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Dr. Katz
Dr. Katz, Dentist - DDS
Category: Dental
Satisfied Customers: 3021
Experience:  Dentist and Anesthesiologist for 35 years.Anesthesiology Fellow-Johns Hopkins School of Medicine.Evaluator for Maryland State Board of Dental Examiners.
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Does a notation on a cone beam scan stating "A well

Customer Question

Does a notation on a cone beam scan stating "A well circumscribed periapical radiolucency noted adjacemt to the apex of the maxillary left premolar" Mean an infection in absolutley present? The reason I ask is I have had a few issuses with lower molars and that was the purpose of the scan. He tapped the upper molars with no pain and pulp tested with no negittive results. Could this be a miss? Or is it he did not see any other issues so direguarded it>
Submitted: 1 year ago.
Category: Dental
Expert:  Dr. Katz replied 1 year ago.

In most cases,the description that you have posted would indicate a tooth with a necrotic pulp and if the tooth has been root canaled,there is a persistent infection that is destroying bone as it expands.The radiolucency describes bone destruction but infection cannot be confirmed unless a culture is taken of the area which is in most cases not practical.If you have this type of radiolucency,it is usually accompanied by a sometimes not noticeable fistula where the infection is draining.Tapping would not give any response in these cases.The lucency is around the bicuspid and not the molars so these issues are unrelated.The maxillary premolar needs to be treated.Without seeing the xrays of the lower molars,I cannot comment on the nature of your problem with those teeth.

Expert:  Dr. Katz replied 1 year ago.

The treatment indicated for the premolar would be ,root canal therapy,retreatment ,apicoectomy or extraction.

Expert:  Dr. Katz replied 1 year ago.

Is there any other information that you need?