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Case of Concern , Is this osteoporosis at the age of 14 (juvenile)

Interesting case - 14 year old Girl Came to clinic with unbearable pain in lower left back region with unable to speak and shivering and high grade fever due to tooth pain , 36 was carious mesially but also mobile a bit more than grade 1 , along with 36 , 34 and 35 also grade 1 mobile , and almost all teeth are slightly mobile but surprisingly no periodontal pocket in any tooth and no intraoral or extra oral swelling but 36 was Super TOP , i immediately did IOPA which is here ,i did emergency Access opening of 36 and found necrotic pulp with no bleeding in any canal , also furcation area looking radiolucent , what you people think Why her teeth are mobile , is this the case of juvenile osteoporosis ??


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Completed Root canal of this patient resolved her pain completely aslo mobility of tooth decreased after antibiotics and calcium supplements prescription thanks everyone to answer

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@Dr. Abrar Ahmed Khan Condensing osteitis irt36 as it is associated with nonvital tooth and here also we can appreciate radiolucency approaching pulp in crown plus we can appreciate inc bone density in the periapical inflammation area... Can appreciated sharpened alveoler crest irt 34,35 No doubt roundening of alveolar crest irt 35,36 and alveolar bone loss involving furcation is present irt 36...tat has made grade 1 mobility ...Local factors could be the reason All these factors may suggest fr Localised Juvinile Periodontits... Acc to me: We cannot say as osteoporosis As lot of factors Are responsible fr that... Physically Short stature inc bone pain specially in knee and arms. Intraorally,Clinically, Altered morphology of crown specially in mandibular anterior will be present.. We should suggest her for Bone mineral density (BMD), serum calcium, serum phosphate, alkaline phosphatase..

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Flatenning of interdental crest, thickning of bony trabeculae suggestive of TFO (R/o chronic bruxism) also radiograph depicts furcation involvment, proximal radiolucency .Adv DXA scan ,serum ca and vitamin D, serum Alkaline phosphatase levels.

Is any systemic problems or bone fracture associated? Is any history of any vit D deficiency? Serum ca, p and PTH is important. X- ray showing furcation involved but clinically it may be cul-de-sac type 2 furcation. Pain may be associated due carious exposure and rarefaction in mesial root of 36. You already extirpated the pulp. Mobility associated with this type of lesion, once it heal mobility will decrease. Please continue RCT. Plz sorting juvenile periodontitis where mobility may be associated. Medicate with broad spectrum antibiotics with metronidazole along with NSAIDS

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furcation involvement irt 36 widning of periodontal ligament space 35

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Completed Root canal of this patient resolved her pain completely aslo mobility of tooth decreased after antibiotics and calcium supplements prescription thanks everyone to answer

Pain in 36 is because of carious lesion exposing the pulp horn and the furcal involvement is there; also not to mention the Widening of pdl at the apex of 36. 35 - I see widening of pdl space at the apex. Evidence of interdental bone resorption at 33-34, 34-35, 35-36 is the reason for slight mobility you mentioned in these areas. Seems to be Aggressive juvenile periodontitis. Although also get her sugar levels checked.

Localised aggressive or juvenile periodontitis

Furcation involvement is seen. Juveniles osteoporosis is usually generalized

It looks like generalised periodontitis, deep scaling and educating the patient on oral hygiene maintance should resove the problem.

36 will definitely need a root canal treatment
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