PMC8528636_01
(a) Paraesthesia testing, (b) preoperative RVG, (c) preoperative CBCT, and (d) access cavity under dental dam.
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fig1
Two-point discrimination light-touch and pin-prick tests were performed on the right mentum region encompassing the area of the skin below the right half of the lower lip and anterior part of the cheek on the same side, which confirmed persistent paraesthesia (Figure 1(a)). A RadioVisio Graphic (RVG) image revealed radiolucency in the apical region involving the mental foramen (Figure 1(b)). To further confirm the diagnosis, a cone-beam computed tomography (CBCT) scan (Vatech PaX I 3D Smart, 74 kV, 10 mA, 10.8 sec) of the same region revealed a large periapical radiolucency involving the second premolar extending into the mental foramen (Figure 1(c)). Root canal treatment was initiated under isolation with a dental dam (Figure 1(d)).
(a) Working length determination, (b) calcium hydroxide placement, (c) master cone selection, (d) obturation, (e) 3-month follow-up, and (f) 6-month follow-up.
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fig2
The working length was determined using an electronic apex locator (Root ZX mini, Morita, Osaka, Japan), which was later confirmed by the RVG image (Figure 2(a)). Ahmedabad India) was placed (Figure 2(b)). The tooth was restored with an interim restoration (Cavit 3M, USA), and the patient was discharged with oral antibiotics Tab. Amoxycillin-Clavulanic acid-625 mg twice daily for seven days and vitamin B oral supplements. The tooth was completely asymptomatic; therefore, obturation was performed at this visit with laterally compacted gutta-percha with MTA-based sealer (MTA Plus, Prevest Denpro, India) (Figure 2(d)). At three- and six-month subsequent follow-ups, examination showed reconstitution of the apical region, cortical lining of the inferior alveolar canal, and paraesthesia was completely resolved (Figures 2(e) and 2(f)).
PMC8528636_02
(a) Paraesthesia testing, (b, c) preoperative CBCT, and (d) access cavity under rubber dam isolation.
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fig3
On palpation, the right second premolar was tender, and two-point discrimination, light-touch, and pin-prick tests were performed as the above-mentioned case, which confirmed persistent paraesthesia (Figure 3(a)). I 3D Smart, 74 kV, 10 mA, 10.8 sec) was obtained, which apparently depicted mental foramen involvement and improper root canal filling, necessitating retreatment in relation to the right second premolar (Figures 3(b) and 3(c)). Informed consent was obtained before beginning the treatment, and all possible outcomes were explained. India) (Figure 3(d)). Intermittent copious irrigation was performed with 3% NaOCl followed by a final rinse with generically prepared 7% maleic acid and 2% CHX (Vishal Dentcare,
(a) Working length determination, (b) obturation, (c) 3-month follow-up RVG, and (d, e) 12-month follow-up CBCT.
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fig4
Three- and twelve-month follow-up examinations showed reconstitution of the apical region, labial cortex, and cortical lining of the mental foramen, and paraesthesia was completely resolved (Figures 4(c)-4(e)).