7

Review

A 29-year-old female was seeking replacement of defective and discoloured composite restorations
in her upper incisor teeth (12,11 and 21). These teeth had been restored approximately 5
years ago.
Chief complaint

Patient is hipertensive

Medical history

The patient’s last dental check-up was 3 years previously. At that time, no periapical lesions
were detected radiographically. The patient had also addressed her diet, including reducing the
quantity and frequency of carbonated drink consumption.
Dental history

The extraoral examination was unremarkable. The patient had a moderately restored dentition,
and her oral hygiene status was good. Composite restorations in all upper incisors were
defective and discoloured.
All the maxillary anterior teeth responded normally to vitality test except for the 12. A periapical
radiograph revealed a periapical radiolucency associated with the 12 (Figure 1.1.1). No swelling
or sinus tracts were detected. Removal of the defective coronal restorations from the 12
resulted in exposure of the pulp, however, the root canal was necrotic. Caries remnants on the
cavity walls were observed underneath the mesial composite restoration.
Clinical examination


What was the diagnosis?
The diagnosis was chronic periapical periodontitis associated with an infected necrotic root canal

Access Cavity properties……

Working length det..

mm