May is the AAE’s ‘Save Your Tooth’ month, so I figured I’d post a case about knowing exactly which tooth to save. Sometimes things aren’t always as they seem, which is why testing and imaging are of critical importance. Here, a patient presented with a draining sinus tract on the buccal aspect of tooth #18. Pulp testing yielded a vital response on tooth #18 and a non-vital response on tooth #19. A narrow, 9mm probing depth was associated with the buccal furcation of tooth #18, and slight discomfort was noted upon percussing both teeth. 2D images showed what seemed to be lesions on both teeth; however, a CBCT scan confirmed my suspicion. This infection, originating solely from tooth #19, drained along the mesial and then furcal aspect of tooth #18. This most unusual path of least resistance may lead one to assume tooth #18 was fractured and in need of extraction. RCT was rendered on tooth #19 and as the photographs reveal, it appears the correct tooth was treated and the innocent bystander was left alone. All symptoms, and the swelling, resolved.
