Patient Details
- Tooth Involved: 47 (mandibular right second molar)
Chief Complaint
- Severe pain in lower right back tooth region.
History
Patient reported a history of biting on hard food, after which pain started. Pain was continuous and aggravated on chewing.
Clinical Examination
- Tooth 47 showed tenderness on percussion and a visible crack line.
- Tender on percussion: Tooth responded positively (painful response).
- No relevant medical history.
Radiographic Findings (OPG)
- Periapical infection evident at the root apex of 47.
- Supporting bone structure otherwise normal.
Diagnosis
- Symptomatic irreversible pulpitis with apical periodontitis in 47.
- Presence of crack associated with history of hard food bite.
Treatment Plan
- Root Canal Treatment (RCT) in 47 followed by full coverage crown.
- Extraction of root pieces of 48 and 16.
Treatment Performed
Day 1
- Local anesthesia administered.
- Access opening done, canals located and cleaned.
- Working length determined.
- Biomechanical preparation performed.
- Intracanal medicament (ICM) placed.
- Temporary restoration given.
- Extraction of root pieces of 48 and 16.
Recall Visit (After 1 Week)
- The patient reported relief from severe pain.
- Canals cleaned, dried and obturated with gutta-percha and sealer.
- Tooth restored with filling.
Final Restoration
- Tooth prepared for crown.
- Impression taken and full coverage crown advised for long-term protection.
Outcome
- The patient became asymptomatic after treatment.
- Tooth saved and reinforced with crown to prevent future fracture.
Conclusion
Successful root canal treatment was performed in tooth 47 with periapical infection and crack history. Early intervention relieved severe pain, and definitive crown placement ensured long-term prognosis.