Dental Case Analysis – Root Canal Infection With Apical Bone Loss

Case Overview

This dental X-ray shows a posterior tooth with previous root canal treatment. A clear radiolucent area at the root apex is visible, indicating a persistent or recurrent infection. The surrounding bone shows signs of loss consistent with chronic inflammation.

Full Analysis and Diagnosis

Radiographic Findings

• Root canal–treated tooth with dense coronal restoration

• Apical radiolucency at the root tip

• Loss of normal bone trabeculation

• Widened periodontal ligament space

• Infection appears chronic rather than acute

Tooth Condition

• Root canal filling may be incomplete or leaking

• Possible missed canal or bacterial persistence

• Apical seal likely compromised

• Tooth structure remains intact but weakened

Diagnosis

• Chronic apical periodontitis

• Failed or compromised root canal treatment

• Localized periapical bone loss

Time Frame to Heal

With Proper Treatment

• Infection control: 7–14 days

• Reduction in inflammation: 1–2 weeks

• Bone healing begins: 4–6 weeks

• Radiographic bone regeneration: 3–6 months

Without Treatment

• Infection persists or enlarges

• Progressive bone destruction

• Pain, swelling, or abscess formation

• Increased risk of tooth loss

Process to Execute (14-Day Window)

Days 1–3

• Clinical evaluation and X-ray review

• Confirm infection source

• Prescribe antibiotics if clinically indicated

Days 4–7

• Root canal retreatment or

• Surgical intervention (apicoectomy) if retreatment is not possible

• Removal of infected tissue

Days 8–14

• Post-treatment evaluation

• Monitor symptoms and healing

• Plan long-term restoration if needed

Issues That Will Scale Up If Untreated

• Expansion of apical lesion

• Further jawbone loss

• Chronic pain or swelling

• Sinus or nerve involvement (depending on location)

• Eventual tooth extraction

Clinical Comments

This type of infection can remain silent for long periods and is often discovered only through imaging. Early intervention significantly improves the chance of saving the tooth and preventing further bone loss.

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