case_images: PMC11325015_01
case_images: Maxillary second molar, FDI 17 (US #2) showing extensive mesial surface root caries.
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case_images: fig1
case_images: No endodontic lesion was radiographically evident, but the location and the severity of the root caries rendered the tooth unrestorable, resulting in extraction (Figure 1).
case_images: Copy of the original full-mouth radiographic survey (FMRS) taken at the periodontal office, January 9, 1991.
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case_images: fig2
case_images: In addition, a full-mouth radiographic survey (FMRS) was taken every 3-5 years at a periodontal office (Figures 2 and 3).
case_images: Full-mouth radiographic survey (FMRS) taken at the periodontal office, November 20, 2006.
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case_images: fig3
case_images: In addition, a full-mouth radiographic survey (FMRS) was taken every 3-5 years at a periodontal office (Figures 2 and 3).
case_images: Full-mouth radiographic survey (FMRS) taken at the periodontal office, December 1, 2009.
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case_images: fig4
case_images: There was radiographic evidence of root caries on FDI 24, 26, 28, 37, 36, 46, and 47 (US #12, #14, #15, #18, #19, #30, and #31) (Figure 4).
case_images: Vertical bitewing radiographs of the left maxillary and mandibular first molars. The "before" was taken November 20, 2006. The "after" was taken December 1, 2009, 19 months after the patient started using nicotine lozenges. Note the extensive root caries involving the mesial and distal surfaces of the maxillary teeth and distal of the mandibular first molar.
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case_images: fig5
case_images: A side-by-side comparison of vertical bitewings highlights the startling change (Figure 5).
case_images: Panoramic radiograph (circa 2016) taken before extractions.
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case_images: fig6
case_images: Over the next 5 years, all these restorations were either replaced or "patched" at least once (Figure 6).
case_images: Panoramic radiograph (circa 2016) following extraction of all posterior teeth, except mandibular first bicuspids. Impacted third molars were not removed due to distinct possibility of ankylosis and potential for fracturing the posterior wall and floor of the maxillary antrum.
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case_images: fig7
case_images: By 2016, the general dentist and patient decided the best course of action was to extract all remaining molars and premolars, except tooth FDI 34 and 44 (US #21, #28) (Figure 7).
case_images: Panoramic radiograph (March 2017) after placement of dental implants and treatment planned for a shortened dental arch.
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case_images: fig8
case_images: In March of 2017, he had four implants placed and treatment planned for a shortened dental arch (Figure 8).
case_images: Case report patient, June 21, 2024.
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case_images: fig9
case_images: At his last dental exam in June of 2024, tooth FDI 13 (US #6) was suspected of having recurrent root caries (Figure 9).