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Jan 27 2024 at 1:05 pm . Edited
27 yr old female patient presented for eval of tooth #10. Patient mentioned she has no pain. Tooth #10 has existing crown, RCT & PARL. Crown shows NSF & was completed 5 yrs ago in Guatemala. No isolated deep pockets present. BOP & grade I mobility present. Crown is not in occlusion & no lateral excursions noted during occlusion. Biological width not invaded. CBCT shows dense root canal fill sealed at the apex, voids found in obturation. Cold Test: #9,11 WNL, #10 -ve. Percussion Test: #9,11 WNL, #10 +. Diagnosis: #10 PT/SAP. Hx: Tooth #10 is dens-in-dente that had a very large PARL extending from tooth #9-11 & palatal swelling. Tooth was treated in 2015 by endodontist. Endodontist completed treatment in 3 visits using Ca(OH)2 inbetween appointments. Endodontist mentioned symptoms & swelling improved drastically before completing treatment. Endodontist also mentioned cystic & pus fluid drained from tooth. MTA was used to obturate canal. PARL decreased greatly in size.Question: Would you monitor or intervene non-surgically/ surgically?