Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a localized intraoral swelling and a persistent draining sinus tract associated with tooth #[Insert Tooth Number]. Reports intermittent purulent discharge, mild to moderate tenderness, and a history of deep caries or previous trauma. No systemic symptoms of fever or lymphadenopathy noted.
Clinical Examination Findings
Intraoral examination reveals a fluctuant swelling or a parulis (gumboil) on the attached gingiva adjacent to the apex of tooth #[Insert Tooth Number]. Sinus tract patency confirmed via gutta-percha tracing and radiographic assessment showing a well-defined periapical radiolucency. Tooth exhibits negative response to pulp vitality testing (EPT/Cold).
Treatment Protocol
Initiated emergency endodontic treatment (pulpectomy/drainage) to relieve pressure. Sinus tract irrigated with saline/chlorhexidine. Prescribed systemic antibiotics if indicated by clinical signs of spreading infection. Scheduled for definitive root canal therapy completion.