PMC4086546_01
Intraoral photograph showing Ellis class IV fracture of
21 and palatal swelling with pus discharge (black arrow)
ijcpd-02-030-g001.jpg
PMC4086546_01_ijcpd-02-030-g001.jpg
F1
On clinical examination, Ellis class IV fracture was found with 21 and a palatal swelling with pus discharge (Fig. 1).
Periapical radiograph showing cystic lesion in relation
to 21 (black arrow) and 'mesiodens' like supernumerary tooth
placed in the mid-palatal region, close to the root apex of 21(red
arrow)
ijcpd-02-030-g002.jpg
PMC4086546_01_ijcpd-02-030-g002.jpg
F2
Periapical radiographic examination revealed a large periapical radiolucency lined by a thin radiopaque line with respect to 21 (Fig. 2). Surprisingly there was a small tooth like structure found close to the root apex of the 21, which was inverted, root of that tooth found to be dilacerated (Fig. 2).
Photograph showing surgical exposure of the cystic
lesion of 21. Root apex and extruded gutta percha can be seen
in cystic cavity (black arrow)
ijcpd-02-030-g003.jpg
PMC4086546_01_ijcpd-02-030-g003.jpg
F3
For apicectomy of 21 labial approach was used (Fig. 3) and as the mesiodens was placed palatal, palatal entry was used for its removal (Fig. 4).