Is It Cracked?
Often when we see a tooth whose periradicular bone has broken down we assume the tooth is cracked and is deemed non-restorable. In this case not only was the lesion “J-shaped” but there was suppuration with apical probing on the mesial root. What there was NOT, was an interruption of the gingival attachment. Also, no fracture was seen. As you can see by the radiographs below, what we were dealing with was a straight-forward endodontic infection. Once the infection was treated, the suppuration subsided and the periradicular bone quickly returned. Below are the pre- op, immediate post-op and 6 month recall films.