooth anatomy carefully restored to match natural contours
  • Final polishing and occlusal adjustment completed

Final Outcome

  • The patient experienced complete relief from pain
  • The restored tooth looked natural and functioned well
  • Occlusion was balanced and the bite re-established

Book your appointment with us today!

Call us on +91 93 777 77 303

Visit us at: www.summirow.com