Question

A patient complains of thermal sensitivity in her "front teeth." Pulp tests indicate a vital tooth, but the radiograph shows a radiolucency in the middle of the root of the maxillary left central incisor. The most probable diagnosis and treatment are

A. internal resorption--extract the tooth.
B. internal resorption--institute root canal therapy.
C. internal resorption--check vitality and take a radiograph in 6-12 months.
D. questionable diagnosis--observe and take a radiograph in 6-12 months.
E. questionable diagnosis--place a root canal filling and perform surgery to repair the defect.

Answer 1

The most probable diagnosis for the patient's thermal sensitivity in her front teeth, combined with the radiograph findings, is internal resorption. The appropriate treatment for this condition is root canal therapy.

Step-by-step explanation:

The most probable diagnosis for the patient complaining of thermal sensitivity in her front teeth and the radiograph showing a radiolucency in the middle of the root of the maxillary left central incisor is B. internal resorption, which requires root canal therapy as the most appropriate treatment.

Internal resorption occurs when the dentin layer of the tooth starts to break down from the inside. This can result in a radiolucency on an X-ray, indicating the destruction of the tooth structure. Even though the tooth is still vital, their preservation requires root canal therapy to remove the affected pulp tissue and prevent further decay and damage. Extracting the tooth (option A) is not necessary as the tooth is still vital, and it can be saved by treating the internal resorption.

It is important to note that regular evaluation of the tooth's vitality and radiographs may be required in the future (option C), but immediate treatment is necessary to prevent the progression of the internal resorption.