Forums › Other Lasers › Misc. Laser Forum › Diagnosis and Treatment Options
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2thlaserSpectatorHere is a case where #19 is sensitive to hot/cold, maybe 20-30sec duration, SOME pressure sensitivity, with minor fractures (sorry no actual pic, was very busy), down the MB cusp. Here are the radiographs:
Mesial angle:
[img]https://www.laserdentistryforum.com/attachments/upload/MVC-393F.JPG[/img]Straight on:
[img]https://www.laserdentistryforum.com/attachments/upload/MVC-394F.JPG[/img]Distal Angle:
[img]https://www.laserdentistryforum.com/attachments/upload/MVC-395F.JPG[/img]Now it looks like a Condensing Osteitis to me, BUT, there appears to be some shape to it, as to it being a supernumerary tooth. I palpated the saliva glands, with no evidence of calcific deposits there…there is no previous restoration in the tooth…I am getting the pan from 2 years ago from the orthodontist sent to me….any ideas???
Mark
AnonymousGuestHow many bi’s already there ,Mark?
When I first glanced at the mesial angle picture the first thing I thought was’upside down bi’. Not quite so certain after seeing the other pics.
2thlaserSpectatorHi Ron,
Both BI-s are there. Cool case huh?
M
jetsfanSpectatormark,
Is that a lingual torus?
I Thought that Condensing osteitis is usually associated with non vital tooth. Did you check vitality?
What about the opposite side?
Any symptoms, expansion or is this just an x-ray pick up?
2thlaserSpectatorQUOTEQuote: from jetsfan on 5:30 am on Nov. 20, 2003
mark,Is that a lingual torus?
I Thought that Condensing osteitis is usually associated with non vital tooth. Did you check vitality?
What about the opposite side?
Any symptoms, expansion or is this just an x-ray pick up?Tooth was vital, no tori present, opposite side, didn’t x/ray opposite side…Condensing osteitis is also associated with trauma, not always necessarily non vital teeth. SO, that being said….any more?
M
Glenn van AsSpectatorCaries which is leading to a crack and that is into the pulp……thats what is causing the sensitivity.
Bet with a scope I could find it…….I have seen it before and its usually a lower first molar that is the culprit.
Tooth eventually cracks vertically if you dont find it.
Condensing osteitis is from the pulpal probs perhaps….
Wild as it may be that is my guess.
SHoot me a picture of the tooth and I would LOVE to see what I can see.
Glenn
Robert Gregg DDSSpectatorWhat’s the occlusion show?
2thlaserSpectatorBob,
CLass I occlusion, and this patient isn’t a bruxer either. Had ortho. Again, this tooth is not SUPER sensitive, or symptomatic, BUT he is just noticing it now. Was told of the calcification about 2 years ago at his follow up with orthodontist, but nothing was ever done as he was asymptomatic….
M
drnewittSpectatorAny Medical highlights Mark?
kellyjblodgettdmdSpectatorHey, Mark. Great case! Did you record any diagnodent readings from the occlusal? These may help determine if Glenn’s thinking is on the right track.
Hope you had a great holiday – see you in San Diego!
Kelly
Lee AllenSpectatorMark,
I like the idea of the diagnodent readings if there is no history of trauma or traumatic occlusion like Bob asked about. (I have seen significant traumatic occlusion post ortho including my own son).
My bet is on the hidden occlusal caries probably toward the mesial aspect of the occlusal looking at the second film.
Odd little hypercalicification, though.
Keep us posted on any new info. Good case.
Oh, what results from using the Tooth Sleuth?
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