This patient came in for regular check up and we took a CBCT to do implant treatment planning. As an incidental finding, we found a periapical lesion over the premolar that we felt should be dealt with before any implants were done. The tooth looked fine but that does not mean anything as it could be a fracture or occlusal trauma. Pulp test suggested vital but I have cases where one part was vital and another part was non vital although this is usually in molars.
1. Radiolucency on 11 x 13cm cbct that I took for implant planning.
2. Definitely looks like the buccal plate is gone.
3. Tooth looks fine. Sensitive to cold although response is a bit delayed.
4. PA looks fine…getting suspicious.
6. Now I’m really suspicious. No deep filling, no pulp exposure, no cracks.
7. Since I’m suspicious, I decide to retake the cbct but this time in the smallest field 5cm, which also gives the highest resolution.
8. And the defect is gone.
9. Air abrasion with aquacare and selective etch of the enamel.
10. Final restoration.
11. In occlusion…reduced slightly to take load off.
Subject to location