ABSTRACT
@#A fractured instrument is an undesirable endodontic mishap that can prevent complete root canal disinfection, thereby affecting the root canal treatment outcome. The present case discussed the surgical management of an extruded fractured barbed broach at the apical third of maxillary right first premolar. A 28-year-old female presented with an endodontic failure on tooth 14 and was diagnosed as previously root canal treated with symptomatic apical periodontitis. Radiographic examination revealed a straightline radiopacity structure that was 2 mm in length extruded from the apical root-end, suggesting a fractured instrument. The case was successfully managed through endodontic microsurgery. The present case emphasises the significance of cone-beam computed tomography as a valuable tool for diagnosis and investigation, while also offering supplementary information for the planning of surgical treatment.
ABSTRACT
Introduction: Garre’s osteomyelitis is mainly caused due to long standing periapical infection, recent infection of soft tissue, unhealed infected extraction areas etc. It mainly affects the mandible than the maxilla and is seen rarely in children. Case presentation: 10 year old patient with a long standing untreated dental infection of lower left molar is treated with root canal treatment. Inconsistent visit of the patient lead to the progression of the pathology to Garre’s osteomyelitis. Management and prognosis: Extraction of the offending tooth followed by targeted antibiotic therapy after a culture and sensitivity test. Lesion completely healed at the end of 2 months and skin changes started to appear. Conclusion: Management of osteomyelitis is children are crucial as they are in the growing phase. Timely management is nec- essary to reduce the deleterious effects caused by it in the bone.
ABSTRACT
Whenever endodontic therapy is performed on mandibular posterior teeth, damage to the inferior alveolar nerve or any of its branches is possible. Acute periapical infection in mandibular posterior teeth may also sometimes disturb the normal functioning of the inferior alveolar nerve. The most common clinical manifestation of these insults is the paresthesia of the inferior alveolar nerve or mental nerve paresthesia. Paresthesia usually manifests as burning, prickling, tingling, numbness, itching or any deviation from normal sensation. Altered sensation and pain in the involved areas may interfere with speaking, eating, drinking, shaving, tooth brushing and other events of social interaction which will have a disturbing impact on the patient. Paresthesia can be short term, long term or even permanent. The duration of the paresthesia depends upon the extent of the nerve damage or persistence of the etiology. Permanent paresthesia is the result of nerve trunk laceration or actual total nerve damage. Paresthesia must be treated as soon as diagnosed to have better treatment outcomes. The present paper describes a case of mental nerve paresthesia arising after the start of the endodontic therapy in left mandibular first molar which was managed successfully by conservative treatment.