A patient presented to my office with pain and localized swelling associated with tooth 19.  There was a large restoration present with a buccal sinus tract.  In addition, there was a 6 mm probing depth on the buccal.  Radiographically there was a defect on the mesial aspect of the distal root canal involving the furcation.  The patient reported that his dentist recommend him to have the tooth extracted and an implant placed, however he wanted to attempt saving his tooth.

 

Patient was explained options on treatment and was told prognosis would be guarded due to the furcal defect.  Patient understood and accepted treatment.  Pulp testing was performed and tooth was diagnosed as chronic irreversible pulpitis with chronic periodontitis and a furcal defect.  Endodontic treatment was performed in 1 visit and the distal root was obturated with MTA (up and including the defect). 

The patient returned in 6 months for a follow up.  No sinus tract or swelling was noted and patient was asymptomatic.  Nice healing has started to take place in the furcation area.  Patient will be recalled and followed for the next 2 years.

 

Furcation defect does not mean extraction.....

 

Thanks for your time.  Please email me any thoughts, questions, and/or suggestions.