26/06/2025
Facial Swelling due to Chronic Periapical Infection
Chief Complaint: Severe swelling on the right side of the face, increasing in size over the last 3 days associated with mild fever and difficulty chewing
📸 Radiographic Findings
• Tooth #4: Single canal filled, underfilled and second canal missed
• Tooth #5: Two canals present, both significantly underfilled.
• Large periapical radiolucency (outlined in yellow) extending apically and laterally
🛠️ Treatment Plan:
1. Emergency Phase:
• Drainage via access cavity or surgical if fluctuant.
• Antibiotics (e.g., Amoxicillin + Metronidazole or Clindamycin if allergic).
• Pain management.
2. Definitive Phase:
• Tooth #4: Locate and treat missed canal, extend obturation to proper length.
• Tooth #5: Thorough cleaning and obturation of both canals to working length.
• Red lines indicate actual canal path and ideal fill length
• White outline: Tooth structure.
• Yellow outline: Extent of the apical lesion.
waleed_kurdi_endo Waleed Kurdi Endodontics Waleed Kurdi
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