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Case 153554

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Troublesome / painful / cracked tooth (Endodontic)

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Canaray 153554

Normal tooth 34

Tooth 34 appears normal radiographically. No signs of endodontic or periradicular pathology are present.

1. Vertical bone loss on tooth 35 suggestive of root fracture

Vertical bone loss extends along the lingual and mesiolingual surfaces of the root of tooth 35 from the alveolar crest to the apical third of the root. The lingual cortical plate is focally lost at the level of the alveolar crest. The remainder of the periradicular bone is intact, and no signs of periapical pathology are radiographically evident. This pattern of bone loss is highly suggestive of a vertical root fracture associated with tooth 35.

Clinical photo of extracted tooth 35

This photograph demonstrates the presence of a vertical fracture plane originating along the lingual aspect of the crown and coronal third of the root of tooth 35. As the fracture plane propagates apically, it exhibits an oblique course to involve the mesial surface of the middle third of the root. This correlates with the pattern of periradicular bone loss noted on the accompanying cone beam CT scan.

Normal post-treatment appearance of tooth 36

The endodontically treated tooth 36 exhibits a normal post-treatment appearance. No signs of endodontic or periradicular pathology are present. The periodontal ligament space is of uniform width around the tooth and the lamina dura is intact. No signs of root fracture or unfilled canals are present.