Endodontic Consultation and Treatment Notes

Consultation Details: Consult for: Tooth #14 Referred by: Dr. Emily Johnson Quote: $850 Today's Fee: $150 Item No: 013 Rubber Dam Notes: Rubber dam placed with isolation achieved using clamp #14A Next Visit (NV): 8 March 2025, for root canal therapy completion Tooth & History: The affected tooth is #14, with a history of intermittent pain over the past two months. The patient reports increased sensitivity to hot and cold, and there is a history of a large restoration placed two years ago. Examination: Intraoral examination reveals tenderness on percussion and slight mobility of tooth #14. No extraoral abnormalities noted. Radiographs: Periapical radiograph shows periapical radiolucency around the root of tooth #14, indicating possible apical periodontitis. Previous restoration is visible, with no signs of fractures or resorption. Diagnosis, Treatment Plan, Prognosis: Diagnosis: Symptomatic irreversible pulpitis with apical periodontitis. Treatment Plan: Initiate root canal therapy, followed by a permanent restoration. Prognosis: Good, considering the tooth's restorability and periodontal condition. Other Options Discussed: Discussed the possibility of extraction and implant placement as alternative options. Start Treatment for: Tooth #14 Anesthesia: 1x lignocaine block administered for local anesthesia. Procedure: - Rubber dam placed with clamp #14A for isolation. - Access cavity prepared, revealing three canals. - Canals located: MB, DB, and P. - Cleaning and shaping performed using #10 K file and S1 rotary files. - Working length (WL) established with electronic apex locator (EAL). - Canals dressed with Odontopaste as intracanal medication. - Temporary restoration placed using Cavit. Working Lengths: - MB canal: 21 mm - DB canal: 20 mm - P canal: 22 mm