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What is the diagnosis ?

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  • 11/12/2011 at 5:42 am #10206
    siteadmin
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    Female patient age about 35 years.

    Medical history: Hypertension

     

    RCT 1-4 done about 8 months ago.

     

    She complains of pain on right site which radiates upto forehead of the right side and thereafter the neck also.

    Pain disturbs sleep at night.

     

    She gets good sleep after taking NSAID’s

     

    Sometimes there is sweating on the right forehead and the right side of the face.

    1-5 RCT was also done and since she was complaining of pain at that time also 1-5 was extracted.

     

    Please see the OPG which is attached to this post.

     

    4-8 is carious.

     

    Clinically 4-7 shows a Class I cavity.

     

    I referred the patient to an oral surgeon. Oral surgeon asked her to get the BP checked and also asked her to take steam inhalations besides prescribing her some NSAID’s. She has been asked to follow up this week.

     

    What could be the cause of the pain.

     

    Any help would be greatly appreciated.

     

    Thanks in advance for all inputs.

     

    Regards,

     

    Veerendra Darakh

            

    11/12/2011 at 4:18 pm #14957
    Drsumitra
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     The rct done doesn’t seem upto the mark.What one can do is repeat the rct of 14, and before the obturation, a calcium hydroxide dressing can be given then the final obturation can be done..

     

            

    12/12/2011 at 7:18 am #14965
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     agreed the RCT is not upto the mark.

    But is the pain because of taht or is it because of the wisdom tooth.

    how does one explain the sweating

     

     

            

    12/12/2011 at 4:07 pm #14967
    drmithila
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     what we can do is that remove the obt material frm d canals, giv a dressing, do the extraction, and then do the final filling of the tooth once the patient is asymptomatic

    The sweating could be an exaggerated reaction of the patient, or trigeminal involvement if one is to take the sweating symptom seriously.

    But doesnt seem like that 

    Once the rct n extraction are done, the patient would be fine

            

    12/12/2011 at 4:08 pm #14968
    drmithila
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     You can put the patient on B complex tabs also 

            

    13/12/2011 at 4:14 am #14972
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     thanx for all the inputs.

    the pt. is going to come today for followup. will speak to her

     

            

    14/12/2011 at 2:22 pm #14973
    Drsumitra
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     do let us know the final diagnosis or treatment that you plan to deliver

            

    17/12/2011 at 3:06 pm #14988
    Ritika Bhat
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     The left condylar head shows slight amount of enlargement in comparison to the right one…could that be a cause too.

     

            

    18/12/2011 at 6:39 am #14989
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     that was a very astute observation ritika. keep it up.

    veeren

     

            

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