48yrs M ..c/o pain upper ant. regn. o/e ch pap.#12. management ???
Have you already started with root canal treatment ?? After finishing root canal. .wait for a month and then Periodontal treatment should be taken into account.. If the probing depth is more than 5 mm then flap surgery is recommended. .
Very poor prognosis. You can try RCT and flap if patient is other wise healthy. I mean non diabetic etc. As you can see the patient did not go for treatment till this condition he might not follow your instructions and maintain the oral hygiene after flap which will again lead to recurrent periodontal problem after your treatment. If he willing to co-operate then you can try treating. With regular check up. Even the adjacent central incisor need RCT as periapical abscess is almost near to its apex. Best option is extraction of lateral, RCT irt central incisor and replace lateral incisor prosthodontically.
What's this?? 11 look ...Radioopaque separated piece & radiolucency surrounded.@Dr. Paramveer Sing Bhati
Sorry @Dr. Paramveer Sing Bhati ..to bother you...please take one more angle IOPA.
Hello Bhati sir, Imo, 12 has bone loss and the prognosis is not very good. The tooth will have to go for apicectomy further reducing the root length and support leading to failure. Better option would be extraction. Followed by prosthesis. Also 11 looks like its also rct treated, 11 needs retreatment.
Expect some laterals at d apical third...
Task is challenging, first do apical curettage in a classical method, thenthorough debridement followed by placement of graft material and finally endodontic therapy. Tooth should be splinted for around 12-16 weeks. Preferred medicines are : 1. Antibiotics like Clindamycine, Amoxy-clav, Doxycycline, Metronidazole etc. Analgesics, preferably with some enzymes and supportive bromaline, rutoside . 3. CHG , Iodine mouth wash. Periodic check ups with radiographs is advisable.
Hopeless prognosis.. Go for extraction with curettage of socket, followed by bone grafting if patient is willing for implant at a later stage.
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