female patient age 17 yrs. complains of swelling since 2 days and no associated pain. 1 yr back she had done composite with 37 by some other doctor.

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The restoration was done deep and pulp involved as seen in OPG. There is periapical lesion irt 37 and localised periodontal abscess involving furcation. RCT and crown irt 37 and flap surgery. IOPA radiograph irt 37 will give better picture. 38 also has to be extracted before giving crown to 37. 46 repeat RCT and crown.

Second your opinion @Dr. Chandrasekhar Lakkoju that is the right way out.
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Faulty composite restoration is the cause for this periapical infection followed by sinus formation buccally w.r.t 37. It has also involved the furcation area. It's a n Endo perio case, need RCT and sinus drainage under antibiotic coverage.

37 is carious exposed .... periapical pathology.....start with endo .....good luck

While going through the iopa it seems that infection has reached to the furcation point as age is consider so you could try to save the tooth by rct followed by applications of medicaments..... Otherwise prognosis of such kind of cases is poor so best wishes and try.... Hope it will be fine otherwise at last you know what to do......

Start endo irt 37 and inform the patient about 46 also

Periapical lesion irt 37 ..go for rct in 37 and 38 extract. short rct irt 46 ..repeat rct irt 48 and crown.

Mesioangular impaction Rt qad 38 Rct qad 37 Extraction Iopa

The tooth in question will go for RCT. 3rd quadrant wisdom tooth may gv problem in future so it has to be extracted when it gives any problem.

Restoration with 37 needs attention As per OPG. Mediocre angular impaction with 38..give antibiotic cover rct and impaction when it starts pain

Restoration seems very deep with possible exposure of the pulp . RCT seems the best option !

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