case_images: PMC5183744_01
case_images: (a) Clinical photograph showing normal periodontal tissues; (b) initial panoramic radiograph; (c) teeth #42 and #43 with open access cavities and exposed pulp prior to instrumentation, demonstrating an error in endodontic diagnosis; relationship between clinical crowns and periapical radiographs.
case_images: CRIM2016-3830987.001.jpg
case_images: PMC5183744_01_CRIM2016-3830987.001.jpg
case_images: fig1
case_images: Initially, we observed slight expansion of the cortical bone in the apical region of #42 and #43, but the periodontal tissues were normal and there was no sinus tract (Figure 1(a)). Periapical radiographs of the area showed a radiolucent lesion with boundaries extending beyond the dimensions of the periapical film (Figures 1(b) and 1(c)).
case_images: Surgical access through the anterior mandible for decompression of periapical lesion. (a) Cavity after packing (b) with gauze impregnated with antibiotic ointment (c).
case_images: CRIM2016-3830987.002.jpg
case_images: PMC5183744_01_CRIM2016-3830987.002.jpg
case_images: fig2
case_images: Surgical access to the anterior mandible was obtained with a scalpel and #6 carbide bur mounted on a high-speed handpiece (Figure 2).
case_images: Periapical radiographs obtained immediately after obturation of root canals.
case_images: CRIM2016-3830987.003.jpg
case_images: PMC5183744_01_CRIM2016-3830987.003.jpg
case_images: fig3
case_images: Briefly, the canals were cleaned and shaped to 1 mm short of full length, using Protaper  rotary instrumentation (Dentsply-Maillefer, Ballaigues, Switzerland), followed by obturation with Protaper F2 gutta-percha cones (Dentsply-Maillefer) and Grossman's cement (Endofill, Dentsply Industria e Comercio Ltda, Petropolis, RJ, Brazil), using the lateral condensation technique (Figure 3).
case_images: (a) Panoramic radiograph obtained at 4-year follow-up. Bone repair is clearly visible; (b) cone-beam computed tomography image (axial slice), demonstrating bone repair. A possible fibrotic bone scar is visible (arrow).
case_images: CRIM2016-3830987.004.jpg
case_images: PMC5183744_01_CRIM2016-3830987.004.jpg
case_images: fig4
case_images: When she resumed contact, plain radiographs (Figure 4(a)) were obtained and computed tomography was performed (Figure 4(b)).