Ivan came to the clinic with a complaint of a broken tooth. The patient was willing to do everything possible to keep the tooth in his mouth.
During the clinical examination, Dr Kateliev found that the crown of the left maxillary first molar was broken. The crown was broken sidelong reaching below the level of the gum at the palate side. In the x-rays made to examine the old root treatment, we saw, in addition to the chronic inflammation of this tooth, a presence of a rounded shadow around the root and the next tooth. To be certain that a correct diagnosis will be given, we referred the patient to a 3D x-ray (CBCT). With this test, the dentist is able to examine the structures supporting the tooth in three planes in space which gives them a real idea of the exact location and degree of the pathological process. The scan test confirmed the presence of a large granuloma positioned sideways around the top of the fifth tooth root. Some tests followed to prove that the nerve of the tooth was dead. After analyzing the collected information, we decided to conduct a retreatment of the maxillary first molar and a primary root treatment of the second. Despite the deep defect resulting from the breakage of the crown of the maxillary first molar and the dubious restoration prognosis, it was concluded that the tooth could be built up and restored. After skilfully made isolation, Dr Gospodinov prepared the tooth by building walls to allow adequate retreatment. The old material used for canal filling was thoroughly cleaned. The root canals were disinfected and sealed. During the next visit, we performed a root treatment of the maxillary second molar. The two teeth were reinforced with paralight posts to prevent possible breakage. The maxillary first molar was prepared for crown restoration, and the second molar was directly restored with a seal. Thanks to the diagnostic tests, their detailed analysis and the perfect collaboration between the colleagues, the patient’s desire was fulfilled and the team was one hundred percent satisfied.
