Advice management

36 y/o female had gingival graft 4 years ago. she said she go for oral prophylaxis every 4 months. Complaining about pain and teeth mobility in mandibular teeth. Worried about esthetic appearance if 31 is removed. 32 slightly mobile. Any suggestion?

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Before jumping into the conclusion of extracting the tooth..if the patient is keen on saving it you could do a cbct for a better picture of the condition..it will give you better idea of the bone and tooth status..after all an ipoar is just a two dimensional image..and if you find it clinically n practically feasible to work on you could do a root canal followed by a good quality graft material if at all there is no root perforation...even if mild perforations are there you could do an mta repair followed by the above mentioned treatment line..though this isnt a definite treatment plan..it will all depend on the patient complaince and how much of money n time he or she is willing to spend..if all these are positive you could give it a try explaining to the patient prior about the success rate..and if none of these are in your favour ofcourse the last option is to extract...(nb: all these only if the patient is so adamant about saving the tooth)
Endoperio lesion wrt 31 bone loss involving middle third of root poor prognosis advise extraction .Rct and splinting can attempted if Pt is not keen for extraction.
Poor prognosis, extraction is the only solution followed by fixed/removal artificial prosthesis.
External resorption is one of the complications of gingival grafts, first documented on using sctg. It is a complication but a rare one. According to me, there must have been poor handling of root conditioners before graft placement. It is not a lesion of endo origin. It has poor prognosis due to resorption. I think you should go for detailed evaluation and consider this one for a case report. It can easily be accepted in a good journal. If canals have been exposed by resroption then rct seems absurd. Better to take an endo opinion. For now you can relief the occlusion and go for splinting after srp. It can postpone the extraction if pain subsides.
t/t also depends on standered of living and medical history of PT. # we can 1st try / can see for splinting after RCT, with proper medication . be in touch with PT. , regular visits should be planned, then after if we need go for extraction , extraction is always the last option..
Perioendo lesion. Bone loss is evident. Questionable prognosis on scaling root planning followed by splinting.. so Adv extraction. And if pt concerned of implants give PRF if possible followed by implant irt 31.
Case of Irreversible Pulpitis. Treatment, 1. Gel-Metrogyl-DG-forte, Apply thrice daily. 2.Tab.Oflox -OZ .BD for 5 days. 3. Mouth wash-Hexidine. 4.Tab. Ketorol-DT .SOS. for 5 days.
No hope for external resorption... Extraction and thorough debribement followed by implant and graft. Or fpd
Boneloss is evident. Diag. Perioendo lesion T/p- rct Splinting Flap surgery with graft or prp I.r.t 31 32
@@controle the diabetes,if no diabetes undergo extraction and post extraction full denture for lower
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