Large Distal Periapical Radiolucency

A 48-year-old woman has had mild discomfort at #19 four years post RCT (Fig.1).  It appears that the tooth has 3 roots.  The latter should help stabilize an implant placed in the septum (tripods).  The affected tooth has large distal periapical radiolucency (Fig,2 *).  There is localized swelling at the buccal furca.  After debridement, treat the sockets with Clindamycin.  Osteotomy will be slightly lingual, since the buccal plate is thinner than the lingual one.  In addition, the buccal plate is most likely defective due to furca and periapical lesions.  The longest IBS implant is going to be chosen unless the implant has to be placed deep due to furca destruction.  In fact the patient has the tooth extracted in other office with socket preservation.

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Xin Wei, DDS, PhD, MS 1st edition 02/15/2017, last revision 11/25/2018