- Medical history: One or more medical problems
- Gag reflex: Gags occasionally with radiographs/treatment
Diagnostic and Treatment Considerations
- Canal and root morphology: Maxillary premolar with three roots
- Endodontic treatment history: Previous access with complications (separated instruments)
Patient presented with a medical history that included controlled diabetes and a previous myocardial infarction followed by an angioplasty procedure with stent placement. In addition, he reported that he frequently gags during the exposure of dental radiographs. The radiographic examination revealed incomplete endodontic therapy complicated by separated instruments and atypical root morphology.
The patient’s multiple medical problems and elevated gag reflex make this case moderately difficult. In addition, maxillary premolars with three roots and previous treatment complications (such as separated instruments) make achieving a predictable treatment outcome highly challenging for even the most experienced practitioner.