40 years old patient CC: " I have sever continus pain in the lower right" Hx CC: pain started before one week Clinical and radiographic examination revealed that there is large old amalgam #46 Amalgam was removed Dx: ?? Tx:??

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Cavity involving pulp. Looks like there is a vertical fracture line distal wall. Check it. If fracture is positive and extending to root canal then might need to do Extraction. If fracture is present but not deep you may go for RCT. If no fracture then RCT and crown can be done. Take proper radiographs before taking decision.

Thank you very much
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There is a crack due to expansion of old amalgam. Crack started from the middle of the to tooth to deep distal area.

You need to extract the tooth in such a case.
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Distal canal is exposed.the only treatment left now is RCT.

I agree with Dr C Lakkoju

Amalgam fillings cause "micro leakage", No doubt it's very stable filling but another hand "micro leakage" due to these filling pulpitis happen, so go for RCT. Best of luck...

An iopa is must...there seems to be a vertical fracture...if so adv extraction otherwise rct would help

Take an iopa ...for periapical region... Then proceed for rct ..

Distal area is cracked.no need of rct.when pt start chewing food after rct.tooth broken.go for extraction

Exposed the pulp chamber ....caused pain ....treatment is RCT root canal treatment...

Cracked tooth syndrome is seldom diagnosed with Iopa

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