Pulpal Fiction?

Do you see anything that catches your eye on the periapical radiograph (above left) taken recently in my office? Perhaps the title here gave it away but what caught my eye was the irregular pulpal space. My thought immediately went to questioning if this was just his normal (yet unique) pulpal anatomy, or perhaps something else.

I could have taken off-angle radiographs to further evaluate. However, I have a Cone Beam CT available in my office and my patient and I came to the consensus that a CT scan would give us the clearest picture of what was happening.

As you can see in the screen shot from the CT (above right), it was unfortunately a resorptive defect compromising the tooth to the point that it will be lost. It would have been ideal to catch this defect earlier; however, it wasn't possible since this patient had not been in years.

John R. Carson, DDS, PC, Spear Visiting Faculty. [ www.johnrcarsondds.com ]