Fig. 2

A dentally anxious 16-year-old patient presented to their general dental practitioner some years following TDI. A) Tooth 11 shows pulpal obliteration in the coronal portion of the root and an apical third root fracture. Clinically, 11 has no signs or symptoms. The radiographic appearance of 11 suggests stability because there are no alveolar changes or areas of resorption affecting the root end or horizontal root fracture area. Clinically, tooth 21 has a discharging sinus. Radiographically, there is a radiolucent lesion on the mid-third region of the root (B & C). From these images, it is difficult to ascertain whether the resorption is internal (and contained within the confines of the root canal system), internal and has perforated out with the root, or is external. Further imaging is needed for planning the appropriate treatment in this case. In this situation, because the diagnosis of 21 is unclear, it is prudent to consider onward referral prior to extirpating the pulp