The patient chief complaint is best described as “soreness when she touches above her tooth.”

Here is the intake periapical radiograph.

The patient chief complaint is best described as “soreness when she touches above her tooth.” Her DDS had been watching the area for over a year, subsequent to rendering the endodontic therapy a couple of years ago.

An oral examination demonstrated a slight swelling, contributory redness, and tenderness at the muco-gingival junction on the buccal aspect of #13.

We recommended acquiring a CBCT scan.

Now what do you suspect is causing the soreness?

Finding the cause of the soreness …

A deep axial view displays apical pathology.

The sagittal view demonstrates extensive loss of osseous tissue extending to the marginal crest.

A second axial slice demonstrates the indication of a vertical fracture as demarcated by the arrow.

 

We went ahead and explained the slices to the patient; forwarded on a report to the DDS, while recommending an extraction with an eventual implant restoration.

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