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As the Pulp Dies

If you have had a CT in your practice long enough, you can start appreciating changes that happen on patients that you have scanned more than once in their lifetime. In this particular case, you can see how the preop scan shows an intact sinus floor, where as the second image, taken five years after the first one shows a periapical lesion and a perforation of the sinus floor. The patient was symptomatic and uncomfortable while biting on the second molar, but there were no other over signs of pulpal involvement. Also, if you are well versed in these matters, you can appreciate the inflammatory response, namely the opaque “cloud” right above the floor of the sinus. This is called Maxillary Sinusitis of Dental Origin MSDO

For a closer look, watch this video that walks you through the area of the perforation instead of just a single slice of an image. There is so much more information to be garnered when you “walk through” the slices