case_images: PMC4686639_01
case_images: Occlusal tubercle in the mandibular premolars.
case_images: CRID2015-393209.001.jpg
case_images: PMC4686639_01_CRID2015-393209.001.jpg
case_images: fig1
case_images: The patient was concerned about the "bubble on her gums." On examination patient had fair oral hygiene and occlusal tubercle present in mandibular premolars (Figure 1).
case_images: Diagnostic IOPAR, periapical radiolucency with respect to 44.
case_images: CRID2015-393209.002.jpg
case_images: PMC4686639_01_CRID2015-393209.002.jpg
case_images: fig2
case_images: Intraoral Periapical Radiograph (IOPAR) revealed periapical radiolucency with respect to 44 (Figure 2).
case_images: After access opening. Dens evaginatus in right and left premolars.
case_images: CRID2015-393209.003.jpg
case_images: PMC4686639_01_CRID2015-393209.003.jpg
case_images: fig3
case_images: Root canal therapy (RCT) of tooth 44 and adjustment of occlusal tubercle of teeth 34, 35, and 45 were planned (Figure 3).
case_images: Placement of calcium hydroxide (Metapex) intracanal medication.
case_images: CRID2015-393209.004.jpg
case_images: PMC4686639_01_CRID2015-393209.004.jpg
case_images: fig4
case_images: Microbiological culture showing gram positive cocci in clusters and in pair and short chains.
case_images: CRID2015-393209.005.jpg
case_images: PMC4686639_01_CRID2015-393209.005.jpg
case_images: fig5
case_images: In the culture media growth of Enterococcus faecalis and Streptococcus species was observed (Figure 5).
case_images: Culture and sensitivity test: triple antibiotic paste with largest inhibition zone in upper left region.
case_images: CRID2015-393209.006.jpg
case_images: PMC4686639_01_CRID2015-393209.006.jpg
case_images: fig6
case_images: The triple antibiotic paste was seen to have the largest inhibition zone (Figure 6).
case_images: Obturation with gutta-percha and endodontic sealer.
case_images: CRID2015-393209.007.jpg
case_images: PMC4686639_01_CRID2015-393209.007.jpg
case_images: fig7
case_images: The tooth was obturated with gutta-percha points (Dentsply, Maillefer) using AH Plus (Dentsply, Konstanz, Germany) root canal sealer followed by restoration with composite resin (Figure 7).
case_images: Six-month follow-up.
case_images: CRID2015-393209.008.jpg
case_images: PMC4686639_01_CRID2015-393209.008.jpg
case_images: fig8
case_images: Follow-up evaluation after six months revealed progressive healing of the lesion (Figure 8).