A 44-year-old man presents with a fistula distolingual to the tooth #15 (Fig.1).  Two pieces of Gutta percha are inserted into the fistula (F) and the mesial pocket (P).  The first gutta percha points to the apex (with periapical radiolucency *).  The tooth #15 has no restoration.  There is possibility of root fracture.  The tooth has guarded to poor prognosis considering perio and endo complex as well as occlusal trauma (mesial tilting and shifting).

From this PA, the two buccal roots appear to be fused.  Lacking wide furcation is related to the mesial tilting of the tooth.

Sinus Between Roots

Xin Wei, DDS, PhD, MS 1st edition 12/27/2014, last revision 12/27/2014