PMC9375119_01
(A, B, C) Photographs of the patient in the first visit. (D) Periapical radiographs of teeth #30 and #31. (E) Sagittal view of cone-beam computed tomography
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F1
The clinical and radiographic examinations were performed (Fig. 1 A-D). Cone-beam computed tomography (CBCT) was then requested for the patient, which indicated extensive bone destruction in the body of the mandible (Fig. 1E).
(A) Photograph of the patient 1 week after treatment, (B) Photograph and (C) Radiograph of the patient 3 months after treatment, (D) Photograph and (E) Radiograph of the patient at the 6-month follow-up
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F2
The second session was scheduled one week later. In the second session, there was no pus discharge, and the sinus tract was closed (Fig. 2A).
PMC9375119_02
(A, B) Preoperative photographs, (C) radiograph, (D) inter-operative photograph and (E) second-visit radiograph after obturation
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F3
The radiographic examination revealed a radiolucent lesion with ill-defined borders in the periapical region of tooth #25 (Fig. 3A-C). The extraoral sinus tract had healed (Fig. 3 D). Thus, the root canal was filled with gutta-percha and AH-26 sealer with the cold lateral compaction technique (Fig. 3 E).
(A) Clinical and (B) radiographic views at the 2-month follow-up (C, D) at the 5-month follow-up, and (E, F) at the 1-year follow-up
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F4
At the 2-month follow-up session (Fig. 4 A, B), the patient had no complaint of pus discharge from the extraoral sinus tract, and the opening had been completely healed. At the 5-month recall session (Fig. 4 C, D), the extraoral sinus tract opening had completely healed, and the periapical lesion had shrunk on the radiographic examination. At the 1-year follow-up (Fig. 4 E, F), the respective tooth was asymptomatic, and the periapical lesion had completely healed.
PMC9375119_03
(A) Computed tomography scan of the patient, (B) extraoral and (C) intraoral photo-graphs of the patient in the first session, (D) periapical radiograph of the respective tooth in the first treatment session. (E) Extraoral photograph of the patient 1 week after first treatment session. (F) Periapical radiograph and (G) extraoral photo-graph of the patient at the 3-month follow-up
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F5
She had undergone a computed tomography scan (Fig. 5A). The extraoral examination revealed a dense mass in the check area (Fig. 5B). On the intraoral examination, her maxillary right first premolar had an incomplete previous RCT with an open access cavity without any temporary restoration (Fig. 5C). The radiographic examination revealed that tooth #5 had a small periapical radiolucency and PDL widening (Fig. 5D). In the second treatment session, the significant healing of the sinus tract opening on the cheek was noticed (Fig. 5E). The patient had no clinical or radiographic signs/symptoms at the 3-month follow-up (Fig. 5F, G).
PMC9375119_04
(A) Photograph and (B) periapical radiograph of the patient in the first treatment session. (C) Photograph and (D) periapical radiograph of the patient at 2 weeks after treatment
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F6
Periapical radiography of the left mandibular quadrant was requested, which revealed that tooth #17 had an incomplete RCT and a radiolucent periapical lesion (Fig. 6A, B). RCT was accomplished, and the root canals were filled using gutta-percha and AH-26 sealer with the cold lateral compaction technique (Fig. 6C, D).