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Referred pain: a confusing case of differential diagnosis between two teeth presenting with endo‐perio problems
Author(s) -
Koyess E.,
Fares M.
Publication year - 2006
Publication title -
international endodontic journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.988
H-Index - 119
eISSN - 1365-2591
pISSN - 0143-2885
DOI - 10.1111/j.1365-2591.2006.01139.x
Subject(s) - differential diagnosis , medicine , dentistry , endodontic therapy , root canal , endodontics , dentition , toothache , pathology
Aim A case of a patient with a confusing referred pain is reported that emphasizes the importance of providing a differential diagnosis in order to avoid inappropriate treatment. Summary This article describes the management of a patient presenting with a combined endo‐perio problem that was apparently treated adequately. After a short period of time, the reappearance of mild pain was misdiagnosed. The situation was more complicated when multiple diagnostic procedures were attempted and inadequate therapies were tried consecutively. When the true differential diagnosis was established and appropriate treatment provided, the symptoms disappeared and normal function returned. Diagnosis of teeth with necrotic pulps may be difficult to establish with possible reasons including inconclusive and poorly localized symptoms and signs. The situation can be further complicated if other teeth developing endodontic or combined endo‐perio problems occur simultaneously as this may lead to misdiagnosis and treatment of the wrong tooth. Key learning points: • Diagnosis of teeth with necrotic pulps can be difficult to establish. • The entire dentition should be examined for possible causes of pain before commencing treatment. • Some periodontal lesions of endodontic origin can heal following root canal treatment alone.