Patient Details
- Age: 28 years
- Gender: Male
- Tooth Involved: 37 (Mandibular left second molar)
Chief Complaint
- Pain and swelling in the lower left back tooth region for the past 1 week
- Difficulty in chewing on that side
History of Present Illness
- Root Canal Treatment in 37 was done several years ago at another clinic
- Patient had intermittent pain in the same tooth for the past few months
- Recently developed continuous pain with localized swelling
- No significant medical history
Clinical Examination
- Tooth 37 grossly decayed with fractured crown structure
- Tender on percussion
- Localized gingival swelling and tenderness
Radiographic Findings
- IOPA revealed previously treated 37
- Severe periapical radiolucency present
- Root resorption noted due to chronic periapical infection
Diagnosis
Tooth 37: Failed Root Canal Treatment with Severe Periapical Infection and Root Resorption
Treatment Plan
- Extraction of 37 due to poor prognosis
- Follow-up for healing and replacement options (implant/prosthesis)
Treatment Performed
- Local anesthesia administered (Inferior alveolar nerve block)
- Tooth sectioned due to weak root structure
- Roots carefully elevated and extracted
- Thorough curettage of infected periapical tissue
- Irrigation with saline and betadine
- Post-extraction dressing given
Postoperative Instructions
- Analgesics and antibiotics prescribed
- Ice application advised for swelling
- Soft diet and warm saline rinses after 24 hours
- Avoid chewing from the operated side
Outcome
Successful extraction of severely decayed 37 with complete removal of infected tissues