Concluded Case

12 yrs female patient complains of pain in the lower back region since 4 days. on intra oral examination deciduos molar and remnants were present which were extracted. 46 is grossly decayed. extra oral swelling is present. going to start rct with 46. any suggestions...

24 Likes

LikeAnswersShare
Concluded answer
Took a good decision to retain the grossly decayed teeth.....( important factor is age of the patient) and I think it will be successful. The tough task you have in this patient is to put efforts to motivate and encourage patient to maintain good oral hygiene and regular check up. I guess and wish you will be successful in that also. Looks like irt all the first molars, dental caries... pulp is involved.... And maxillary molars roots are not visible clearly in this OPG . I prefer to take IOPA radiograph irt all first molars and treat accordingly... check for apex closure Dr. Nazia Sayed...
All Answers
Root canal treatment with 46 with multiple inter appointment calcium hydroxide dressings. Do evaluate the natural apical stop. As the patient is 12 years old, you may need to do apexification. Also follow up the rct with a stainless steel crown. And after her growth is complete (16-17 years of age), replacement of stainless steel crown with PFM or all ceramic crown. Good luck :)
With add triple anti biotic paste as intracanal medicament if needed
5

View 1 other reply

Took a good decision to retain the grossly decayed teeth.....( important factor is age of the patient) and I think it will be successful. The tough task you have in this patient is to put efforts to motivate and encourage patient to maintain good oral hygiene and regular check up. I guess and wish you will be successful in that also. Looks like irt all the first molars, dental caries... pulp is involved.... And maxillary molars roots are not visible clearly in this OPG . I prefer to take IOPA radiograph irt all first molars and treat accordingly... check for apex closure Dr. Nazia Sayed...
I would like to add one point, doc before proceeding with the treatment, put the pt on antibiotics for 3-4 days before the day of extraction.
2

View 3 other replies

I don't think there is a need for apexification. Root apex usually closes 3 years after eruption. So first molar doesn't need apexification,since patient is already 12 years.. a regular RCT will do. Go ahead,all the best
Start with preop antibiotics, let the swelling reduce,and proceed with RCT. If vestibular obliteration is there irt 46, there may be a need to place an incision to pus out the contents.
2
In this case 46, 36 is going for rct... No need of apexification as first molar eruption at the age of 6 year.. so kindly check 16, 26, 11,12,21,22 also need filling n please share clinical pic of all the teeth n molar iopar... Thnx go ahead with rct n stainless steel crown
46 need apexification , followed by rct , also seeing the multiple caries in 12yr patient ,go for pit n fissure sealents and fluroide application.
12 yr old patient... so 46 doesn't need apexification...
0
Rct and SS crown with 16,36 and 46..and SS Crown’ with 26 after a filling .. prognosis of 36 is a little poor.. it’s a case of mih I feel ..
Start with antibiotics then apexification folloed by Rct with 46 along with multiple calcium hydroxide interappointment dressing
Even 16, 36 look grossly decayed. May require RCT and crown like 46. Please proceed with confidence. All the best and good luck.
Do RCT 36,46 she is at growing stage, sometimes there good healing response in children. Do your best. Good luck
your treatment plan is fine.proceed with it.open the acess as soon as possible follwed by antibiotic
Load more answers

Cases that would interest you