2. Case History/Examination
An 11-year-old boy went to our outpatient clinic with a complaint of ”swelling and pain in the gums of the left lower posterior teeth for one week”. He was healthy, with normal general development, and denied a history of systemic diseases, family diseases, and drug allergies. The left lower deciduous teeth had a history of filling treatment.
Maxillofacial examination: The bilateral maxillofacial regions are symmetrical, without obvious maxillofacial swelling. No swollen lymph nodes were palpated in the left submandibular region, and mandibular function movement was not limited.
Intraoral examination (Figure 1): He presented with mixed dentition. Tooth 74 has not been replaced, and the remaining deciduous teeth have been replaced. Fillings were observed on the distal and middle adjacent surface of tooth 74, with painful knocking (+) and loose (I°), and the gingiva in the buccal apical area was swollen and tough.
Auxiliary examination (Figure 2): Cone beam computed tomography (CBCT) showed 74 apical areas with an oval transmission of about 11 mm × 7 mm. The germ of the permanent tooth 34 was inclined in the buccal direction, impacted horizontally, and the root was curved. The roots developed to the Nolla stage 8.