Time to take the root canals back: A systematic approach to endodontic pain

As doctors, we are often presented with an issue and generally know how to treat it. In endodontics, taking the appropriate time to get to the right diagnosis is crucial. Depending upon the diagnosis, there will be either urgent treatment of the affected tooth or palliative care where the tooth will be watched and evaluated based upon the symptoms prior to any endodontic treatment.

A 45-year-old female presented with a fractured amalgam restoration of the right mandibular second molar with no symptoms. The restorative team was consulted, and it was determined to remove and replace the filling. Upon removal, a pulp exposure was identified. A direct pulp cap and protective restoration were placed to see if any symptoms would develop. With time, a symptomatic tooth presented itself and required consultation with the endodontic faculty leading to a need for endodontic therapy. A build-up restoration and patient follow-up completed this complex case.

Author: Ross Burman, DDS ’22
Mentors: Dr. Alan Gluskin, Dr. Mark Stevenson, Dr. James Stephens, and Dr. Sandy Ward

OKU Endodontics Award

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