Case 18: Predictable endodontics

Case 18a: pre-operative x-ray
Case 18a: photo


















Case 18b: pre-operative x-ray

Case 18b: photo













Please note in both cases alloy on pulp chamber wall.





















Comments:
As noted above many restorations are placed close to if not into the pulp chamber. In both of these cases, patients were very surprised that this was the case. Granted, most of the time the dentist who place the restoration tell patients of the situation and the possible need of root canal therapy due to the depth of the filling.  However, in my experience, patients never hear this. If a restoration will probably lead to future root canal therapy, it needs to be well documented in the patient's record and explained in detail to the patient as to not infer it was the dentist's "fault" it was so deep.  Most of the time, these fillings are replacements for other fillings because of fracture or decay. Symptoms may occur only after the new filling is placed.  It also needs to be explained that the tooth may be asymptomatic prior to the new filling, but may become symptomatic after the filling.