Management of Endodontic Failure Under Existing PFM Crowns: A Multidisciplinary Approach

Introduction Patients presenting with pain beneath existing prosthetic restorations often pose a diagnostic and treatment challenge. Differentiating between prosthetic, periodontal, and endodontic causes is critical to establishing an appropriate treatment plan. Case Presentation A patient presented with complaints of pain on biting accompanied by a vague itching sensation associated with old PFM connected crowns and previously treated root canals. Clinical Examination Clinical evaluation revealed inflamed gingival tissues surrounding the crowns, primarily due to improper crown design, suggesting a periodontal component. Radiographic Findings A CBCT scan was performed for further evaluation, revealing: Missed MB2 canal in UR6 Periapical radiolucency associated with the DB and MB canals in UR6 Short obturation in the MB2 canal of UR7 Severe curvature in the MB…