This patient was bounced from her family physician to a dermatologist who, over the course of a couple of years, repeatedly cauterized this recurring pimple (probably thinking it was a sebaceous cyst or something similar). The patient finally ended up at a dental office where they found that the source was a tooth abscess.

This picture shows the tracer pointing to the apex of a tooth. Both the canine and lateral incisor were probable sources of infection, so the root canal was redone in the canine and a root canal was done in the lateral incisor.

This is the post op film. No recall pictures yet but the chin has healed with a little scarred dimple.

Here’s a case that came into the office a few years ago.

The patient had been having symptoms and was medicated with antibiotics. They were referred to me for a retreatment. There was no information about when the original root canal was done but the obturation is thin and short and there is apical rarefying osteitis.

It looked at first like a straight forward crown access, post removal, and canal retreatment. On second glance at the film, I became a little worried about coronal leakage under the distal crown margin and the impact this might have on the prognosis of the retreatment.

So we took a vertical bitewing to check the crown margins:

Wow. Here we now have an ill-fitting crown, a much longer than expected post in MB that is heading to a perforation, furcation involvement, a probable perforation into the furcation, and on top of all of that…a crappy root canal.

I ended up recommending extraction of this tooth.

Moral of the story: Take different angled films and don’t forget about the usefulness of vertical bitewings.