What is the diagnosis ?

[smilesbyveeren@gmail.com]

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

        

[Drsumitra]

 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..

 

        

[smilesbyveeren@gmail.com]

 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

 

 

        

[drmithila]

 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

        

[drmithila]

 You can put the patient on B complex tabs also 

        

[smilesbyveeren@gmail.com]

 thanx for all the inputs.

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

 

        

[Drsumitra]

 do let us know the final diagnosis or treatment that you plan to deliver

        

[Ritika Bhat]

 The left condylar head shows slight amount of enlargement in comparison to the right one…could that be a cause too.

 

        

[smilesbyveeren@gmail.com]

 that was a very astute observation ritika. keep it up.

veeren

 

        

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