Why does an endodontic treatment fail?
Patient: 38 year-old female with chronic myelogenous leukemia, taking Imatinib (antineoplastic agent, tyrosine kinase inhibitor)
Chief Complaint: Toothache on the left side
Dental History: Patient developed mild tooth pain of recent duration during chemotherapy. No recent dentistry had been performed and the mandibular left first molar had been restored with a full gold crown.
Significant Findings (#19): Slight percussion sensitivity was localized to tooth #19 which reproduced symptoms. Both teeth #’s 18 and 20 responded within normal limits to cold thermal stimulation while tooth #19 responded with a sharp, transient response. Periodontal findings were within normal limits. A periapical radiograph revealed periodontal ligament space widening at the mesial root periapex. Moderate diffuse calcification of the root canal system was also noted.