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Patient: 81 year-old male with atrial fibrillation, heart valve disease, and chronic lymphocytic leukemia

Chief Complaint: Biting sensitivity (#31)

Dental History: History of an amalgam restoration (#31). Moderate pain to biting developed 3 days prior to the date of examination localized to tooth #31. The adjacent first molar had been treated with endodontic therapy and unknown number of years earlier and restored with a crown having a restored occlusal access.

Significant Findings:

1. Tooth #31: Moderate percussion sensitivity, 6mm sulcular defect at the mid-distal area, negative response to cold thermal stimulation, and a cracked distobuccal cusp noted upon transillumination with a fiberoptic light. The radiographic findings included Class 2 distal caries and pulp chamber calcification.

2. Tooth #30: Class 1 furcation, slight gingival recession and bleeding upon probing. Radiographic findings included a previous endodontic filling treated slightly short in each root and a diffuse moderate sized periapical radiolucency about the mesial root. All other findings were within normal limits