Patient Information

Age: 47 years

Medical History: No significant history, no known allergies

Chief Complaint

The patient presented with persistent pain and swelling in the lower left premolar region (tooth 35). She reported difficulty in chewing and occasional spontaneous pain.

History of Present Illness

  • Discomfort in tooth 35 for several months.
  • Pain worsened while chewing and was sometimes spontaneous.
  • Visible swelling in the region prompted treatment.
  • History of intermittent pain, with no prior dental care until symptoms intensified.

Clinical Examination

  • Palpation : Moderate tenderness with noticeable swelling.
  • Percussion Test: Positive response, indicating pulp involvement or periapical infection.
  • Radiographic Findings: Periapical radiolucency at the apex of tooth 35 → chronic apical periodontitis.

Diagnosis

  • Periapical abscess in tooth 35 with associated periapical radiolucency, consistent with chronic apical periodontitis.

Treatment Plan

Initial Root Canal Therapy:

  • Access Opening: Cavity prepared to access root canals.
  • Cleaning & Shaping : Mechanical preparation using endodontic instruments.
  • Interim Medicament : Calcium hydroxide (Ca(OH)₂) placed for multiple sittings to disinfect canals and support healing.

Obturation:

  • Final Disinfection : Ensured complete cleanliness of root canals.
  • Filling Material : Bioceramic sealer used for obturation, offering superior sealing and biocompatibility.

Restoration:

  • Post-endodontic restoration placed to seal the access cavity and restore function depending on the remaining tooth structure.

Follow-up:

  • The patient was recalled after 1 week for crown preparation for cap fabrication.

Discussion

Root canal treatment was essential to manage the periapical abscess in tooth 35.

  • Calcium hydroxide was applied as an interim medicament to eliminate infection and create favorable healing conditions.
  • Bioceramic sealer was chosen for its excellent sealing capacity and biocompatibility, ensuring long-term success.
  • Proper canal cleaning, shaping, and sealing were crucial in achieving a positive treatment outcome.

Conclusion

The root canal therapy for tooth 35 successfully treated the periapical radiolucency and infection.

  • Interim use of calcium hydroxide controlled infection before final obturation.
  • Bioceramic sealer ensured a reliable seal and healing environment.
  • Continuous follow-up is vital to confirm healing and maintain tooth function.
  • Regular dental visits remain important for long-term success. 

Book your appointment with us today!

Call us on +91 93 777 77 303

Visit us at: www.summirow.com