Long post ahead :
Recently i have been seeing patients who are in need of a root canal treatment or their old fillings fail then replace a restoration then days after they feel still sensitivity.
Last feb may nireplace akong pasta niya na class v (ginawa ung class v na yun nung 2024 pa) bale may gr na to on the root area na, naexpose for few weeks or months before siya nakabalik sa clinic para irefill yung area. Bale nirefill ko kahit na alam niya na may possible for debonding kasi nasa may root area na ung ginawa after few days sumakit padin chineck ng ibang dentista okay naman daw yung pasta ko intact naman pero (+) sa percussion na si patient so prinescribe muna siya ng other doctor ng antisensitivity, after few days masakit padin daw so nireplace ko ung filling naglagay ako liner tas may xray din ako ng pre and post op to check if may overhangs ba at nismoothen out ko ung fillings. Sa recall okay na daw wala siya nafefeel na pain very good na daw.
Not until this april nag message ulit ung patient na sensitive ung area, masakit nanaman and nagraradiate na ung pain towards the jaw.
At this point ano na po ba pwedeng gawin, and based sa kausap kay patient she already inquires if pwede iRCT na kasi its been 5/6 days in pain tas 3 days don nag iibuprofen na siya.
Kindly please leave your suggestions for me to better assess or give a final treatment na for this because yung pasta naman ay nandon pa intact pa sabi niya pero in pain.
Nireview ko ung periXray niya ulit ngayon may bone loss sa proximals mostly sa mesial and may space kasi talaga yung 44 and 45 niya ng mga .5mm tas ung itsura ng pulp niya may vertucci parang 2-1-1.
Kindly help me out eto ung mga cases na napapaisip ako if nag fail ba ko sa first line of treatment ko knowing na nag assess naman ako maigi bago ako mag lead sa treatment na un??
Kasi I have 2 options in my mind right now.
Check with desensitizer ung paligid if narelief siya ng pain/sensitivity most probably may microleakage - if meron palitan na ng GIC
RCT na especially if gusto na ni px marelieve agad agad
Magkikita pa lang kami this week ulit. Kindly suggest a noobie out.