Case Study #1Marci M.

Patient Fact SheetName: Rachel SattlerAge: 20Reason for Today’s Visit: 6-month recall Established Patient: Yes

ScenarioRachel presents today for her routine 6-month dental cleaning and

check-up. She is due for her routine bitewing x-rays. Upon greeting Rachel she seems a bit concerned which is unusual for her personality. You ask Rachel if she is having any problems with her teeth. Hesitantly, she responds “well, I have been having some pain on the top right.”

Your response is: “what kind of pain and can you pinpoint which tooth?” She responds a constant dull ache that is exacerbated by extreme temperature change. She also points to her 2nd bicuspid.”You explain to Rachel that she is due for her x-rays today and that they will most likely show where the problem lies. You take Rachel’s bitewing x-rays.This is what is found!

X-Ray ReadingLarge radiolucent lesion seen on distal of

#13Appears to be located in interproximal regionLesion appears to extend towards pulp

DiagnosisBased on Rachel’s x-ray, what do you think is

the most likely cause of her pain?Extensive decay causing nerve involvement

and pulpal exposure

TreatmentRoot canal therapy, followed by post and core

build up completed with a porcelain crown to prevent fracture