got to review a case today after a pulpect, thought this one was worth writing up.
pt walk-in c/o lingering sensitivity on #12
pt walk-in c/o lingering sensitivity on #12
o/e: #12 barrel morphology, AR (o) intact (and yes the barrel was that big), nttp/pp and perio normal but lingering to cold, EPT positive
dx: #12 irreversible pulpitis, normal periapex
so there i was with a pulpect of a #12 in a tooth with an old AR which i suspected to be a dens invaginatus. hacking out the AR yielded.... no pulp chamber or canal. gentle exploration at the base of the invagination yielded nothing either. and so, one consult later, my answer appeared in front of me... the canal, by very very careful staring at the PA, was in fact mesial to the dens invaggie chamber, and had i gone on a quixotic dig-to-china spree on the base of the chamber i may well have done a mid-root perf. heng ah!
lesson learned... in the dens invaginatus the pulp chamber proper may not lie in the middle of the tooth!
dx: #12 irreversible pulpitis, normal periapex
so there i was with a pulpect of a #12 in a tooth with an old AR which i suspected to be a dens invaginatus. hacking out the AR yielded.... no pulp chamber or canal. gentle exploration at the base of the invagination yielded nothing either. and so, one consult later, my answer appeared in front of me... the canal, by very very careful staring at the PA, was in fact mesial to the dens invaggie chamber, and had i gone on a quixotic dig-to-china spree on the base of the chamber i may well have done a mid-root perf. heng ah!
lesson learned... in the dens invaginatus the pulp chamber proper may not lie in the middle of the tooth!
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