Teeth Case Analysis (Based on Photo)

Visual Findings (Zoom 100%)

From the provided image, the lower posterior teeth show:

1. Multiple failing restorations

• Old amalgam fillings with breakdown and marginal leakage

• Visible dark gaps suggesting secondary caries

2. Deep cavitated lesion

• The middle molar shows a large open cavity with food debris

• Likely dentin involvement → possible pulp irritation

3. Gingival inflammation

• Localized swelling and redness near the cavitated tooth

• Possible food impaction + plaque retention

4. Fractured tooth structure

• Loss of enamel walls around restoration

• Tooth integrity compromised

Possible Diagnosis (Clinical Correlation Needed)

• Recurrent dental caries under old fillings

• Fractured restoration with food trap

• Pulpitis risk (reversible or irreversible)

• Localized gingivitis / early periodontal pocket

• Possible need for endodontic assessment

Recommended Treatment Process

Step 1 – Diagnostic Phase (Day 1–2)

• Periapical X-ray or bitewing

• Pulp vitality testing

• Periodontal probing

Step 2 – Initial Treatment (Day 2–5)

• Removal of failing restorations

• Caries excavation

• Temporary filling if pulp close

Step 3 – Definitive Treatment (Day 5–14)

Depending on pulp status:

• Large composite/onlay if pulp healthy

• Root canal treatment + crown if pulp infected

• Extraction + implant/bridge if non-restorable

Healing Timeline

If only deep filling:

• Sensitivity settles in 3–7 days

• Gum healing 5–10 days

If root canal:

• Pain relief within 48–72 hours

• Full tissue stabilization 7–14 days

If extraction:

• Soft tissue healing 7–14 days

• Bone healing 6–12 weeks

Risk If Delayed Beyond 14 Days

• Pulp necrosis → severe infection

• Abscess formation

• Facial swelling

• Bone loss around tooth

• Possible tooth fracture to gum level (non-restorable)

• Spread of infection requiring antibiotics or emergency care

Clinical Comments

This case shows high risk of pulp involvement due to:

• Large recurrent decay

• Food impaction

• Structural weakness of molar

Early intervention greatly improves tooth survival.

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